Basic knowledge of coal mine emergency

1. First aid principles of trauma

1. For fracture patients, they should be fixed first and then transported2. Stop bleeding first and then transport

3< The blood volume of adults is about 4300-5000ml, which is equivalent to 1 / 13 of their body weight. 1f the blood loss is more than 1000ml, their lives will be in danger. 1n order to avoid excessive blood loss, temporary hemostasis should be used quickly (1) dressing compression wound hemostasis method the situation is urgent after the injury. 1n order to fight for time and save lives, dressings, such as clean towels, handkerchiefs, torn work clothes, etc., can be used for pressure bandaging hemostasis with things that can be easily obtained, or hand pressing close to the wound can be used for hemostasis. This method is suitable for capillary hemorrhage< (2) finger pressure hemostasis in the emergency situation where tourniquet can not be used or there is no tourniquet or other substitute, finger pressure hemostasis can be used temporarily, that is, pressing the artery above the wound onto the bone below with fingers to achieve the purpose of hemostasis. This method is a temporary emergency hemostasis method. Finger pressure hemostasis A, head and neck bleeding B. axillary and upper arm bleeding C. forearm, elbow, lower arm and hand bleeding D. lower extremity arterial bleeding< (3) limb flexion method uses the extreme flexion of the joint to compress the blood vessels to achieve the purpose of hemostasis. 1f the forearm or leg bleeding, can be placed in the elbow or knee fossa a cotton pad, and then make the joint extreme flexion, and then the leg and thigh or forearm and upper arm with “8” bandage together< (4) tourniquet hemostasis method the large artery of limbs ruptured and bleeding, the bleeding speed is very fast, so it needs to stop bleeding quickly. Tourniquet, rubber tube, etc. can be used. 1n case of emergency, wide cloth, rope, triangular towel, etc. can also be used. However, gun wire, electric wire, string, etc. cannot be used to bind. Air tourniquet is the best< The procedure of hemostasis with tourniquet is as follows: A. hold the tourniquet in your left hand with a length of 13-17cm, keep the back of your hand close to the pad, and hold the long end of the tourniquet in your right hand B. with the right hand, the tourniquet should be stretched and taut, wrapped under the left hand and the limbs separated by clothes or pads, tightly braided for 2-3 turns, and the tourniquet should be tightened, and then the tourniquet should be clamped between the left middle finger and the index finger C. hold the tourniquet between the middle and index fingers of the left hand and pull it down along the limbs to make the tourniquet form a ring D. insert the upper end into the ring and tighten it 5) strangulation hemostasis method when there is no tourniquet, it can be folded into a band with towel, triangular towel, bandage, handkerchief, rag and other materials, put a pad above the wound, tie a knot around the pad, insert it with a small stick, lift it first, strangle it until there is no bleeding, and then fix the other end of the stick with a cloth strip below wound dressing in the process of underground operation, if there is trauma, the symptoms of trauma are damage, fracture and bleeding. Bandaging is a kind of on-site rescue method for general skin injury. 1t has the functions of fixing dressing, splint position, hemostasis and supporting the injured limb. When skin and muscle are rubbed or lacerated, it is necessary to immediately avoid wound contamination and bandage by hand. Wound dressing materials are: first aid kit, bandage, triangular towel, four headbands. 1f the above materials are not available on site, they can be replaced by towel, handkerchief, clothes, etc< (1) the purpose of bandaging is to protect the wound, reduce pollution, stop bleeding, fix the limbs, reduce pain and prevent secondary injury. Therefore, in the process of bandaging, we should act quickly and quickly, and do not touch the wound to avoid bleeding, pain and infection (2) the wound should not be washed with underground sewage, and the foreign bodies on the surface of the wound should be transported to the hospital for removal to prevent repeated infection (3) the bandaging should be gentle, the tightness should be appropriate, and the knot should not hit the wound (4) the prolapsed viscera should not be taken back to the wound, so as to avoid infection in the body cavity (5) the wound after preliminary dressing in the mine should be rinsed, disinfected, debridement, sutured and re bandaged after reaching the surface clinic or hospital (6) the bandage should be 5-10cm beyond the edge of the wound fracture temporary fixation fracture fixation can reduce the pain of the wounded, prevent the adjacent tissues, blood vessels and nerves from being stabbed due to the displacement of the fracture end, and it is also an effective first aid measure to prevent traumatic shock< Key points of rescue: (1) according to the cause, location, symptoms and body symptoms of the injury, make a brief examination and judgment first (2) splint, bandage, triangular towel, cotton pad and other items should be used for fracture fixation. 1f they are not available at hand, they can be replaced by local materials, such as splint, branch, stick, cardboard, plastic board, clothing, towel, etc. 1f necessary, the injured limb can also be fixed on the uninjured limb of the wounded (3) fracture fixation should include upper and lower joints. Cotton or clothing should be applied at the joints of shoulder, elbow, wrist, knee and ankle to avoid crushing the skin at the joints. The fixation should be based on the inability of the injured limb to move and should not be too loose or tight (4) in the treatment of fractures, we should pay attention to whether there are visceral injury, hemopneumothorax and other complications, if there are, we should deal with them first (5) the handling should be light, fast and stable resuscitation of asphyxiated patients cardiac resuscitation there are two cases of cardiac arrest: one is that respiratory failure occurs first, which leads to cardiac arrest after ineffective rescue; The other is cardiac arrest at the beginning, such as poisoning, electric shock and so on A. resuscitation by percussion in the precordial area the stress of the heart is enhanced within half a minute after cardiac arrest. Percussion in the precordial area can often make the heart beat again. Methods: clench your fist with your hand, lift it to a height about one foot above the chest wall, from the left nipple to the middle of the chest, percussion 3 to 5 times continuously, and observe the pulse and heart sound. 1f recovered, it means successful resuscitation, otherwise, it should be given up immediately and changed to external cardiac compression< The operator stands on the patient's side (or straddles on the outside of the two thighs) and faces the patient. The root of the right palm is placed in the middle and upper part of the sternum, the left hand is crossed and overlapped on the right arm, and the elbow joint is straight. The heart is squeezed between the sternum and the spine and the blood is discharged, After that, the wrist is quickly relaxed to make the sternum reset due to the elasticity of the thorax. The negative pressure of the thorax caused by the rebound of the thorax can make the venous blood return to fill the heart. And then it's repeated in such a rhythmic way. The pressing rate is about 60-80 times per minute. During chest compressions, the head of the wounded should be lowered to 10-15., 1n order to facilitate venous blood return artificial respiration artificial respiration is to maintain the gas exchange of the wounded by artificial methods. 1n order to improve the hypoxia state of the body and eliminate the CO in the body, it is a method to create conditions for the recovery of spontaneous breathing. The following preparations should be made before artificial respiration: A. move the wounded to a safe, ventilated and warm place first B. lie flat on hard ground or wooden board: C. put clothes on the shoulders to make the neck over extended D. loosen the buttons, trouser belts and bare chest of the wounded< E. remove the foreign body, mucus and vomit in the mouth and nose of the wounded to ensure smooth breathing: F. make the head of the wounded lean back as far as possible, make the line from the mandibular angle to the earlobe perpendicular to the ground, and make the lower teeth higher than the upper teeth g. keep the face to one side to prevent the back of the tongue from blocking the respiratory tract the methods of artificial respiration include mouth-to-mouth artificial respiration, supine chest pressure artificial respiration and prone back pressure artificial respiration. The best method is mouth to mouth artificial respiration, which can be used except for poisoning patients. The first step is to make the wounded lie on his back, put a soft pillow or clothes under his shoulder, and put his head back as far as possible; 1n the second step, the operator kneels on the other side of the wounded, covers the nose and mouth of the wounded with handkerchief, gauze or mask, raises the patient’s head from the jaw with one hand, and opens the mouth, and holds the patient’s nostril with the other hand to prevent gas leakage from the nostril. 1n the third step, the operator takes a deep breath and blows hard at the mouth of the patient. The operator opens the hand holding the nose and allows the chest and lungs to retract and exhale. Keep every minute 16 times 18 times, with chest visible expansion or hear alveolar breathing sound as an effective sign supine chest pressure artificial respiration: first, let the wounded lie on his back with a soft pillow at the waist to lower his head and shoulders slightly; Second, the operator kneels near the head of the wounded, holds the middle of the two forearms of the wounded with both hands, and raises the two arms to the top of the head to expand the chest; Third, bend the arms close to the chest, and use the elbow of the wounded to move for two seconds, so that the air in the lung can be eliminated. Such a continuous one stroke, 20 times per minute or so is appropriate prone back pressure artificial respiration: first, make the wounded prone, face to one side, head down slightly, one arm bent on the head; Second, the operator kneels on the ground across the patient’s thighs, straightens his arms, puts his palms on the lowest pair of ribs at the lower part of the patient’s chest, separates his fingers, and then presses his weight forward from the lower part of the patient’s back through his two upper limbs for 3 seconds to press the gas out of the lung; Thirdly, the operator should straighten the upper body and release both hands to make the thorax of the wounded expand naturally and absorb air. After two seconds, it should be repeated, about 20 times per minute. Do not use excessive force to prevent rib fracture< 3. Transportation of the wounded. When there is work-related injury in the mine, the above-mentioned on-site rescue measures should be taken immediately, and then the wounded should be transported out of the well and sent to the hospital for treatment. Underground conditions are complex and roads are not smooth. 1mproper handling may aggravate the pain of the wounded, or even worsen the injury. Therefore, the handling of the wounded is also an indispensable part of trauma first aid. Attention should be paid to the following items during transportation: 1. The wounded with respiratory, cardiac arrest and shock coma should be resuscitated in time before transportation

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