If a person has received an electrical injury, then he should be given emergency first aid in case of damage. electric shock according to a special algorithm. Household appliances that people use at home can be faulty and lead to trouble. When first aid for electric shock is performed correctly, it is possible to resuscitate the patient before the arrival of doctors.

What is electric shock

The impact of current on a person leads to pathological disorders in the body and death. Domestic electrical injuries and lightning strikes have different sources of occurrence and require the right approach to treatment. They often get damaged due to non-compliance with safety rules, in case of violation of the wiring insulation. Electrical injury due to natural atmospheric phenomena is rare.

Signs of electric shock

If the victim lost consciousness without witnesses, then the cause of the condition can be determined by the main signs of electric shock:

1. Nearby are bare electrical wires.
2. There are wounds from the inlet.
3. Pulse and breathing are intermittent.
4. The skin, lips have a bluish tint.

The negative effect of electricity is manifested in the disruption of the functioning internal organs. Due to the electric shock, tissue heating and contraction of all muscle groups occur. The electric arc leaves marks at the entrance and exit, hitting the deep layers of the skin. The input is the place of contact with the cable. The consequences are:

• dizziness;
• spasm of the vocal cords;
• myocardial infarction;
• convulsions;
• heart failure;
• loss of consciousness.

Actions in case of electric shock

For a person, voltage up to 50 V is safe, and with high humidity in the room, even 12 V poses a threat to life, so at home you need to provide first aid in time. Actions in case of electric shock to a person:

1. Pull out the damaged device from the network, bite the wire with pliers, cut it with an ax without touching it. You can use dry rubber gloves, a cloth, a wooden object.
2. If it is not possible to de-energize the source of damage, you need to pull the person over the edge of the clothing for several meters. Can't be touched with bare hands to his skin.
3. Assess the emotional and physical state of the patient. Electric shock causes severe shock, accompanied by hallucinations.

First aid for electric shock

The brain and heart suffer the most, there is a rhythm disturbance that leads to a cessation of breathing, so it is important to start providing assistance in case of electric shock in the first minutes after the incident. The actions of a person who is next to the victim, depending on the degree of the patient's condition and the complexity of his injuries, are carried out in the following order:

1. If consciousness is present - it is necessary to place on a hard surface, ensure peace, lubricate the skin around the burns with iodine 5% or potassium permanganate, apply a clean, dry bandage over the burns. It is necessary to give an analgesic drug Analgin or Aspirin, a few (25-30) drops of valerian diluted in water.
2. If a person is fainting, but the pulse is felt in the region of the carotid artery, then first aid for electrical injury is performed before the doctors arrive. It is necessary to release from squeezing clothing, bring to consciousness with ammonia, warm.
3. During loss of consciousness and clinical death, it is necessary to resuscitate by performing chest compressions and artificial respiration mouth to mouth or mouth to nose if the muscles of the mouth are spasmodic.

Indirect massage of the heart muscle is carried out alternately with the inhalation of air. The head is thrown back, the mouth is freed from foreign objects. An individual nozzle is placed on the lips for the procedure, the nose is clamped and 5 strong breaths are taken. Then 10 pushes are carried out with straight hands laid on top of each other in the area of ​​the solar plexus.

First aid for electric shock

After the arrival of specialists, an additional assessment of the patient's condition at the moment and the quality of pre-medical manipulation is carried out. If the first medical aid in case of electric shock did not work, the actions continue using special means. Instead of artificial respiration, a portable ventilator is connected through which oxygen is supplied.

Resuscitation in case of electric shock

When resuscitation from electric shock fails after 4-5 minutes, intracardiac, intravenous, or intramuscular injection adrenaline 0.1%, strophanthin solution 0.05%, mixed with 20 ml of glucose 40%. If consciousness is restored, then the person is laid on his side and the health worker gives him anti-shock, painkillers, which ensure the normal functioning of the heart. In this state, when first aid is provided in case of electric shock, he is ready for transportation to the hospital.

Video: first aid for electric shock

electrical injury- damage to organs and systems of the body under the influence of electric current.

• The first mention of death from electric current was registered in 1879 in France, Lyon, a carpenter died from an alternating current generator.
• In developed countries, the frequency of cases of electric shock is on average about 2-3 cases per hundred thousand of the population.
• Most often, young people of working age suffer from electric shock.
• The death rate of men from electrical injuries is 4 times higher than that of women.

The effect of electricity on the human body

Electric current has a thermal, electrochemical and biological effect on a person.

• thermal effect: electrical energy, meeting resistance with body tissues, turns into thermal energy and causes electrical burns. Mostly burns occur at the point of entry and exit of current, that is, in places of greatest resistance. As a result, the so-called labels or current signs. Thermal energy, converted from electrical energy, destroys and changes tissues on its way.
• Electrochemical action:“gluing”, thickening of blood cells (platelets and leukocytes), movement of ions, changes in the charges of proteins, the formation of steam and gas, giving tissues a cellular appearance, etc.
• Biological action: disruption of work nervous system, violation of the conduction of the heart, contraction of the skeletal muscles of the heart, etc.

What determines the severity and nature of electrical injury?

Electric shock factors:

1. Type, strength and voltage

• Alternating current is more dangerous than direct current. At the same time, low-frequency currents (about 50-60 Hz) are more dangerous than high-frequency ones. The frequency of the current used in everyday life is 60 Hz. With an increase in frequency, the current travels along the surface of the skin, causing burns, but is not fatal.
• The most significant is the strength and voltage of the electric current.

The reaction of the body to the passage of alternating current
Current strength	How does the victim feel?
0.9-1.2 mA	The current is barely perceptible
1.2-1.6 mA	Feeling of goosebumps or tingling
1.6-2.8mA	Feeling of heaviness in the wrist
2.8-4.5mA	Stiffness in the forearm
4.5-5.0 mA	Convulsive contraction of the forearm
5.0-7.0mA	Spasmodic contraction of the shoulder muscles
15.0-20mA	Can't take my hand off the wire
20-40mA	Very painful muscle cramps
50-100 mA	Heart failure
More than 200 mA	Very deep burns

• High voltage current (more than 1000 volts) causes more severe damage. High voltage electric shock can occur even while being a step away from the current source (“voltaic arc”). As a rule, deaths occur precisely as a result of high-voltage lesions. Low voltage shocks are mostly domestic and fortunately the percentage of deaths from low voltage shocks is lower than with high voltage injuries.

1. The path of current through the body

• The path that current takes through the body is called the current loop. The most dangerous is a full loop (2 arms - 2 legs), in this case, the current passes through the heart, causing malfunctions in its work up to its complete stop. The following loops are also considered dangerous: hand-head, hand-hand.

1. Current duration

• The longer the contact with the current source, the expression of the lesion and the higher the probability of death. Under the action of a high voltage current, due to a sharp contraction of the muscles, the victim can be immediately thrown away from the current source. At lower voltages, muscle spasm can cause a prolonged grip on the conductor with the hands. With an increase in the time of exposure to current, the resistance of the skin decreases, therefore, contact of the victim with the current source should be stopped as soon as possible.

1. Environmental factors

The risk of electric shock increases in damp and damp rooms (bathrooms, baths, dugouts, etc.).

1. The outcome of an electrical injury also largely depends on age and body condition at the moment of defeat

• Increase the severity of the lesion: childhood and old age, fatigue, exhaustion, chronic diseases, alcohol intoxication.

Degrees of electric shock

Electrical Hazard or the consequences of an electric shock

System	Effects
Nervous system	Possible: loss of consciousness of varying duration and degree, loss of memory of past events (retrograde amnesia), convulsions. In mild cases, possible: weakness, flickering in the eyes, weakness, dizziness, headache. Sometimes nerve damage occurs, which leads to impaired motor activity in the limbs, impaired sensitivity and tissue nutrition. Possible violation of thermoregulation, the disappearance of physiological and the appearance of pathological reflexes. The passage of electric current through the brain leads to loss of consciousness and the appearance of convulsions. In some cases, the passage of current through the brain can lead to respiratory arrest, which often causes death from electric shock. Under the action of a high voltage current on the body, a deep disruption of the central nervous system can develop with inhibition of the centers responsible for respiration and cardiovascular activity, leading to "imaginary death", the so-called "electrical lethargy". This is manifested by imperceptible respiratory and cardiac activity. If resuscitation in such cases is started on time, in most cases they are successful.
The cardiovascular system	Cardiac disorders in most cases are functional in nature. Violations manifest themselves in the form of various failures of the heart rhythm (sinus arrhythmia, an increase in the number of heart contractions - tachycardia, a decrease in the number of heart contractions - bradycardia, heart blockade, extraordinary heart contractions - extrasystole;). The passage of current through the heart can cause a violation of its ability to contract as a whole, causing the phenomenon of fibrillation, in which the cardiac muscle fibers contract separately and the heart loses its ability to pump blood, which equates to cardiac arrest. In some cases, electric current can damage the wall of blood vessels, leading to bleeding.
Respiratory system	The passage of electric current through the respiratory center located in the central nervous system can cause inhibition or complete cessation of respiratory activity. In case of high voltage shock, bruises and ruptures of the lungs are possible.
sense organs	Tinnitus, hearing loss, tactile disturbance. Tympanic membrane ruptures, middle ear injuries with subsequent deafness (in case of exposure to high voltage current) are possible. When exposed to bright light, damage to the visual apparatus can occur in the form of keratitis, choroiditis, cataracts.
striated and smooth muscles	The passage of current through the muscle fibers leads to their spasm, which can be manifested by convulsions. Significant reduction skeletal muscle electric shock can lead to fractures of the spine and long bones. Spasm of the muscular layer of the vessels can lead to an increase in blood pressure or the development of myocardial infarction due to spasm of the coronary vessels of the heart.
Causes of death: The main causes of death in electrotrame: cardiac arrest and respiratory arrest as a result of damage to the respiratory center.
Long-term complications: The action of electric current can cause long-term complications. Such complications include: damage to the central and peripheral nervous system (inflammation of the nerves - neuritis, trophic ulcers, encephalopathy), cardiovascular system (disturbances in heart rhythm and conduction of nerve impulses, pathological changes in the heart muscle), the appearance of cataracts, hearing loss, etc. Electrical burns can heal with the development of deformities and contractures of the musculoskeletal system. Repeated exposure to electric current can lead to early arteriosclerosis, obliterating endarteritis, and persistent vegetative changes.

Electric shock sign or electrotag

electrotag- areas of tissue necrosis at the points of entry and exit of electric current. Occur as a result of the conversion of electrical energy into thermal energy.
The form	Color	Characteristic features	A photo
Rounded or oval, but may be linear. Often there is a ridge-like elevation along the edges of the damaged skin, while the middle of the mark seems to be slightly sunken. Sometimes it is possible to peel off the top layer of the skin in the form of blisters, but without liquid inside, unlike thermal burns.	Usually lighter than the surrounding tissue - pale yellow or grayish white.	Complete painlessness of the marks, due to damage to the nerve endings. Deposition of conductor metal particles on the skin (copper - blue-green color, iron brown, etc.). When exposed to a low voltage current, metal particles are located on the surface of the skin, and when a high voltage current is applied deep into the skin. The hair in the area of ​​the marks is twisted in a spiral, retaining its structure.
Electrical burns are not always limited to marks on the skin. Quite often, damage to deeper tissues occurs: muscles, tendons, bones. Sometimes lesions are located under apparently healthy skin.

Help with electric shock

The consequences of electric shock largely depend on the provision of timely assistance.

Should I call an ambulance?

There are cases of sudden death within a few hours after electric shock. Based on this, any victim of an electric shock must necessarily be taken to a specialized hospital, where, if necessary, emergency assistance can be provided.

Electric shock relief steps

1. Stop the effect of current on the victim following the established rules. Open the electrical circuit with a circuit breaker or switch, or remove the plug from the socket. Remove the current source from the victim using insulating objects (wooden stick, chair, clothing, rope, rubber gloves, dry towel, etc.). You should approach the victim in rubber or leather shoes on a dry surface or with a rubber mat or dry boards under your feet.

In the case of a current source above 1000 volts, special safety measures must be taken to save the victim. To do this, it is necessary to work in rubber shoes, rubber gloves, use insulating pliers for the appropriate voltage.
If necessary, drag the victim out of the “step voltage” zone of action (at a distance of up to 10 m), holding him by the belt or dry clothes, while not touching open parts of the body.

1. Determine the presence of consciousness

• Take it by the shoulders, shake it (do not do it if you suspect a spinal injury), ask loudly: What's wrong with you? Do you need help?

1. Assess the state of cardiac and respiratory activity. And, if necessary, perform resuscitation measures, according to the ABC algorithm (closed heart massage, artificial lung ventilation (mouth-to-mouth breathing)).

ABC algorithm	What to do?	How to do?
BUT	Free up the airways	It is necessary to make a number of techniques that allow you to move the root of the tongue from the back wall and thus remove the obstacle in the way of the air flow. The palm of one hand is placed on the forehead, with 2 fingers of the other hand they raise the chin, pushing the lower jaw forward and upward, while tilting the head back. (if you suspect a spinal injury, do not throw your head back)
AT	Check for breath	Bend over to the victim's chest and determine if there are respiratory movements of the chest. If it is visually difficult to determine whether there is breathing or not. To the mouth, to the nose, you can bring a mirror, which will fog up in the presence of breathing, or you can bring a thin thread, which will deviate in the presence of breathing.
FROM	Determine if the pulse	The pulse is determined on the carotid artery, fingers bent at the phalanges.
At the present stage of medicine, it is recommended to start resuscitation from point C - an indirect heart massage, then A - release of the airways and B - artificial respiration.
If respiration and pulse are not detected, it is necessary to start resuscitation measures: Indirect cardiac massage, 100 compressions per minute on the chest (with an amplitude for adults of 5-6 cm and with full expansion of the chest after each compression). For manipulations, the patient must lie on a flat hard surface. The point of placement of the hands during the massage should be located on the chest between the nipples, the shoulders should be directly above the palms, and the elbows should be fully extended. Mouth to mouth breathing 2 breaths every 30 chest compressions. If it is impossible to perform mouth-to-mouth breathing, only chest compressions can be performed. CPR should continue until the ambulance arrives. The optimal time to start resuscitation is 2-3 minutes after cardiac arrest. The practical limit of resuscitation is 30 minutes, with the exception of victims who are in cold temperatures. The effectiveness of resuscitation is assessed by the color of the skin of the victim (rosination of the face, the disappearance of cyanosis).
Medical treatment. If the measures are unsuccessful for 2-3 minutes, 1 ml of 0.1% adrenaline is administered (intravenously, intramuscularly or intracardiac), calcium chloride solution 10% - 10 ml, strophanthin solution 0.05% - 1 ml diluted in 20 ml 40% solution glucose.
In the presence of breathing, the victim must be given a stable lateral position and wait for the arrival of an ambulance.

4. Dry gauze or contour dressings should be applied to the burned surfaces. The imposition of ointment bandages is contraindicated.

5. If the victim is conscious, it is possible to give painkillers (analgin, ibuprofen, etc.) and / or a sedative (valerian tincture, persen, ankylosing spondylitis, etc.) if necessary before the arrival of the ambulance.

6. The victim should be transported only in the prone position and warmly covered.

Treatment in the hospital

• All victims with symptoms of shock are hospitalized in the intensive care unit.
• Victims without signs of electrical or burn shock with limited electrical burns are hospitalized in the surgical ward. According to indications, toilet burn wounds, dressings, drug treatment (cardiac and antiarrhythmic drugs, vitamins, etc.) are carried out. If necessary, complex surgical interventions are carried out to restore the integrity and functional ability of damaged tissues and organs.
• Victims without local lesions, even in a satisfactory condition, need to be hospitalized in a therapeutic department for further observation and examination. Since cases of belated complications are known, both from the side of the cardiovascular system (cardiac arrest, cardiac arrhythmias, etc.), and from other systems (nervous, respiratory, etc.).
• People who have suffered an electrical injury often need long-term rehabilitation. Since the action of electric current can cause long-term complications. Such complications include: damage to the central and peripheral nervous system (inflammation of the nerves - neuritis, trophic ulcers, encephalopathy), cardiovascular system (disturbances in heart rhythm and conduction of nerve impulses, pathological changes in the heart muscle), the appearance of cataracts, hearing impairment, as well as impaired functions of other organs and systems.

Electric shock protection

The best protection against electric shock is "head on shoulders". It is necessary to clearly know all the requirements and safety rules when working with electric current, use the necessary means personal protection and be extremely careful when performing any work on electrical installations.

Remedies:

• Insulating pads and stands;
• Dielectric carpets, gloves, galoshes, caps;
• Portable grounding;
• Tools with insulating handles;
• The use of screens, partitions, cameras for protection against electric current;
• Use of special protective clothing (type Ep1-4);
• Reduce the time spent in the danger zone;
• Posters and safety signs.

Safety requirements

• Approach live parts only at a distance equal to the length of the insulating part of electrical protective equipment.
• It is mandatory to use an individual shielding set of clothing when working in open switchgear with a voltage of 330 kV and above.
• In electrical installations with voltages above 1000V, it is necessary to use dielectric gloves when working in electrical devices above 1000V.
• In conditions of an approaching thunderstorm, all work in switchgears should be stopped.

First aid in case of electric shock and other accidents (drowning, falling from a height, backfilling with soil, etc.). Emergency medical care for victims

First aid for electric shock. Emergency medical assistance to victims.

In case of natural disasters, industrial accidents, malfunctions of electrical appliances, exposure to lightning and other accidents, people may be struck by electric current - electrical injuries.

They cause pain, convulsive muscle contractions, disruption of the activity of nerve centers, respiratory and circulatory organs. There may also be instant death. At the site of contact with the source of damage, so-called current signs appear, sometimes burns of varying degrees, up to charring and burning of individual parts of the body. The severity of electrical injury depends on the magnitude and degree of current exposure, the ways it passes through the body.

Electric shocks are possible due to unauthorized overcoming of electrified wire fences used for the protection and defense of various objects, including military ones.

Electric shock occurs not only from touching a source of electricity, but also when approaching high voltage installations at a distance sufficient to form a spark or a voltaic arc.

First aid for electrical injury

A person who has been energized must first of all be freed from the effects of electric current as soon as possible. If it is impossible to turn off the current with a switch, a knife switch, or turn out electrical plugs, you need to cut the wires with an ax with a wooden handle or a tool whose handle is wrapped in insulating material. The wires twisted into a cord should be crossed one at a time, at some distance from each other, in order to avoid short circuits and burns.

Release of the victim from the action of electric current

You can remove the wires or conductive part of an object under voltage with a dry board, stick, pole, dry roll of an overcoat and other objects.

When an electric current passes through the body of the victim into the ground, you need to move a dry board or other insulating material under his feet. It is very important to take precautions so that you yourself do not get under stress. In this case, it is advisable to use rubber gloves and rubber shoes.

Severe injuries are often found in victims of lightning - separation of limbs, crushing of bones, paralysis of limbs, etc. The appearance on the skin of a sinuous branching pattern of a reddish color is characteristic.

After releasing the victim from the action of the current, in case of respiratory arrest and palpitations, it is necessary to immediately begin a closed heart massage and expiratory breathing “from mouth to mouth” or “from mouth to nose”. The success of resuscitation is determined by the timeliness of the start of these activities - they should be carried out, as a rule, no later than 1-2 minutes after the electric shock.

While maintaining breathing and heartbeat, but the unconscious state of the victim, he needs to unbutton his clothes, provide fresh air, give him a sniff of ammonia or spray his face with water and evacuate the victim to a medical facility in a lateral stabilized position.

The victim, who is conscious, must be laid down, not allowed to remain on his feet, as complications associated with severe circulatory and metabolic disorders are possible. A sterile bandage is applied to the burned areas of the body. The victim should be protected from cold.

For an objective assessment of the severity of the condition and the appointment of further treatment, it is necessary to call a doctor to the scene of the incident as soon as possible.

Prevention of electrical injuries consists in the exact fulfillment of safety requirements during the installation, operation and repair of electrical installations and electrical appliances.

First aid for drowning. Emergency medical care for victims

Drowning is usually observed as a result of neglecting the rules of bathing. The causes of drowning may be the inability to swim, malaise, overwork, previous overheating, alcohol intoxication, fear of a person in the water. Sometimes even good swimmers drown due to overestimation of their capabilities. Drowning occurs when crossing water barriers, natural disasters associated with floods and a large rise in water.

When rescuing a drowning person, first of all, you should take care of your own safety. A drowning person is characterized by convulsive, not always sufficiently conscious movements, which can pose a serious danger to the rescuer.

You should swim up to a drowning person from behind and, grabbing him by the hair or armpits, turn him face up so that he is above the water. The victim must be pulled out of the water as soon as possible, freed from clothing that makes it difficult to breathe (unfasten the collar, waist belt, etc.).

After that, the rescuer lays the victim with his stomach on the thigh of his leg bent at the knee, face down, so that the head of the victim is below the body, cleans the oral cavity from silt, sand, mucus. Then, by vigorous pressure on the body, the lungs and stomach are freed from water. No more than 20-30 seconds should be spent on cleansing the respiratory tract and their release from water.

Removal of water from the respiratory tract If the victim is not breathing, it is necessary, without wasting a minute, to begin resuscitation.

It is possible to restore the life of the victim if the person has been under water for no more than 5 minutes, and assistance was immediately provided to him. However, there are cases when, due to a spasm of the larynx, the lungs do not fill with water, while the heart continues to work for some time. In these cases, salvation is possible even after a person stays under water for half an hour.

It should be remembered that artificial respiration and closed heart massage are only priority measures.

To determine the severity of the condition and further treatment, it is necessary to call a doctor without delay and, if possible, quickly transport the victim to a medical institution, where resuscitation measures should be continued in full.

First aid for a fall from a height. Emergency medical care for victims

When falling from a height, the easiest injury to the victim may be a bruise.

Swelling quickly appears at the site of the bruise, and bruising (bruising) is also possible. When large blood vessels rupture under the skin, accumulations of blood (hematomas) can form.

In case of injury, first of all, it is necessary to create rest for the damaged organ. It is necessary to apply a pressure bandage to the bruised area, to give this area of ​​the body an elevated position, which helps to stop further hemorrhage into the soft tissues. To reduce pain and inflammation, cold is applied to the site of injury - an ice pack, cold compresses.

When falling from a height different areas body often appear open bleeding wounds. They can cause the majority of deaths due to acute blood loss, so the first measures should be aimed at stopping the bleeding in any possible way (pressing the vessel, pressure bandage, and with severe arterial or venous bleeding, applying a tourniquet, etc.). An equally important task of first aid is to protect the wound from contamination and infection. Proper wound treatment prevents the development of complications in the wound and reduces the healing time by almost 3 times.

Wound treatment should be carried out with clean, preferably disinfected hands. When applying an aseptic dressing, you should not touch those layers of gauze with your hands that will be in direct contact with the wound.

The wound can be protected by a simple application of an aseptic bandage (bandage, individual bag, scarf). The skin around the wound is lubricated with 5% iodine tincture, loose foreign bodies are removed from the wound.

When providing first aid to a patient with a penetrating wound of the chest, it is necessary to stop the communication of the pleural cavity with the external environment as soon as possible using a sealing bandage.

The wound should not be washed with water - this contributes to infection. Cauterizing antiseptic substances should not be allowed to enter the wound surface. The wound should not be covered with powders, ointment should not be applied to it, cotton wool should not be applied directly to the wound surface - all this contributes to the development of infection in the wound.

Another result of a fall can be a fracture. A fracture is a break in the integrity of a bone.

Fractures are divided into closed (without damage to the skin) and open, in which there is damage to the skin in the fracture zone. A fracture is characterized by: a sharp pain that increases with any movement and load on the limb, a change in the position and shape of the limb, a violation of its function (inability to use the limb), the appearance of swelling and bruising in the fracture zone, shortening of the limb, pathological (abnormal) bone mobility.

The main task of first aid for bone fractures is to immediately immobilize bone fragments by immobilizing the limb (immobilization of the limb). This is done by applying a tire. The tire can be standard (service) or made from improvised material (boards, pieces of plywood, sticks, weapons, etc.).

Basic first aid measures for bone fractures:

Creation of immobility of bones in the fracture area;

Implementation of measures aimed at combating or preventing shock;

Organization of immediate delivery of the victim to a medical facility.

The rapid immobilization of the bones in the area of ​​the fracture - immobilization reduces pain and is the main point in the prevention of shock. Immobilization of the limb is achieved by the imposition of transport splints or splints made of improvised solid material.

Splinting should be carried out directly at the scene of the incident and only after that the patient should be transported.

At open fracture before immobilization of the limb, it is necessary to apply an aseptic bandage. When bleeding from a wound, methods of temporarily stopping bleeding should be applied (pressure bandage, tourniquet, etc.), an anesthetic from a syringe tube of an individual first-aid kit should be introduced.

First aid for backfilling with soil. Emergency medical care for victims

Victims who find themselves under the rubble of buildings, defensive structures, etc., may have various injuries, as well as be in a state of acute hypoxia from suffocation caused by blockage of the respiratory tract by dust, earth, lack of air, compression of the chest and neck.

After carefully removing the victim from under the collapse, his mouth and nose are cleaned and, if necessary, resuscitation is carried out. After restoration of spontaneous breathing in the victim, if necessary, anti-shock measures are taken, bandages are applied, fractures are immobilized, and then evacuation to a medical institution.

Special attention pay to identify the fact of prolonged compression of the victim. A peculiar complex of disorders, called compression syndrome, arises and develops as a result of prolonged (over 3 hours) compression of soft tissues - more often lower extremities. This syndrome develops after the resumption of blood circulation upon release from prolonged tissue compression.

The severity of the condition of the victims depends on the extent of damage to the soft tissues and the duration of being under the rubble. Paleness, sometimes cyanotic spots, is observed on the limbs that have undergone prolonged compression. The general condition of the victims in the beginning usually does not cause concern. However, after a few hours, a bluish-purple color of the limb appears, blisters filled with bloody contents appear on the skin. Subsequently, tissue necrosis is noted. The absorption of toxic decay products of damaged tissues leads to a sharp deterioration general condition affected, especially significantly reduced kidney function. Complete cessation of urine output is possible.

In the case of establishing signs of prolonged compression, the victims are considered as seriously affected, regardless of their condition. Providing them with medical care begins with the rapid elimination of compression, tight bandaging (from the foot) and transport immobilization of the injured limb. It is necessary to enter an analgesic from a syringe tube. In case of severe injuries of the limb, a tourniquet is applied.

FIRST AID FOR ELECTRIC SHOCK

An electric shock occurs if a current of 0.06 A or more passes through the human body. A current of 0.1 A is fatal for a person.
Human resistance to the effects of electric current is a variable value and depends on many factors, including a person’s fatigue, his mental state. The average value of this resistance is in the range of 20-100 kOhm. Under particularly unfavorable circumstances, it can drop to 1 kΩ. In this case, a voltage of 100 V and below will be dangerous to human life.
The amount of current passing through a person depends on the resistance of his body. At low voltages, the resistance mainly depends on the condition of the skin. In the CIS, the resistance equal to 1.0 kOhm is taken as the calculated value of the electrical resistance of the human body.
The resistance of the human body also depends on the frequency of the current. It is the smallest at current frequencies of 6-15 kHz.
Especially dangerous is the passage of current through the heart. A significant part of it passes through the heart in the following ways: right hand- legs - 6.7%; left arm - legs - 3.7; hand - hand - 3.3; leg - leg 0.4% of the total damaging current.
Direct current is less dangerous than alternating current. So, a direct current up to 6 mA is almost not noticeable. At a current of 20 mA, cramps appear in the muscles of the forearm. Alternating current begins to be felt already at 0.8 mA. A current of 15 mA causes contraction of the arm muscles.
The danger of direct and alternating current changes with increasing voltage. At voltages up to 220 V, alternating current is more dangerous, and at voltages above 500 V, direct current is more dangerous.
The more current flows, the less the electrical resistance of the body becomes and the greater the magnitude of the current. If the action of the current is not quickly interrupted, death may occur.
The degree of damage is also significantly affected by the resistance at the point of contact of a person with the ground. In the case of the passage of current through the victim from the hand to the feet, the material and quality of the shoes are essential.
Electric current can cause severe damage, up to cardiac arrest and cessation of breathing. Therefore, you need to be able to provide assistance to the victim before the arrival of the doctor.

Releasing the victim from the current.

First of all, it is necessary to quickly release the victim from the action of electric current, i.e. disconnect the current circuit using the nearest plug connector, switch (knife switch) or by unscrewing the plugs on the shield.
If the switch is far from the scene of the incident, you can cut the wires or cut them (each wire separately) with an ax or other cutting tool with a dry handle made of insulating material.
If it is impossible to quickly break the chain, it is necessary to pull the victim away from the wire or throw the broken end of the wire away from the victim with a dry stick.
It must be remembered that the victim himself is a conductor of electric current. Therefore, when releasing the victim from the current, the person providing assistance must take precautions so as not to be energized himself: put on galoshes, rubber gloves or wrap your hands with a dry cloth, put an insulating object under your feet - a dry board, a rubber mat, or, in extreme cases, folded dry clothes.
The victim should be pulled away from the wire by the ends of his clothes; you should not touch open parts of the body. When releasing the victim from the current, it is recommended to operate with one hand.
If it is on a stepladder, stand or any other device, care must be taken to prevent bruises or fractures when falling.
If a person is exposed to voltages above 1000 V, such precautions are insufficient. It is necessary to contact specialists who will immediately relieve stress.

First aid to the victim

First aid measures depend on the condition of the victim after release from the current.
To determine this state, you must:
- immediately lay the victim on his back;
- unfasten clothing that restricts breathing;
- check by lifting the chest, whether he is breathing;
- check for a pulse (on the radial artery at the wrist or on the carotid artery in the neck;
- check the condition of the pupil (narrow or wide).
A wide fixed pupil indicates a lack of blood circulation to the brain.
Determining the state of the victim should be carried out quickly, within 15 - 20 seconds.
1. If the victim is conscious, but before that he was in a faint or was under electric shock for a long time, then he must be provided with complete rest until the arrival of a doctor and further observation for 2-3 hours.
2. If it is impossible to quickly call a doctor, it is necessary to urgently deliver the victim to a medical institution.
3. In a serious condition or lack of consciousness, you need to call a doctor (Ambulance) to the scene.
4. In no case should the victim be allowed to move: the absence of severe symptoms after the injury does not exclude the possibility of a subsequent deterioration in his condition.
5. In the absence of consciousness, but preserved breathing, the victim should be comfortably laid down, create an influx of fresh air, give ammonia to sniff, sprinkle with water, rub and warm the body. If the victim is breathing poorly, very rarely, superficially, or, conversely, convulsively, like a dying person, artificial respiration should be done.
6. In the absence of signs of life (respiration, heartbeat, pulse), the victim cannot be considered dead. Death in the first minutes after the defeat is apparent and reversible in the provision of assistance. The affected person is threatened with the onset of irreversible death if he is not immediately provided with assistance in the form of artificial respiration with simultaneous heart massage. This event must be carried out continuously at the scene until the arrival of a doctor.
7. The victim should be transferred only in cases where the danger continues to threaten the victim or the person providing assistance.

Carrying out artificial respiration

Artificial respiration is started immediately after release from the electric current and is carried out continuously until a positive result or indisputable signs of actual death (cadaveric spots and rigor mortis) appear. There have been cases when, after an electric shock, people were brought back to life only after a few hours of continuous assistance. The expediency of continuing the measures taken is determined by the doctor.
Before proceeding directly to the procedure, it is necessary to quickly release the victim from everything that restricts breathing: unfasten the collar, loosen the belt, etc.; quickly free your mouth from mucus and foreign objects such as removable dentures. If the jaws are tightly clenched as a result of spasms, four fingers of both hands are placed behind the corners of the lower jaw under the ears and, resting their thumbs on the jaw from below, push it so that the lower teeth are in front of the upper ones. If this method fails to open the mouth, carefully, so as not to break the teeth, a board, a metal plate, a spoon handle or other similar object is inserted between the back molars and the jaws are opened with their help.
The technique of blowing air into the mouth or into us is as follows. The victim lies on his back. The caregiver before the start of artificial must ensure the free passage of air into the lungs through the respiratory tract. The head of the victim must be thrown back, for which they put one hand under the neck, and with the other hand they press on the forehead. This ensures the departure of the root of the tongue from the back wall of the larynx and the restoration of airway patency. When the head position is indicated, the mouth usually opens. If there is mucus in the mouth, it is wiped with a handkerchief or the edge of a shirt pulled over the index finger, one more time they check for foreign objects in the mouth that must be removed, after which they start blowing air into the mouth or nose. When air is blown into the mouth, the assisting person tightly (possibly through gauze or a handkerchief) presses his mouth to the victim’s mouth, and with his face (cheek) or fingers of the hand located on the forehead, pinches his nose to ensure that all the blown air enters his lungs.
If it is impossible to completely cover the victim's mouth, air should be blown into the nose, while tightly closing the victim's mouth. Then the rescuer leans back and takes a new breath, and at this time the victim's chest drops and he makes a passive exhalation.
During artificial respiration, it is necessary to ensure that with each breath the victim’s chest expands, and also carefully observe his face: if the lips or eyelids move or a swallowing movement is noticed, check if an independent breath occurs; if after a few moments of waiting it turns out that the victim is not breathing, artificial respiration is immediately resumed.
Air is blown in every 5-6 seconds, which corresponds to a respiratory rate of 10-12 times per minute. After each blowing ("inhalation"), the mouth and nose of the victim are released for the free exit of air from his lungs.

External (indirect) cardiac massage

External (indirect) heart massage maintains blood circulation both with a stopped heart and with an impaired rhythm of its contractions.
To conduct an indirect heart massage, the victim should be laid on his back on a hard surface (bench or floor). Expose his chest: all tight clothing, the belt is unfastened or removed. The caregiver stands on the side of the victim so as to be able to bend over him (if the victim lies on the floor, they kneel next to each other). The palm of the other hand is placed on top of the first and they begin to rhythmically press on the lower edge of the sternum.
It is necessary to press on the sternum with sharp jerks: in this case, the sternum moves down (towards the back) towards the spine by 3-5 cm. The heart is compressed, and blood is squeezed out of its cavity into the blood vessels. Pressing must be repeated approximately 1 time per second.
You should be careful not to press on the ends of the ribs, as this can lead to their fracture. It is impossible to press below the edge of the sternum on soft tissues: this can damage the organs located in the abdominal cavity and, first of all, the liver.
A prerequisite for providing the body with oxygen in the absence of the work of the heart is simultaneous artificial respiration with a heart massage. Since pressure on the chest makes it difficult to expand during inspiration, air is blown in during a pause, which is specially observed every four to six pressures on the sternum.
As a rule, two specially trained people should carry out the revival, each of which can alternately perform artificial respiration and heart massage, changing each other every 5-10 minutes. This is less tiring than doing the same routine over and over again (especially heart massage).
In extreme cases, help can be provided by one person who alternates artificial respiration and heart massage in the following order: after two or three deep blows of air into the mouth (or nose) of the victim, he performs 15 pressures on the sternum (heart massage), after which again produces two or three deep blows of air and proceeds to massage the heart, etc.
As a result of the correct implementation of artificial respiration and heart massage, the victim shows signs of improvement: a gray-earthy complexion with a bluish tint is replaced by pinkish; independent, more and more uniform respiratory movements begin to be established; pupils constrict. Narrow pupils indicate a sufficient supply of oxygen to the brain, and the beginning expansion indicates a deterioration in blood supply. Then more effective measures are needed, for example, to raise the victim's legs by 40-60 cm in order to promote better blood flow to the heart from the veins of the lower body. To keep the legs in a raised position, a bundle is placed under them.
Artificial respiration and massage are carried out until spontaneous breathing appears and the activity of the heart is restored. However, the appearance of weak breaths, even in the presence of a pulse, does not give grounds for stopping artificial respiration. The restoration of the work of the heart is judged by the appearance of its own regular pulse, not supported by massage. To check, interrupt the massage for 2-3 seconds and, if the pulse is not detected, the massage is immediately resumed.
After the appearance of the first signs of improvement, external heart massage and artificial respiration continue for another 5-10 minutes, so that the blowing coincides in time with your own breath.

We are surrounded everywhere electrical devices, and therefore, unfortunately, situations when you can get an electrical injury are not uncommon. The consequences of electric shock can be very dangerous for the health and even the life of the victim, so it is very important to know how first aid is provided in case of electric shock.

Among all other injuries, injuries resulting from electric shock are among the most dangerous. The degree of danger of such injuries depends on defeat forces, which in turn depends on the power of the electric charge, on the time the charge affects the victim, on the nature of the electric current, as well as on the state of the victim himself and the places of his contact with the source of electric current.

For human body minimally sensitive is the impact of an electric current with a force of 1-1.5 mA in the case of alternating current (frequency 50 Hz) or 5-7 mA - if the current is direct. The minimum current strength, under the influence of which a person can no longer independently remove limbs from the current source, is 10-15 mA for alternating current and 50-80 mA for direct current. Conditionally fatal to humans is the threshold of 300 mA for direct current and 100 mA for alternating current - when an electric current of such a force is applied to the body for more than 0.5 s, fibrillation of the heart muscles occurs in almost 100% of cases.

Electric shock can lead to burns of I-IV degrees of severity, malfunctions of the heart muscle, and malfunctions of the nervous system. If you do not provide first aid to the victim of electric shock in time, then the outcome can even be fatal. What are the rules for providing first aid for electrical injuries?

First aid rules for electric shock

First aid for electric shock is always provided only after the impact of the damaging factor on the victim has been eliminated. This means that before providing assistance, it is necessary to turn off the source of electric current or stop the contact of the victim with the current-carrying parts of the electrical appliance.

At the same time, it is important that the rescuer himself does not end up in the place of the victim, so he must secure yourself against electric shock, for example, with rubber gloves and rubber-soled shoes. In no case should you touch the victim with your bare hands if he is still in contact with a source of electric current.

After you managed to drag the victim away from the current source or turn off the current supply to the electrical appliance, you need to call ambulance . Even if the victim does not have visible injuries, it may turn out that the electric shock gave the so-called delayed complications, so an examination of the victim by specialists is mandatory.

First aid for electric shock depends on the condition of the victim.

You can quickly assess the clinical condition of the victim in 15-20 seconds according to the following signs:

Clear, disturbed or absent consciousness;

Pink, pale or bluish lips;

Normal or dilated pupils;

Normal, disturbed or absent breathing;

Good, bad or absent pulse.

After assessing the condition of the victim, it is necessary to choose the correct algorithm for providing first aid. If there is no breathing and pulse, the pupils are dilated, and the lips and skin have a bluish tint, then this indicates the onset of clinical death, you should immediately start resuscitation: do artificial respiration and chest compressions.

If the victim has breathing and pulse, but they are disturbed, consciousness is absent, then it is necessary to take measures to provide first aid in case of fainting. If the victim has thermal burns of I-IV degrees of severity, then you need to act in accordance with the rules for providing first aid for burns.

When providing first aid in case of electric shock, a high response rate, a clear sequence of actions and a clear mind are important. It is best to call others for help when a victim is found from the current in order to distribute the responsibilities for his rescue among several people: someone should call an ambulance, someone should help move the victim, rid him of tight clothing, someone should start artificial breathing and external cardiac massage, if required.

The health and life of the victim depends on the coherence and speed of the actions of the rescuers, therefore, when providing first aid, you should try not to panic. First aid must be provided until the arrival of the ambulance or until the victim is taken to the nearest medical facility. Doctors must be informed about all the assistance provided to the victim so that they can correctly assess his current condition.

Section: POWER SUPPLY AND ELECTRICAL SAFETY.

Subsection: First aid in case of accidents.

Part: Providing first aid in case of electric shock.

Saving the life of a person struck by an electric current largely depends on the speed and correctness of the actions of the persons assisting him. First aid should begin to be provided immediately, if possible at the scene, while simultaneously calling for medical assistance.

REMEMBER: Never refuse to help a victim who has stopped breathing and heartbeat. Only a doctor has the right to ascertain death.

First aid to the victim from the electric current is provided in two stages: the release of the victim from the action of the current and the provision of first medical aid to him.

The release of the victim from the action of the current. If a person affected by current comes into contact with live parts, it is necessary to quickly release him from the action of the current, while taking precautions so that he himself does not come into contact with live parts or the body of the victim, as well as under the voltage of the step.

It is best to turn off the installation, and if this is not possible, it is necessary (in installations up to 1000 V) to cut the wires with an ax with a wooden handle or bite them with a tool with insulated handles. To disconnect the line, you can cause it to short circuit by throwing a bare wire. The victim can be pulled away from the current-carrying part by grasping his clothes if it is dry and lags behind the body. At the same time, one should not touch the body of the victim, his shoes, damp clothes, etc. If it is necessary to touch the body of the victim, the person providing assistance should isolate their hands by wearing dielectric gloves.

In the absence of dielectric gloves, wrap your hands with a scarf, put a hat on your hands, etc. Instead of isolating your hands, you can isolate yourself from the ground by wearing rubber overshoes on your feet, or by standing on a rubber mat, board, etc. If the victim squeezes the wires very strongly with his hands, put on dielectric gloves and unclench his hands, bending each finger individually. If the victim is at a height, turning off the unit may cause him to fall. In this case, it is necessary to take measures to ensure safety in case of a possible fall of the victim.
At voltages above 1000 V, put on dielectric gloves, boots and, acting with an insulating rod, pull the wire or the victim from the wire by 8 meters.

Determining the condition of the victim.

To determine the condition of the victim, it is necessary to lay him on his back and check for consciousness; if unconscious, check for breathing and pulse. The presence of breathing in the victim is determined by eye on the rise and fall of the chest. The pulse is checked at the radial artery, approximately at the base of the thumb. If the pulse is not detected on the radial artery, you should check it on the carotid artery on the neck on the right and left sides of the protrusion of the thyroid cartilage - Adam's apple. The absence of blood circulation in the body can also be judged by the state of the eye pupil, which expands a minute after the heart stops. Checking the condition of the victim should be carried out quickly within no more than 15-20 seconds.

The first pre-medical medical aid to the victim is provided immediately, after his release from the action of the current, here, at the scene.

The sequence of actions for providing first aid at the scene of an accident:

If there is no consciousness and there is no pulse on the carotid artery, proceed to resuscitation;

If there is no consciousness, but there is a pulse on the carotid artery - turn on the stomach and clean the oral cavity;

In case of heavy bleeding, apply a tourniquet (scarlet blood flows out of the wound in a gushing stream, a roller of flowing blood has formed over the wound, a large bloody stain on clothes or a pool of blood near the victim);

In the presence of wounds - apply bandages;

If there are signs of fractures of the bones of the limbs, apply transport tires.

In case of sudden death of a person:

Make sure that there is no pulse on the carotid artery;

Release the chest from clothing and unfasten the waist belt;

Cover the xiphoid process with two fingers;

Strike with a fist on the sternum;

Start performing a resuscitation complex (indirect heart massage - place your palm on your chest so that thumb sent to the lifeguard.

The depth of pushing through the chest is at least 3-4 cm. The frequency of pressing is 50-100 times per minute; artificial respiration - pinch the victim's nose, grab the chin, tilt the victim's head back and exhale as much as possible into his mouth, two "breaths" of artificial respiration are done after 30 pressures on the sternum)

It is necessary to resuscitate the victim either until spontaneous breathing and independent cardiac activity appear, or until the arrival of medical workers, or until signs of biological death appear.

Signs indicating the biological death of the victim:

Drying of the cornea of ​​the eye;

Deformation of the pupil with careful compression of the eyeball with fingers;

The appearance of dead spots.

Signs indicating sudden (clinical) death of the victim:

Lack of consciousness;

To the victim in a state of coma (no consciousness, but there is a pulse):

Bring the hand closest to you to the victim behind his head;

Turn the victim with his chest to his knees;

Clean the oral cavity with your fingers and press on the root of the tongue;

Lay on the stomach and apply cold to the head.

In case of bleeding, the artery must be pressed:

On the extremities - above the place of bleeding;

On the neck and head - below the wound or in the wound.

The tourniquet with dangerous bleeding changes after an hour after application and then every 30 minutes. The tourniquet applied to the thigh is removed only by order of the medical worker.

The procedure for providing first aid to the victim with bleeding from the forearm:

Press the brachial artery against the humerus above the wound;

Seat the victim and put his wounded hand on his shoulder;

Apply a tourniquet on the raised arm and make sure that there is no pulse on the radial artery (if the limb turns blue, quickly remove the tourniquet and apply it again);

Apply a sterile dressing to the wound (do not wash the wound with water and pour alcohol or any other solutions into the wound);

Attach a note about the time of application of the tourniquet and once again check the pulse. Secure the hand with a scarf.

The procedure for providing first aid to a victim with a chest injury:

To seat the victim and to press a palm to a wound, to close air access to it;

Apply a plaster or adhesive tape;

In case of loss of consciousness, give him a "half-sitting" position and monitor the state of the pulse and breathing.

The procedure for providing first aid to a victim with a wound to the abdomen:

Raise your knees and unfasten your waist belt;

Cover the contents of the wound with a clean cloth. Ensure peace in the position "lying on your back";

Attach a napkin that completely covers the edges of the wound with adhesive tape;

Put cold on the stomach.

Protection against harmful substances at work.

Harmful chemicals

Rapid development chemical industry and chemicalization of the entire national economy led to a significant expansion of the production and use of various chemicals in industry; the range of these substances has also expanded significantly: many new chemical compounds have been obtained, such as monomers and polymers, dyes and solvents, fertilizers and pesticides, combustible substances, etc. Many of these substances are not indifferent to the body and, getting into the air. workplaces, directly on workers or inside their bodies, they may adversely affect the health or normal functioning of the body.

Such chemicals are called harmful. The latter, depending on the nature of their action, are divided into irritating substances, toxic (or poisons), sensitizing (or allergens), carcinogenic and others. Many of them have several harmful properties at the same time, and above all, to some extent toxic, therefore the concept of "harmful substances" is often identified with " toxic substances”, “poisons” regardless of the presence of other properties in them.

Poisoning and diseases resulting from exposure to harmful substances in the process of performing work at work are called occupational poisoning and diseases.

Causes and sources of release of harmful substances

Harmful substances in industry can be part of the raw materials, final, by-products or intermediate products of a particular production. They can be of three types: solid, liquid and gaseous. Formation of dust of these substances, vapors and gases is possible.

Toxic dusts are formed due to the same reasons as ordinary dusts described in the previous section (grinding, burning, evaporation followed by condensation), and are released into the air through open openings, leaks in dusty equipment or when they are poured in an open way.

Liquid harmful substances most often seep through leaks in equipment, communications, splash when they are openly drained from one container to another. At the same time, they can get directly on the skin of workers and have a corresponding adverse effect, and in addition, pollute the surrounding outer surfaces of equipment and fences, which become open sources of their evaporation.

With such pollution, large evaporation surfaces of harmful substances are created, which leads to rapid saturation of the air with vapor and the formation of high concentrations. The most common causes of leakage of liquids from equipment and communications are corroding gaskets in flange connections, loose taps and valves, insufficiently sealed glands, metal corrosion, etc.

If liquid substances are in open containers, evaporation also occurs from their surface and the resulting vapors are introduced into the air of working premises; the larger the open surface of the liquid, the more it evaporates.

In the case when a liquid partially fills a closed container, the resulting vapors saturate the empty space of this container to the limit, creating very high concentrations in it. If there are leaks in this container, concentrated vapors can enter the workshop atmosphere and pollute it. The vapor output increases if the container is under pressure.

Massive vapor emissions also occur at the time of filling the container with liquid, when the liquid is being poured. displaces accumulated concentrated vapors from the tank, which enter the shop through the open part or leaks (if the closed tank is not equipped with a special air outlet outside the shop). The release of vapors from closed containers with harmful liquids occurs when opening lids or hatches to monitor the progress of the process, mixing or loading additional materials, sampling, etc.

If gaseous harmful substances are used as raw materials or obtained as finished or intermediate products, they, as a rule, are released into the air of working premises only through accidental leaks in communications and equipment (since if they are present in the apparatus, the latter cannot open even for a short time ).

As mentioned in the previous section, gases can settle on the surface of dust particles and be carried away with them over certain distances. In such cases, places of dust release can become at the same time places of gas release.

The source of the release of harmful substances of all three types (aerosol, vapor and gas) are often various heating devices: dryers, heating, roasting and melting furnaces etc. Harmful substances in them are formed as a result of combustion and thermal decomposition of certain products. Their release into the air occurs through the working openings of these furnaces and dryers, leaks in their masonry (burnouts) and from the heated material removed from them (molten slag or metal, dried products or fired material, etc.).

A frequent cause of massive emissions of hazards is the repair or cleaning of equipment and communications containing toxic substances, with their opening and, moreover, dismantling.

Some vaporous and gaseous substances, released into the air and polluting it, are sorbed (absorbed) by individual building materials, such as wood, plaster, brick, etc. Over time, such building materials are saturated with these substances and under certain conditions (temperature changes, etc.) ) themselves become sources of their release into the air - desorption; therefore, sometimes even with the complete elimination of all other sources of harmful emissions, their elevated concentrations in the air can remain for a long time.

Ways of entry and distribution of harmful substances in the body

The main routes of entry of harmful substances into the body are the respiratory tract, the digestive tract and the skin.

Their receipt is of the greatest importance. through the respiratory organs. Toxic dusts, vapors and gases released into the indoor air are inhaled by workers and penetrate into the lungs. Through the branched surface of the bronchioles and alveoli, they are absorbed into the blood. Inhaled poisons have an adverse effect almost throughout the entire period of work in a polluted atmosphere, and sometimes even at the end of work, since their absorption is still ongoing. Poisons that have entered the blood through the respiratory organs are carried throughout the body, as a result of which their toxic effect can affect a wide variety of organs and tissues.

Harmful substances enter the digestive organs by swallowing toxic dusts that have settled on the mucous membranes of the oral cavity, or by bringing them there with contaminated hands.

Poisons that enter the digestive tract are absorbed through the mucous membranes into the blood along its entire length. Most absorption occurs in the stomach and intestines. Poisons that enter through the digestive organs are sent by blood to the liver, where some of them are retained and partially neutralized, because the liver is a barrier to substances entering through the digestive tract. Only after passing through this barrier, poisons enter the general bloodstream and are carried by them throughout the body.

Toxic substances that have the ability to dissolve or dissolve in fats and lipoids can penetrate the skin if the latter is contaminated with these substances, and sometimes if they are present in the air (to a lesser extent). Poisons that have penetrated the skin immediately enter the general bloodstream and are carried throughout the body.

Poisons that have entered the body in one way or another can be relatively evenly distributed throughout all organs and tissues, exerting a toxic effect on them. Some of them accumulate mainly in certain tissues and organs: in the liver, bones, etc. Such places of predominant accumulation of toxic substances are called depots in the body.

Many substances are characterized by certain types of tissues and organs where they are deposited. The delay of poisons in the depot can be both short-term and longer - up to several days and weeks. Gradually leaving the depot into the general circulation, they can also have a certain, as a rule, mild toxic effect. Some unusual phenomena (alcohol intake, specific food, illness, injury, etc.) can cause more rapid removal of poisons from the depot, as a result of which their toxic effect is more pronounced.

The excretion of poisons from the body occurs mainly through the kidneys and intestines; the most volatile substances are also excreted through the lungs with exhaled air.

HARMFUL CHEMICALS. PHYSICO-CHEMICAL PROPERTIES OF HARMFUL SUBSTANCES

Physical and chemical properties of harmful substances

The physical and chemical properties of harmful substances in the form of dust are as follows. the same as ordinary dust.

If solid but soluble harmful substances are used in production in the form of solutions, their physicochemical properties will be similar to those of liquid substances in many respects.

When harmful substances enter the skin and mucous membranes, the greatest hygienic value of the physical and chemical properties is the surface tension of the liquid or solution, the consistency of the substance, the chemical affinity for fats and lipoids covering the skin, as well as the ability to dissolve fats and lipoids.

Substances of liquid consistency and liquids with low surface tension, when they come into contact with the skin or mucous membranes, wet them well and contaminate a larger area, and, conversely, liquids with high surface tension, thick consistency (oily) and solids, once on the skin, more often they remain on it in the form of droplets (if they are not rubbed) or dust particles (solids), in contact with the skin in a limited area. Thus, substances with a low surface tension and a liquid consistency are more dangerous than solid or thick substances with a high surface tension.

Substances that are similar in their chemical composition to fats and lipoids, when they get on the skin, dissolve relatively quickly in fats and lipoids of the skin and together with them pass through the skin into the body (through its pores, ducts of the sebaceous and sweat glands). Many liquids have the ability to dissolve fats and lipoids themselves, and due to this they also penetrate the skin relatively quickly. Consequently, substances with these properties are more dangerous than others with opposite physical and chemical properties (other things being equal).

In relation to pollution with harmful vapors or gases of the air environment, the volatility of a substance, the elasticity of its vapors, the boiling point, specific gravity, chemical composition.

The volatility of a substance is the ability to evaporate a certain amount of it per unit time at a given temperature. The volatility of all substances is compared with the volatility of ether under the same conditions, taken as a unit. Substances with low volatility saturate the air more slowly than substances with high volatility, which can evaporate relatively quickly, creating high concentrations of them in the air. Consequently, substances with increased volatility pose a greater danger than those with low volatility. As the temperature of a substance increases, its volatility also increases.

Of great hygienic importance is the elasticity or vapor pressure of a toxic liquid, that is, the limit of saturation of air with it at a certain temperature. This indicator, like air pressure, is expressed in millimeters of mercury. For each liquid, the vapor pressure for certain temperatures is a constant value.

The degree of possible saturation of the air with its vapor depends on this value. The higher the vapor pressure, the greater the saturation and the higher the concentrations that can be created when this liquid evaporates. As the temperature rises, the vapor pressure also increases. This property is especially important to take into account during prolonged evaporation of toxic substances, when vapors are released until the air is completely saturated with them, which is often observed in closed, poorly ventilated rooms.

The boiling point, which is a constant value for each substance, also determines the relative danger of this substance, since volatility under normal temperature conditions of the workshop depends on it. It is known that the most intense vaporization, that is, evaporation, occurs during boiling, when the temperature of the liquid rises to this constant value.

However, a gradual increase in the volatility of a liquid occurs as its temperature approaches the boiling point. Therefore, the lower the boiling point of a substance, the smaller the difference between the last and usual temperature of the workshop, the closer the temperature of this substance (if it is not additionally cooled or heated) to its boiling point, therefore, its volatility is also higher. Thus, substances with a low boiling point are more dangerous than high-boiling ones.

The specific gravity of a substance is one of the factors that determine the distribution of vapors of this substance in the air. Vapors of substances with a specific gravity less than the specific gravity of air under the same temperature conditions rise to the upper zone, therefore, passing through a relatively thick layer of air (when vapor is released in the lower zone), they quickly mix with it, polluting large spaces and creating the highest concentrations in the upper zone (if there is no mechanical or natural exhaust from there).

When the specific gravity of substances is greater than the specific gravity of air, the released vapors accumulate mainly in the lower zone, creating the highest concentrations there. However, it should be noted that this last regularity is often violated when heat releases take place or the vapors themselves are released in a heated form. In these cases, despite the large specific gravity, convection currents of heated air draw vapor into the upper zone and also pollute the air. All these patterns must be taken into account when placing workplaces at different levels of the workshop and with equipment exhaust ventilation.

For some of the above physical properties substances has a significant impact on the state of the environment, and above all meteorological conditions. Thus, for example, an increase in air mobility enhances the volatility of liquids, an increase in temperature increases the vapor pressure and enhances volatility, and rarefaction of the air also contributes to the latter.

The most significant hygienic value is the chemical composition of harmful substances. The chemical composition of a substance determines its main toxic properties: different substances in their chemical composition have different toxic effects on the body, both in nature and strength. A strictly defined and consistent relationship between the chemical composition of a substance and its toxic properties has not been established, however, some connection between them can still be established.

So, in particular, substances of one chemical group, as a rule, are largely similar in nature of their toxicity (benzene and its homologues, a group of chlorinated hydrocarbons, etc.). This sometimes makes it possible, by the similarity of the chemical composition, to roughly judge the nature of the toxic effect of some new substance. Within separate groups similar in chemical composition of substances, a certain pattern was also revealed in the change in the degree of their toxicity, and sometimes in the change in the nature of the toxic effect.

For example, in the same group of chlorinated or other halogenated hydrocarbons, as the number of hydrogen atoms replaced by halides increases, the degree of toxicity of substances increases (tetrachloroethane is more toxic than dichloroethane, and the latter is more toxic than ethyl chloride); the addition of nitro or amino groups to aromatic hydrocarbons (benzene, toluene, xylene) instead of a hydrogen atom gives them completely different toxic properties.

Some interrelationships between the chemical composition of substances and their toxic properties have been identified, which made it possible to approach an approximate assessment of the degree of toxicity of new substances based on their chemical composition.

HARMFUL CHEMICALS. ACTION OF HARMFUL SUBSTANCES ON THE ORGANISM

The effect of harmful substances on the body

Harmful substances can have local and general effects on the body. Local action most often manifests itself in the form of irritation or chemical burns of the place of direct contact with the poison; usually this is the skin or mucous membranes of the eyes, upper respiratory tract and oral cavity. It is a consequence of the chemical action of an irritating or toxic substance on living cells of the skin and mucous membranes. In a mild form, it manifests itself in the form of redness of the skin or mucous membranes, sometimes in their swelling, itching or burning sensation; in more severe cases, the painful phenomena are more pronounced, and the change in the skin or mucous membranes can be up to their ulceration.

The general effect of the poison occurs when it penetrates into the blood and spreads throughout the body. Some poisons have a specific, that is, selective effect on certain organs and systems (blood, liver, nervous tissue, etc.). In these cases, penetrating the body in any way, the poison affects only a certain organ or system. Most poisons have a general toxic effect or an effect simultaneously on several organs or systems,

The toxic effect of poisons can manifest itself in the form of acute or chronic poisoning - intoxication.

Acute poisoning occurs as a result of a relatively short exposure to significant amounts of a harmful substance (high concentrations) and is characterized, as a rule, by the rapid development of painful phenomena - symptoms of intoxication.

There are several stages in the development of acute poisoning. The initial period of intoxication - prodromal - is characterized, as a rule, by some non-specific phenomena, sometimes even weakly.

Measures to prevent occupational poisoning and diseases should be aimed primarily at the maximum elimination of harmful substances from production by replacing them with non-toxic or, at least, less toxic products. It is also necessary to eliminate or minimize toxic impurities in chemical products, for which it is advisable to indicate the limits of possible impurities in the approved standards for these products, that is, to carry out their hygienic standardization.

When there are several types of raw materials or technological processes to obtain the same product, preference should be given to those materials that contain fewer toxic substances or the substances present have the least toxicity, as well as those processes that do not emit toxic substances or the latter have the least toxicity. toxicity.

Particular attention should be paid to the use in the production of new chemicals, the toxic properties of which have not yet been studied. Highly toxic substances may also be among such substances, therefore, if appropriate precautions are not taken, the possibility of occupational poisoning cannot be ruled out. To avoid this, all newly developed technological processes and newly obtained chemicals should be simultaneously studied from a hygienic standpoint: assess the risk of hazardous emissions and the toxicity of new substances. All innovations and envisaged preventive measures must be coordinated with the local sanitary authorities without fail.

Technological processes with the use or possibility of formation of toxic substances should be as continuous as possible in order to eliminate or minimize the release of harmful substances at intermediate stages of the technological process. For the same purpose, it is necessary to use the most sealed technological equipment and communications, which may contain toxic substances. Particular attention should be paid to maintaining tightness in flange connections (use gaskets resistant to this substance), in closing hatches and other working openings, stuffing box seals, samplers.

If leakage or knocking out of vapors and gases from the equipment is detected, urgent measures must be taken to eliminate the existing leaks in the equipment or communications. For loading raw materials as well as unloading finished products or by-products containing toxic substances, sealed feeders or closed pipelines should be used so that these operations are carried out without opening the equipment or communications.

The air displaced during the loading of containers with toxic substances must be removed by special pipelines (air vents) outside the workshop (as a rule, to the upper zone), and in some cases, when particularly toxic substances are displaced, it must be pre-cleaned from harmful substances or neutralized, disposed of, etc. Further.

It is advisable to maintain the technological mode of operation of equipment containing toxic substances in such a way that it does not contribute to an increase in harmful emissions. The greatest effect in this regard is the maintenance of a certain vacuum in the apparatuses and communications, in which, even in the event of a leak, air from the workshop will be sucked into these apparatuses and communications and prevent the release of toxic substances from them. It is especially important to maintain a vacuum in equipment and apparatus that have permanently open or non-hermetically closed working openings (furnaces, dryers, etc.).

At the same time, practice shows that in those cases where, according to the conditions of technology, it is required to maintain especially high pressure inside the apparatus and in communications, knocking out of such apparatus and communications is either not observed at all, or it is very insignificant. This is due to the fact that with significant leaks and knocking out high pressure falls sharply and disrupts the technological process, that is, it is impossible to work without proper tightness.

Technological processes associated with the possibility of harmful emissions should be mechanized and automated as much as possible, with remote control. This will eliminate the danger of direct contact of workers with toxic substances (contamination of the skin, overalls) and remove jobs from the most danger zone location of the main technological equipment.

Timely preventive maintenance and cleaning of equipment and communications are of significant hygienic importance.

Cleaning of technological equipment containing toxic substances should be carried out mainly without opening and dismantling it, or at least with a minimum opening in terms of volume and time (by blowing, washing, cleaning through stuffing box seals, etc.). Repair of such equipment should be carried out on special stands isolated from the general room, equipped with enhanced exhaust ventilation. Before dismantling the equipment, both for its delivery to the repair stand and for on-site repairs, it is necessary to empty it completely of the contents, then blow it well or rinse it until the residues of toxic substances are completely removed.

If it is impossible to completely eliminate the release of harmful substances into the air, it is necessary to use sanitary engineering measures and, in particular, ventilation. The most appropriate and giving a greater hygienic effect is local exhaust ventilation, which removes harmful substances directly from the source of their release and prevents them from spreading throughout the room. In order to increase the efficiency of local exhaust ventilation, it is necessary to cover the sources of harmful emissions as much as possible and extract from under these shelters.

Experience shows that in order to prevent the knocking out of harmful substances, it is necessary that the hood provides air leakage through open openings or leaks in this shelter at least 0.2 m / s; with extremely and especially dangerous and highly volatile substances, for greater guarantee, the minimum suction speed is increased to 1 m / s, and sometimes more.

General exchange ventilation is used in cases where there are scattered sources of harmful emissions that are practically difficult to fully equip with local exhausts, or when local exhaust ventilation for some reason does not provide complete capture and removal of emitted harmful substances. It is usually equipped in the form of suction from areas of maximum accumulation of harmful substances with compensation for the removed air by the influx of outside air, which is usually supplied to the working area. This type of ventilation is designed to dilute the hazards released into the air of working premises to safe concentrations.

To combat toxic dust, in addition to the general technological and sanitary measures outlined, the anti-dust measures described in the previous section are also used.

HARMFUL CHEMICALS. PREVENTION OF OCCUPATIONAL POISONING AND DISEASES

Prevention of occupational poisoning and diseases

The layout of industrial buildings in which harmful emissions are possible, their architectural and construction design and the placement of technological and sanitary equipment should, first of all, ensure the predominant supply of fresh air both naturally and artificially to the main workplaces, service areas. For this it is expedient similar productions be placed in low-span buildings with opening window openings for natural intake of outside air into the workshop and with the location of service areas and stationary workplaces mainly near the outer walls.

In cases of possible release of especially toxic substances, workplaces are located in closed consoles or isolated control corridors, and sometimes the most dangerous equipment in terms of gas emissions is placed in isolated cabins. In order to exclude the danger of a combined effect of several toxic substances on workers, it is necessary to isolate production sites with various hazards from each other as much as possible, as well as from sites where there are no harmful emissions at all. At the same time, the distribution of the inflow and exhaust of ventilation air should provide for a stable backwater in clean or less polluted rooms with harmful emissions and vacuum in more gassed ones.

For interior lining of floors, walls and other surfaces of workrooms, building materials and coatings should be selected that would not absorb toxic vapors or gases in the air and would not be permeable to liquid toxic substances. In relation to many toxic substances, oil and perchlorovinyl paints, glazed and metlakh tiles, linoleum and plastic coatings, reinforced concrete, etc. have such properties.

The above are only general principles for improving working conditions when working with harmful substances; depending on the hazard class of the latter, their use in each specific case may be different, and in some of them a number of additional or special Measures are recommended.

For example, sanitary standards design industrial enterprises(SN 245 - 71) when working with hazardous substances of hazard classes 1 and 2, it is required to place technological equipment that can release these substances in isolated cabins with remote control from consoles or operator zones. In the presence of "substances of the 4th hazard class, it is allowed to suck air into adjacent rooms and even partially recirculate it, if the concentration of these substances: does not exceed 30% of the MPC; in the presence of substances of the 1st and 2nd hazard classes, air recirculation is prohibited even during off-hours and blocking is provided local exhaust ventilation with the operation of technological equipment.

All of the above measures are mainly aimed at preventing air pollution of working premises with toxic substances. The criterion for the effectiveness of these measures is the reduction of concentrations of toxic substances in the air of working premises to their maximum permissible values ​​(MAC) and below. For each substance, these values ​​are different and depend on their toxic and physico-chemical properties. Their establishment is based on the principle that a toxic substance at the level of its maximum permissible concentration should not have any adverse effect on workers, detected modern methods diagnostics, with an unlimited period of contact with him. In this case, a certain safety factor is usually provided, which increases for more toxic substances.

To control the state of the air environment, organize measures to eliminate identified hygienic deficiencies and, if necessary, provide first aid in case of poisoning at large chemical, metallurgical and other enterprises, special gas rescue stations have been created.

For a number of harmful substances, especially hazard classes 1 and 2, in recent years automatic gas analyzers have been developed and began to be used, which can be interlocked with a recording device that records concentrations throughout the shift, day, etc., as well as with sound and light signals , announcing the excess of MPC, with the inclusion of emergency ventilation.

In cases where it is necessary to carry out any work at concentrations of toxic substances that exceed their maximum permissible values, such as: liquidation of accidents, repair and dismantling of equipment, etc., it is necessary to use personal protective equipment.

To protect the skin of the hands, rubber or polyethylene gloves are usually used. Sleeves and aprons are made from the same materials to prevent the wetness of overalls with toxic liquids. In some cases, the skin of the hands can be protected from toxic liquids with special protective ointments and pastes with which hands are lubricated before work (pastes of HIOT, Selissky, various talkers, etc.), as well as the so-called biological gloves. The latter are thin layer film formed during the drying of highly volatile non-irritating special compounds such as collodion. The eyes are protected from splashes and dust of irritating and toxic substances with the help of special goggles with a tight-fitting soft frame to the face.

If potent substances get on the skin or mucous membranes of the eyes, oral cavity, they must be immediately washed off with water, and sometimes (if caustic alkali or strong acids get in) and neutralized by additional wiping with a neutralizing solution (for example, acid - weak alkali, and alkali - weak acid).

If the skin is contaminated with hard-to-wash or coloring substances, they cannot be washed off with various solvents used in industry, since most of them are in. It has toxic substances in its composition, so they themselves can irritate the skin or even penetrate through it, causing a general toxic effect. For this purpose, special detergents should be used, such as Rakhmanov's paste, etc. At the end of the shift, workers should take warm shower and change into clean home clothes; in the presence of especially toxic and impregnating clothing substances, everything should be changed up to underwear.

In those industries where, after the implementation and strict observance of all preventive measures, there is still a certain danger of possible exposure to toxic substances, workers are provided with benefits and compensations that are provided for by the standards, depending on the nature of the production.

When entering a job where there is a risk of contact with toxic substances, workers undergo a preliminary medical examination, and when working with substances of chronic action - a periodic medical examination.

CONTROL OF THE CONTENT OF HARMFUL CHEMICAL SUBSTANCES IN THE AIR OF THE WORKING AREAHARMFUL FACTORS OF PRODUCTION ENVIRONMENT OF CHEMICAL ORIGIN.

The requirements laid down in the document “Guidelines for the hygienic assessment of factors in the working environment and the labor process. Criteria and classification of working conditions", establish the procedure for monitoring the content of harmful chemicals and aerosols of predominantly fibrogenic action in the air working area.

The management determines the choice of places (points) for sampling the air of the working area, the frequency of their sampling, the procedure for evaluating the measurement results.

To determine the presence of harmful substances in the air of the working area, express and indicator methods are used. The express method is based on fast chemical reactions with a change in the color of the filler in transparent glass tubes.

The indicator method for determining the most dangerous substances in the air uses the property of some chemical reagents to instantly change color under the influence of even negligible concentrations of only certain chemicals or chemical compounds.

To control the concentration of harmful substances in the workplace, the method of sampling in the breathing zone is used. Quantitative and qualitative analysis is carried out using chromatographs or gas analyzers. The actual values ​​of the concentration of harmful substances are compared with the MPC standards.

PROTECTION AGAINST THE HARMFUL EFFECT OF CHEMICAL SUBSTANCES HARMFUL FACTORS OF THE PRODUCTION ENVIRONMENT OF CHEMICAL ORIGIN.

The main measure of protection against the harmful effects of chemicals on workers in conditions possible pollution working area is a systematic control of the content of these substances in the working environment. In the event that the content of harmful substances in the air of the working area exceeds the MPC, special organizational and technical measures are taken to prevent poisoning.

Organizational measures include the mandatory use of personal protective equipment (special protective clothing, footwear, gloves, helmets, gas masks and respirators, goggles, protective face shields, neutralizing pastes and ointments to protect and clean the skin). For example, persons employed in work with leaded gasoline should be provided with PVC aprons, gloves, and rubber boots. To work with timber treated with antiseptics, workers without overalls and protective equipment (tarpaulin jackets, trousers, rubber boots, mittens) are not allowed.

With the peculiarities of the professional activity of employees, when there are no technical and organizational possibilities to reduce the concentration of harmful and hazardous chemicals in the air of the working area to a safe level, working conditions are assessed according to the criteria given by the “Guidelines for the hygienic assessment of factors of the working environment and the labor process. Criteria and classification of working conditions.

Classes of working conditions are established depending on the type of harmful substance of a chemical nature and the multiplicity of exceeding its MPC in the air of the working area. For employees who are constantly in the zone of release of toxic substances, protection measures have been established by limiting the time spent in a dangerous or harmful environment (shortened working hours, breaks in work, additional leave, reduced length of service for retirement).

The government has approved a list of harmful and dangerous substances, when working with which preliminary and periodic medical examinations of employees are mandatory. The frequency (terms) of examinations in medical institutions has also been established.

Technical measures include: sealing of equipment and communications, automatic control of the air environment, natural and artificial ventilation, alarms, remote control, installation of safety signs.

Special tanks are used to transport chemically harmful liquid substances. Technological processes for loading hazardous substances, their discharge or squeezing out of tanks, as well as washing and steaming tanks are carried out in ways that exclude contact of workers with harmful substances.

For transportation to the place of loading and in the process of loading bulk materials, conveyors and elevators should be used; for dusty powder materials (cement, lime, etc.) - pneumatic transport or conveyors with the use of dedusting devices. For liquid hazardous substances - pipelines that exclude the leakage of these substances.

In emergency situations, a person may be exposed to short-term, but with a significant excess of MPC, exposure to harmful and hazardous chemicals. There is no need to talk about permissible concentrations in places of emergency work. The protection of workers is carried out by the mandatory use of personal protective equipment and the rationing of the permissible work time in the accident zone.

HARMFUL BIOLOGICAL FACTORS AND THEIR SOURCES HARMFUL BIOLOGICAL FACTORS IN THE PRODUCTION ENVIRONMENT.

Harmful biological factors: pathogens, living cells and spores are the causative agents of infectious diseases that can cause infection in humans or animals.

One of the main sources of harmful biological factors in railway transport is the sanitation zones of wagons after the transportation of sick livestock. Economic and commercial ties of our country with foreign countries made this a serious problem. Periodically, cargoes began to arrive from regions with an unfavorable epidemiological and epizootic (presence of mass livestock diseases) situation.

Wherein harmful factor can be both animals themselves and products of animal origin (leather, furs, etc.). For workers who have contact with pathogens of infectious diseases, working conditions can be assigned to class 3.3.

Biological harmful substances of plant origin are also transported by rail.

CONTROL PREVENTION MEASURES HARMFUL BIOLOGICAL FACTORS IN THE PRODUCTION ENVIRONMENT.

Organizational measures to prevent infection during loading, unloading, sorting, customs inspection and transportation of biologically dangerous goods include: regulatory documents and rules for the transportation of infectious substances by rail, supervision of the transportation of sanitary and epidemiologically significant goods, development of emergency maps, regulation of the work of border sanitary control points, organization of disinfection and washing stations for the disinfection of wagons, packaging and cargo.

Organizational measures to protect workers include hygienic regulation and the use of personal protective equipment.

MPCs of microorganisms in the air of the working area are regulated by the document “Guidelines for the hygienic assessment of factors in the working environment and the labor process. Criteria and classification of working conditions. Classes of working conditions are established depending on the content of the biological factor in the air of the working area.

The criterion is the multiplicity of exceeding the MPC (in the absence of technical and organizational opportunities to reduce their content in the air of the working area).

The use of personal protective equipment includes the use of special protective clothing, shoes, gloves, headgear; for respiratory protection - gas masks and respirators; for eye protection - goggles.

Technical measures to protect workers include: equipment and preparations for disinfection, disinsection (destruction of harmful insects and ticks using chemical and biological agents), deratization (extermination of rodents that are sources or vectors of infectious diseases, such as plague), protective devices, automatic control air environment, the use of natural and artificial ventilation, alarms, remote control, safety signs.