[Problems in the work analysis of the Leningrad first aid station].
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Members of the public were questioned regarding previous first aid training and whether they believed that they would be able to manage a seriously injured person adequately. They were then assessed as to their awareness of basic principles of dealing with such a person. It was found that, whilst confidence as an independent variable was not associated with better knowledge, those who had some form of training were significantly more confident about their own abilities and also performed better in the assessment. However there remained a minority who would be unwilling to become involved in the initial treatment of a seriously injured person and training did not appear to reduce this tendency.
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A field trial of efficacy of local compression immobilization first-aid technique in 42 Russell's viper bite cases was studied and only 19 were envenomed. Proper immobilization was carried out in 3/13 immobilized cases. The average time of application of the pad was 1.12 hours (range 5 minutes to 7 hours) and the total duration of the pad application was 3 hours 40 minutes (range 30 minutes to 9 hours). Venom levels measured at the hospital before and at 15 and 30 minutes after release of the pad (n=10) showed a rise of 5 to 30 ng/ml of venom following release. Movement of venom antigen was found to be retarded in all cases (n=9) whose venom levels were measured at 15 and 30 minutes with the pad in place. Sixteen out of 19 cases had systemic envenoming, indicating that pad or immobilization alone is not effective in delaying spread of venom. The incidence of local necrosis 3/42 (8%) following use of the pad was comparable to that of the systemic cases without the pad. No ill effects were observed following its application for as long as 9 hours. Local blackening seen in 4/36 (10%) cases was likely to be result of a local venom effect.
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In the last 7 years were observed 945 patients with head injuries in our emergency care. First aid is aimed to stabilize respiration and cardiovascular system and to avoid secondary posttraumatic lesions.
Nurses have a moral duty to act when faced with emergency situations. Fear of legal recourse is no excuse for failing to provide first-aid care. This article considers the ethical implications for the nurse, midwife and health visitor at the scene of an accident.
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The advantages of the pressure/immobilization technique as the first-aid measure for envenomation are discussed. The use of arterial tourniquets is no longer recommended in the management of any type of envenomation in Australia.
In catastrophic disasters such as major earthquakes in densely populated regions, effective Life-Supporting First-Aid (LSFA) and basic rescue can be administered to the injured by previously trained, uninjured survivors (co-victims). Administration of LSFA immediately after disaster strikes can add to the overall medical response and help to diminish the morbidity and mortality that result from these events. Widespread training of the lay public also may improve bystander responses in everyday emergencies. However, for this scheme to be effective, a significant percentage of the lay population must learn in eight basic steps of LSFA. These have been developed by the International Resuscitation Research Center in collaboration with the World Association for Emergency and Disaster Medicine, the City of Pittsburgh Department of Public Safety, and the American Red Cross (Pennsylvania chapter). They include: 1) scene survey; 2) airway control; 3) rescue breathing (mouth-to-mouth); 4) circulation (chest compressions; may be omitted for disasters, but should be retained for everyday bystander response); 5) abdominal thrusts for choking (may be omitted for disasters, but retained for everyday bystander response); 6) control of external bleeding; 7) positioning for shock; and 8) call for help.
The first article in this series examined the nurse's duty to act at the scene of an accident. This article explores this theme further by looking at the legal implications and the four arenas of accountability.
The first and second articles in this series considered whether there was a duty in law to volunteer help when there was no pre-existing duty to do so and discussed the standard of care that should be followed. This article examines the volunteer's rights if he/she is injured while assisting at an accident.
If you are first on the scene of a disaster, approach safely and liaise with police and ambulance officers. Carry out triage, identifying those victims who need urgent treatment and those who do not--because they are not ill enough, too ill or dead. Establish priorities of treatment within the urgent group in the airway (A), breathing (B), circulation (C) sequence. Record assessment and treatment given.
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Explore the source record for details and available documents.