The FIRST MEDICAL ASSISTANCE in field conditions — one of types of medical care including the elementary medical treatment-and-prophylactic actions directed to maintenance of life of victims, the prevention of dangerous complications of the fighting defeats, and also on preparation struck and patients to evacuation.
In field conditions of P. of accusative, as a rule, render on regimental medical aid station (see). It is most effective in early terms from the moment of defeat. At mass losses, an adverse fighting and medical situation of P. of accusative it can appear also in medical and sanitary battalion (see) or separate medical group (see).
The item of accusative precedes medical sorting (see. Sorting medical ). In the course of medical sorting allocate the following basic groups struck and patients: constituting danger to people around; P. needing rendering. accusative at this stage of medical evacuation; struck and patients, the Crimea the help can be postponed until the following stage; subject to return. P.'s actions of accusative for urgency of performance divide into two groups: the urgent events held at states, life-threatening the struck (patient) and actions, performance to-rykh it can be delayed. The full volume of P. of accusative includes to lay down. - professional, actions of both groups. It provides correction of bandages, their change at pollution by products of nuclear explosion, correction of shortcomings of a transport immobilization, administration of anesthetics, antibiotics of a broad spectrum of activity, cordial, anticonvulsants, tetanic anatoxin, underrunning and fixing of language, introduction of an air duct, a tracheostomy; control of a plait, imposing of a compressing bandage, a tamponade of a wound or imposing of a styptic clip on the bleeding vessel; imposing of the pressurizing bandage — at open pheumothorax; a puncture or a thoracocentesis — at a tension pneumothorax; carrying out novocainic blockade, and also transfusion of blood-substituting liquids at shock and massive blood losses; cutting off of the extremity hanging on a rag; catheterization or puncture of a bladder; a gastric lavage — at acute poisonings; introduction of antidotes, inhalation of oxygen — at gas poisonings; use of antiemetics at an acute radial illness. At an adverse fighting and medical situation the volume of the help is reduced to the elementary actions allowing to carry out their further transportation with the smallest damage to victims. First of all prepare for evacuation struck, needing an operative measure according to vital indications (wounded in a stomach and a breast with symptoms of internal bleeding and internal injury, wounded in the head with the phenomena of a prelum of a brain, with a mephitic gangrene and so forth). For succession of treatment the held P.'s events of accusative are fixed in to primary medical card (see).
Features of rendering the first medical assistance by the ships
For P.'s rendering accusative in a fighting situation by the ship the main or zapasny point of medical care — PMP is developed (see. Medical aid station, ship ). Regular and auxiliary rooms of PMP are equipped with necessary medical property in advance. P.'s rendering accusative to ground mass of struck begins only after permission to evacuate victims from fighting posts on PMP. In this regard success of treatment struck by the ship in general is defined not only the first medical, but also especially by the first medical aid rendered on fighting posts (see. First aid, by the ships ). At medical sorting allocate group for PMP easily struck, to-rye later receiving medical aid can be returned on fighting posts that provides maintenance of fighting capacity of the ship. Other accusative struck with P. render in the same volume and in the same sequence, as in field conditions. However as struck are forced to be sometimes by the ship a long time, the naval doctor at P.'s rendering accusative shall carry out a number of additional actions: sewing up of a wound at pheumothorax, unremovable by means of a bandage, a stop of outside bleeding bandaging of a vessel in a wound, a necrotomy at deep circular burns, etc.
Features of rendering the first medical assistance in GO
the First medical assistance in GO appears in groups of first aid (see. Group of first aid ) or in to lay down. the institutions which remained in the center of defeat.
The first medical assistance includes in GO approximately the same volume of actions, as in field conditions. However in the presence of an opportunity the volume of the help extends, including performing urgent surgeries. First of all P. render accusative to victims according to urgent indications. At the same time it is necessary to consider that at elderly people, and also at children of an effect of an injury proceed heavier. After P.'s rendering accusative all struck, except for nontransportable, evacuations are subject. The first the most sparing transport evacuate children.
Bibliography: Vishnevsky A. A. and Schreiber M. I. Field surgery, M., 1975; Health service of civil protection, under the editorship of F. G. Krotkov, M., 1975; Sketches of field surgery, under the editorship of Yu. G. Shaposhnikov, M., 1977; Oshbrov S.A. and Zaostrovtsev I. T. The manual on health service of civil protection, M., 1973; The Guide to traumatology for health service of civil protection, under the editorship of A. I. Kazmin, M., 1978; Fishes the expert about in V. A. Organization of health service of civil protection, M., 1970; Encyclopaedic dictionary of military medicine, t. 1, Art. 741, t. 3, Art. 505, M., 1948.
K. M. Lisitsyn; V. A. Katonin (naval medicine), G.E. Kharlamov (MS of GO).