Ingress of foreign bodies into the upper respiratory tract. What to do if a foreign body enters the respiratory tract, esophagus, ear or nose? How to help when hit

From a chemical point of view, an acid is a substance, which includes hydrogen atoms (capable of being replaced by metal atoms) and an acid residue.

Acetic acid, malic, citric, ascorbic (vitamin C), oxalic and some other acids are familiar to us in everyday life. This is the so-called. organic acids, that is, synthesized by living organisms.

In the chemical industry, there are inorganic acidic compounds, for example, the well-known sulfuric (H2SO4) or hydrochloric (HC1) acid.

All acids are distinguished by an irritating effect (to one degree or another) on the human body.

What are the types of acid burns?

1st degree burn: moderate redness appears, the affected area burns and hurts.

2nd degree burn: more intense redness, swelling appears, severe pain, blisters may appear on the skin.

3rd degree burn: skin necrosis, burn sites change their color (may become completely white, or vice versa, darken), the tissues around the burn turn red, severe pain.

4 degree burn: necrosis of the skin, subcutaneous tissue, muscles, sharp pain.

How to provide first aid in case of acid contact with the skin?

1. First of all, it is recommended to thoroughly rinse the burnt area with running water (for 15-20 minutes) to reduce the concentration of the chemical. After that, wash the affected area again with soapy water or a solution of baking soda (a teaspoon of soda in a glass of water).

2. Try not to touch the burnt area with your hands, this can lead to acid residue getting on you and causing pain to the victim. In general, all manipulations are best done with tight gloves.

3. Release the burnt surface of the skin from clothing, if you can’t remove it, cut it off with scissors. However, do not peel the fabric from the surface of the skin if it is not removable.

4. If a person is in shock (he turned pale, breathing quickens, the pulse is barely palpable), 15-20 drops of valerian tincture should be given to the victim.

5. After providing first aid, be sure to consult a doctor.

Which burns should not be washed with water?

Remember that washing is contraindicated in case of burns with quicklime or organic aluminum compounds, which become much more active when in contact with water. The area affected by lime should be treated with vegetable oil, with which to remove the chemical compound from the surface of the skin, and then make a lotion from a 5% solution of citric or acetic acid. Aluminum compounds should be treated with kerosene or unleaded gasoline. If phenol gets on the skin, use a 40% solution of ethyl alcohol, if phosphoric acid gets in, first remove phosphorus particles from the skin, and then wash it with a 5% copper sulfate solution or potassium permanganate solution.

If acid gets into your eyes or mouth?

Acid can enter the mouth or eyes as a liquid, vapor, or gas. In this case, it is necessary to rinse them with plenty of water, and then with a solution of baking soda at the rate of half a teaspoon per glass of water or a weak solution of potassium permanganate. Open the victim's eyelids over a sink and gently irrigate the eyeball with a small stream.

If acid enters the esophagus, the first step is to call a doctor. The victim should be laid down and wrapped warmly, mucus and saliva should be removed from the mouth as they occur. If the victim feels sick, you can give him water in order to dilute the concentrated acid that has entered the body, but not more than three glasses. It is dangerous to induce nausea, because when the acid moves back through the esophagus, it can again injure the mucous membrane.

If there are signs of suffocation, the victim must be given mouth-to-nose artificial respiration, as the larynx was burned with acid.

What should not be done?

1. Burned areas should not be lubricated with fats, ointments or sprinkled with starch.

2. Do not open blisters if they are formed from a burn on the surface of the skin.

3. Do not use swabs, towels or wipes to remove acid from the victim - by doing so, you will only rub them into the skin.

4. If you are not sure what kind of acid you have suffered from, you should not try to neutralize it yourself! Simply wash the damaged area with water and a baking soda solution.

5. Never leave the victim without professional medical assistance. The first aid provided by you does not cancel the call for an ambulance.

Thanks to action films, a stable image of the protagonist has long been formed in my head. The inflated protagonist, casually holding a machine gun in one hand, and an American flag in the other against the background of explosions, shoots back from enemies who attack from all sides. Not a single bullet flies past the enemies and they all fall dead in a picturesque way.

Such pictures will certainly cause laughter among people who fought and saw all the horrors of war. It turns out that a bullet hitting a person does not always, or rather, almost never leads to instant death. So how does it affect the body and how does a person feel?

Sledgehammer or drill

The feeling of getting a gunshot wound depends on the type of cartridge: they are high-velocity (supersonic) and low-velocity (subsonic).

Combatants describe it this way: “Hit a supersonic bullet feels like a strong blow from a sledgehammer that can knock you down. The site of contact becomes numb and does not hurt at first. A subsonic bullet is much more vile in this regard - it inflicts a burning, boring pain, as if the body was pierced by a red-hot rod.”

But this is all only if we are talking about standard FMJ ammunition (full metal jacket) or in Russian - a bullet with a full metal jacket. The design feature is, as you might guess, in a hard metal coating around a soft lead bullet. Such a bullet does not shatter into pieces inside the body and does not tumble. In the situation described above, we are talking about an intermediate automatic cartridge 7.62x39 mm and a subsonic pistol cartridge 9x18 mm.

Currently, the so-called low-impulse cartridges 5.45x39 mm or 5.56x45 NATO are also used in military conflicts. When hit in the body, such cartridges begin to tumble and cause extensive internal damage.

“At first I didn’t even understand what happened, as if they had poured boiling water over everything. And then my head suddenly began to spin, a cold sweat broke through - it's hard to explain, but those who felt - will understand, and the state is pre-fainting. And when the shock passed after a couple of minutes, the pain began so much that I can’t even tell.” - describes the consequences of hitting the thigh with an AK-74 veteran of military operations in the North Caucasus.

bullet fool

Meanwhile, even gunshot wounds do not incapacitate instantly. A person, even when mortally wounded, can continue to fight for some time. Greg Ellifritz, an American police instructor from Ohio and a member of the local firearms association, conducted a study on the effects of various types of handgun ammunition on humans, and the results were extremely surprising.

Cartridge 6.35 × 15 mm Browning.
To disable an average of 2.2 shots. Even with a hit in the torso, the probability of incapacitating a person is 49%. 35% of the people to whom this caliber was applied did not lose the opportunity to resist. And only 25% of people died from wounds caused by such cartridges.

Cartridge 5.6 × 15.6 mm (In Russia, such a cartridge is called “small”)
It takes an average of 1.38 shots to disable. Even with a hit in the torso, the probability of incapacitating a person is 60%. 31% of the people to whom this caliber was applied did not lose the opportunity to resist. And only 34% of people died from wounds caused by such cartridges.

Cartridge 9x19 mm “Parabellum”
To disable an average of 2.45 shots. Even with a hit in the torso, the probability of incapacitating a person is 47%. 13% of the people to whom this caliber was applied did not lose the opportunity to resist. And only 24% of people died from wounds caused by such cartridges.

Bulletproof Platt

A clear example of how a person is tenacious and can continue to resist can serve as a story that happened in the United States in 1986 and was called the “Massacre in Miami”.

The police surrounded the car in which there were two suspects in the bank robbery, one of whom was former commando Michael Platt. The criminals began to shoot back. One of the suspects was wounded and stopped firing, but Platt continued to resist. He received a bullet in the neck from a revolver, then an expansive (explosive) bullet flew into his chest, having beaten his arm in front of these, which pierced the lung and artery. After that, Platt received two more expansive bullets in the leg and back. Already wounded, he hides behind the car and receives two more revolver shots in the arm (he crushes his hand) and in the chest. When trying to get into the car of the FBI agents, he gets shot in the legs, which breaks one of the bones.

All this time, seriously wounded, Michael continued to fight, moving under fire and reloading weapons. He killed two and wounded five FBI officers. The gunfight ended with three shots to his head as he got into a police car to escape. Newspapers dubbed him "bulletproof Platt."

Physiology

As the medical examiner says, it's not the bullet that kills, it's the damage it does. And these damages are divided into two types: damage from the bullet itself, tearing tissue and breaking bones, and damage from the energy of the bullet. The fact is that our cells are filled with liquid and a gunshot wound is accompanied by a water hammer. This causes damage to the nerve endings and a secondary tissue rupture when the bullet has already passed further along the wound channel. The mood of a person also plays a significant role.

According to the doctors, the already mentioned Platt was able to continue acting because he initially set himself such a goal. He did not feel pain even when hit in parts of the body riddled with nerve endings. Despite the fact that such places are among the most sensitive.

In such a stressful state, the body tries not to pay attention to damage, focusing on the task. A similar incident occurred in 1991 in Vilnius. Extremists settled in the television center, and “Alfa” was sent to deal with them. When the special forces crossed the square and went inside, one of the fighters complained that he had something in his back. It turned out that even on the square an automatic bullet flew into his back, but he was focused on fulfilling the order and did not even immediately notice the wound, which turned out to be fatal.

Despite the fact that cycling is a relatively safe method of transportation, no one is immune from an accident. Therefore, it is necessary to determine in advance for yourself what exactly needs to be done under such circumstances.

Most often, accidents with cyclists happen due to the fault of car drivers. Official statistics show that most of the accidents are collisions with a passing car that turns right.

Cyclists are less likely to collide with each other and with pedestrians.
What should a cyclist do in an accident?

You need to stop, calm down and check if any transport is coming at you. Don't stay on the road. Also, do not move or touch the bike. Then you need to call the traffic police and an ambulance, if necessary.
In the first minutes after the accident, a person is in a state of shock. This feeling can greatly numb the pain, even if significant wounds are present. It is advisable to ask someone from those around you to examine you and provide first aid. By the time the doctors arrive, you should already know all the visible and invisible damage. They should be recorded and a medical certificate should be obtained, which may be useful in legal proceedings.
Even if the bicycle has caused traffic jams, it must not be removed from the roadway until the traffic police arrive. If you are outside the city limits, install an identification sign 15-30 meters before the accident. You can also take pictures of the scene of the accident.
In no case should you let the culprit of the accident leave the scene of an accident. He needs to be held accountable first. If he fled, try to remember or write down the number of his car. If he is injured, he needs to provide first aid and call an ambulance.
It is very important to find witnesses who will be able to tell all the details of the collision with you. Then all their testimonies will be entered into the protocol of the road patrol service. You can even record their data in order to later enter them into the protocol. If you turn to the law, then any person who has any information on the case can act as a witness.
If the bike strongly interferes with the movement of cars, it is necessary to draw up a detailed scheme of the accident. All this must be recorded in the presence of several witnesses.

If there are no victims as a result of an emergency, drivers have the right to arrive at the nearest traffic police post with a diagram of the incident and resolve the problem on their own.
When communicating with a traffic police officer, you do not need to provide unnecessary information. It is enough to calmly talk about the situation and state all the facts. You must create the impression of a competent and educated person. It is not necessary to write in the protocol what the inspector dictates. Be sure to make sure that the protocol includes all damage to the bike, even the most minor. Two participants in the accident and several witnesses must sign under the accident diagram.

According to the Constitution, you are not required to testify to the traffic police. It is best to calm down and resolve all issues in the presence of a lawyer. After an accident, you should ask someone you know to take you home if you are not picked up by an ambulance.

If you have an insurance contract, you can receive financial compensation for an accident. To do this, you need to bring the act of the traffic accident to the insurance company. The amount of insurance will depend on many factors: the type of contract, the specifics of an accident, damage to the bike, etc.

Treatment and first aid for extravasation - getting under the skin. The amount of intervention depends on the stage of extravasation, the solution administered and specific antidotes. The treatment regimen for injuries of the 3rd-4th stage has not been developed. In the absence of randomized controlled trials, some organizations have published treatment protocols based on their own experience, case series and single hard data.

1. In all cases of extravasation - getting drugs under the skin do the following:
a. Immediately stop intravenous infusion.
b. Remove compressive bandages that can act as a tourniquet (for example, when fixing a limb).
in. Give the limb an elevated position to reduce swelling.
d. Local use of warming and cooling packs, which is debatable. Under the action of heat, local vasodilation occurs, which promotes the reabsorption of infiltrated solutions. However, according to the literature, moist warming packs can cause skin maceration.

2. Extravasation 1st and 2nd stage:
a. Remove the intravenous catheter.
b. Choose an antidote.

3. Extravasation 3rd and 4th stage:
a. Leave the IV catheter in place and aspirate as much of the injected fluid as possible using a 1 ml syringe.
b. The catheter is removed unless an antidote is needed.
in. Decide whether to use hyaluronidase or an antidote.
d. Method of multiple punctures. After extravasation with acidic or hyperosmolar solutions, tense edema develops with blanching of the skin over the site of infiltration. The use of the stylet after aseptic precautions allows the infiltrated solution to flow freely, while reducing swelling and the likelihood of necrosis. Then apply a dressing moistened with saline to improve drainage.
e. Flushing with saline. Some authors recommend using the method of washing with saline solution of subcutaneous tissues. After treatment and infiltration of the area with 1% lidocaine, 500-1000 units of hyaluronidase are injected subcutaneously. Then four small incisions are made with a scalpel along the periphery of the infiltration site. Washing is carried out. Physiological saline is injected through a catheter installed subcutaneously in one of the incisions, the liquid is poured out through another incision. The resulting swelling is squeezed out towards the incision with massaging movements to facilitate the removal of substances that have poured out of the vessel.

e. Hyaluronidase. Dispersants are effective in extravasation of calcium preparations, parenteral nutrition solutions, antibiotics, sodium bicarbonate, etc. According to some practice guidelines, hyaluronidase is not recommended for the treatment of damage resulting from the extravasation of vasopressors. However, there are also publications on the successful treatment of such extravasation by the use of hyaluronidase in combination with saline irrigation:
(1) Mechanism of action. The destruction of hyaluronic acid, interstitial substance or intercellular compounds contributes to an increase in the dispersion and reabsorption of fluid that has gone beyond the vascular bed, respectively, reduces tissue damage by mechanical means.
(2) Administration is most effective within an hour, may be administered up to 12 noon.
(3) Inject 1 ml (150 U/ml; 5 separate injections of 0.2 ml) around the site of extravasation with 25 or 26 gauge needles.
(4) Side effects. Cases of complications in newborns are not described in the literature, there are reports of rare cases of hypersensitivity reactions in adults.

4. Specific drug antidotes:
a. Phentolamine:
(1) Used in the treatment of injuries resulting from the extravasation of vasopressors such as dopamine and adrenaline, which cause tissue damage through intense vasoconstriction and ischemia.
(2) The effect develops almost immediately. Most effective within an hour, but can be administered up to 12 hours. The biological half-life of phentolamine when administered subcutaneously is less than 20 minutes.
(3) Mechanism of action: competitive blockade of α-adrenergic receptors, resulting in relaxation of smooth muscle cells and hyperemia.
(4) Doses have not been established for neonates. They depend on the size of the damage and the body weight of the newborn.
(5) Recommended doses range from 0.01 mg/kg per administration to 5 ml of a 1 mg/ml solution.
(6) The solution at a concentration of 0.5-1.0 mg/ml is injected subcutaneously into the infiltrated area after the removal of the intravenous catheter.
(7) Precautions. Hypotension, tachycardia, and rhythm disturbances may occur; should be administered with extreme caution in preterm infants; re-introduce in small doses.

b. Nitroglycerine locally:
(1) Effective in treating damage caused by dopamine extravasation.
(2) Mechanism of action: relaxation of vascular smooth muscle.
(3) Application: 2% nitroglycerin ointment at 4 mm/kg per affected area, may be reapplied every 8 hours if tissue perfusion does not improve.
(4) Transdermal patches are also used.
(5) Precautions. Absorption through the skin may lead to hypotension.

in. Terbutaline:
(1) Effective in the treatment of peripheral ischemia due to extravasation of vasopressors in adults and older children; there are no publications on its use in neonatological practice.
(2) Mechanism of action: Peripheral vasodilation due to activation of beta2-adrenergic receptors.
(3) Administer subcutaneously at a concentration of 0.5-1.0 mg/ml; doses in adults range from 0.5 to 1 mg.

5. Treatment of a wound after extravasation - getting the drug under the skin:
Purpose of neonatal wound care with partial or complete loss of the skin is to achieve healing by primary or secondary intention without the formation of scars, contractures and surgical intervention. Different treatment regimens are used in different medical institutions.
a. Wash the injured area with sterile saline.
b. Apply sulfadiazine ointment to the affected area and change the bandages every 8 hours, carefully cleaning the wound surface, re-apply the ointment. Sulfonamides increase the risk of kernicterus, therefore, they are contraindicated in newborns in the first 30 days of life.
in. Water-based amorphous gels containing carboxymethyl cellulose polymer, propylene glycol and water keep the wound moist and facilitate healing. They are produced in the form of gels and films that can be applied directly to the wound surface and left in place for repeated dressings. The gel is easily removed with saline and changed every 3 days. More frequent change of dressings is carried out with excessive exudation.
d. Wet-dry dressings with saline and povidone-iodine dressings are also effective. Massive application of povidone-iodine to an open wound is not recommended in very low birth weight neonates because iodine absorption may depress thyroid function.
e. The effectiveness of the use of antibacterial ointments has not been proven.
e. Wound healing is assessed every day. Healing takes 7 days to 3 months.
well. If the wound is on the flexion surface, perform passive exercises within physiological volume with each dressing change in order to prevent contractures.

6. Plastic surgeon's consultation:
a. Carried out with damage to the entire thickness of the skin and significant areas of individual damage due to extravasation.
b. Enzymatic or surgical debridement or skin grafting may be required.

Our eyes are tender and sensitive. Any substance or foreign object that gets into the eye immediately responds with unpleasant sensations and even pain. If you do not respond in any way to foreign substances entering the cornea, you can get serious injury, even lose your eyesight. What to do in cases where an adult or child accidentally splashed any liquids into the eye or covered it with dry substances? What should be your first steps? What and how to rinse the eye? Let's talk in detail.

Washing the affected eye

After what happened, the first thing you need to do is go to a pediatric or adult eye emergency room *. However, before seeking professional help, it is necessary to rinse the eyes.

Most often, things that are available in every home are at hand - this is tea or pharmacy chamomile. Brew stronger tea or chamomile in the usual way (following the instructions on the pharmacy box). Let it cool, as hot liquid can aggravate the situation. Next, seat the victim on a chair, tilt his head to one side, put the dishes down into which the liquid will drain from the face. Wash your hands with soap. Take a sterile bandage in your hands, fold it several times, wet it abundantly and rinse the eye from the inner corner. Do not rub, namely rinse, so that moisture enters the corner of the eye, and excess liquid flows down. Blot your face with a tissue.

If you need to wash the other eye, do the same, starting with washing your hands. Change the solution, take a new swab!

How to wash your eyes

In addition to the above solutions, it is allowed to wash the eyes with moisturizing ones. For example, if you are at work and there is no tea leaves at hand, let alone chamomile. In the absence of eye drops, you can rinse your eyes with saline, a weak solution of potassium permanganate, and even ordinary boiled water. Also, this procedure can really be carried out with the help of furacilin. To do this, a couple of tablets of furacilin crumble and dissolve in a glass of warm water. Before moistening the swab, the furacilin solution must be filtered through a bandage or gauze folded in several layers.

How to wash your eyes

It is not always convenient to wash your eyes with a swab, especially if the child or person in front of you is in pain. In such cases, you can use a pipette, a syringe (of course, without a needle!), A rubber bulb (be sure to disinfect, at least boil before use).

In the presence of polymer baths, eye washing will be more successful and faster. Having typed a solution into such a container, you need to tilt the victim to her face so that the edges of the bath tightly fit the contours of the eye. Then, holding the bath with your hand, throw back the victim's head. It is necessary that he opens his eyes and blinks several times. Drain the used solution, refill with new and repeat if necessary. It is impossible to wipe the eye, it is only allowed to blot it with a sterile napkin.

First aid for clogged eyes is often decisive for further treatment. Therefore, remember how to act if a child or adult gets sand in their eyes or sprays them with hairspray. There can be many situations with eye damage, but the reaction must be quick and adequate. After providing first aid for eye injury, seek professional ophthalmic care immediately.