Emergency assistance for drug addicts

What is "First Aid" no.

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Attention! This page is not to study all the medicine, or at least all the urgent narcology. It uses a very simplified description of schemes and techniques are designed only for first aid. Tip: A related drug addicts to take courses for home nursing and learn how to practice first aid. Complications are regular drug status, life-threatening and require emergency care. They can develop at any addict. The more experience of drug abuse, the higher the probability of their occurrence. What is this condition? It should be noted that only directly threaten the lives of respiratory and heart failure, which usually develop together. Here's talk about how to recognize these states and help in the event of their occurrence. Attention! If you have no medical education, and you is not working as a nurse in a hospital drug or poison, the best help you can provide - IMMEDIATELY make a patient with threatening the state was under the supervision of professionals (the easiest way to cause "fast"). Overdose of drugs is a major cause of life-threatening conditions addict. Who it is particularly common in drug-abusing opiate group - heroin. Important! If you have a relative "heroin addict", you need to have at home at least one injection of the drug honey "Naloxone" because "fast" may not have time. When symptoms of an overdose of heroin, it is necessary to inject naloxone (maybe im), it is the most effective first-aid, which is used by doctors "ambulance".

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Overdose is not less dangerous to use cocaine and amphetamine. Heroin overdose of sleeping pills or respiratory arrest calls directly without any additional reasons. Respiratory arrest in this case is not a sudden, it seems to be "developed" gradually, that is, the patient's breathing becomes shallower and more rare. Outwardly, it looks as if the person just deeply asleep. The skin in these cases, very pale, cold to the touch; lips, fingertips and ears - bluish color. The issue of parents: How do you determine that a drug addict respiratory disorders? Best of all - just listen to the way he breathes.

But it is necessary to bring the right ear to the patient's face. Proper breathing - When in a dream a person breathes deeply and rhythmically. At the same time take a breath to be heard at least 12 times per minute. If you hear that: 1. The victim does not breathe for 1 minute. 2. Breathing less than 10 times per minute, or more frequently than 30 times per minute; 3. He is breathing irregularly, "pausing" for 30-60 seconds and then starts to breathe deeply and loudly; 4. Breathing is very rare and barely audible for 10 minutes or more; 5. When his breath ear heard gurgling wheeze - so it is urgently necessary to assist and to cause "fast". If you have found a rare shallow breathing of a sleeping drug addict, immediately begin to shake and clap his cheeks. If as a result of your efforts to wake up, sit or jump to his feet and loudly inveigh against you - all right, you too can curse him back and calm down. If he does not wake up, wake up not to the end and will remain sluggish, urgently call "ambulance." It is better if "soon" will cause an assistant, and you at this time continue to bother.

If you become sick at least talk to keep it going and do not stop to talk with him while "ER" will not come. If as a result of your efforts, he still can not speak, begin artificial respiration "mouth to mouth". The point is not complicated, but it requires physical effort, so far as possible, draw him a healthy man. Artificial respiration "mouth to mouth" is done as follows: Place the victim on a hard, flat surface (preferably on the floor). His finger check for him in the mouth of any foreign objects (eg, vomit). Under the shoulders (not behind his head, do not under your neck!) Enclose tightly rolled cushion thickness of about 15-20 cm. (For example, you can roll up tight flannel blanket) so that his head was badly thrown back and his mouth opened.

Use your fingers to pull out the upper jaw, as shown in the figure. This is necessary to ensure that the language of the victim is not sunk and blocked airways. Pinch his nostrils with your fingers or clothes pegs - but not very tight, so as not to damage the nose. Take a deep breath, firmly press his lips to it, and do a quick strong breath (for the victim it would be a breath). And do so at least 10 (preferably 12) times per minute. Exhale it will have to happen on their own. You understand that you are working correctly when affected by breathing will be much movement of the chest, and her lips and fingertips he porozoveyut. Artificial respiration "mouth to mouth" so physically difficult task, it is better to produce it together and change often. So if you were going to do, call for help. But it is the only effective method of artificial respiration.

An overdose of stimulants (cocaine and amphetamine) is dangerous not only to the development of a psychotic condition with delusions and hallucinations, but can cause serious and direct violation of heart rate (which is such a path: tachycardia => atrial fibrillation => ventricular fibrillation => cardiac arrest). Ventricular fibrillation is accompanied by cessation of breathing. Usually respiratory arrest occurs suddenly, rather than gradually as an overdose of opiates (heroin). So if you have found the victim not breathing, immediately check his pulse in the carotid artery (located on the side of the neck just below the angle of the mandible - Feel at home right now, where there is the pulse. Found? That's what it looks like to the touch). If there is no breathing and no pulse, this is called "clinical death". So, you need to call in addition to the "first" to start emergency measures - artificial respiration "mouth to mouth", while chest compressions (closed, because the heart is massaged through the thorax).
Breath "mouth to mouth" described above. Closed cardiac massage is done as follows: The victim is placed in the same position as for artificial respiration. First (manual defibrillation - "to run the Heart") made two strong, with all his strength, hitting his fist on the sternum - the vertical axis of symmetry of the chest by 5-6 cm. Above the "solar plexus" (ie at the level of 4 th intercostal space).
If after this pulse and breathing on there, you stacked palm - one to the other - in the place where he had just punched (not the entire surface of the palm, and the part that hand is attached to the forearm - as shown in Fig. 8) and start producing on the sternum sharp pushes all the weight of the body so that the sternum went down by 5-6 cm. The frequency of shocks should be approximately 1 per second. If you work together, then one should have to breathe 4-5 shocks if you alone are fighting for the life of the victim - first do two breaths, then 15 aftershocks, then again two breaths, and so on. These activities can be quite long, and if you have no confidence that the victim breathing, keep them for as long as is not coming "soon."

Does not weaken the effort! In books resuscitation write that this way can be long (over 30 minutes) to maintain the life of the patient. I personally do artificial respiration "mouth to mouth" and chest compressions. I must say that this is a decent exercise even for two healthy men. And again, even with the specially trained critical care teams is considered incredibly high efficiency, when it is possible to catch his breath every second (ie 50%) patients with clinical death. So do not reproach himself if that fails you - Are you sure you have done everything possible to save the victim. irregular heartbeat - we are, in general, was dismantled. I just want to note that it is not always arrhythmias arise from overdose, sometimes they are against the backdrop of withdrawal. Fortunately, in this case, to ventricular fibrillation is not usually the case comes.
Just a man feels weakness, lightheadedness and "failures" of the heart. This bell: enough to misbehave, it's time to see a doctor. Because if the heart is not treated, it fails.

Next condition - sepsis, in Russian it is called blood poisoning. Before describing it, I'll talk about why sepsis occurs. You remember that the drug is inevitably reduced immunity, that is, the body's ability to fight off infection? So, in practice, this means that they can be easily (and quite often) there are various purulent diseases. Very often - those who inject drugs intravenously. When injection drug users rarely use non-sterile needles, never treated with the injection site with antiseptic, and sterile drug solution itself is rare. As a result, the bacteria penetrate directly into the tissues of the body, and there are about the complications thrombophlebitis - inflammation within the vein. On the wall of the damaged vein injection of a blood clot formed from blood cells and germs get inside of the thrombus already during its formation. Then they begin to proliferate (and why would not they multiply - warm, and the food is, and there is no immunity). As a result, the outflow of blood from the tissues of this vein stops and the arm (or leg) the patient strongly swells.
Because the process is accompanied by inflammation, limb becomes red and hot to the touch. Redness and pain spread right along the vein. If the patient is not treated, the infection begins to spread through the blood vessels and as a result we have sepsis. There is another danger directly from thrombosis: if the femoral thrombophlebitis ("groin", as it is called diseased) vein, the case may end in amputation of the limb. Besides this vein, outflow tract of the legs virtually non-existent, and the complete cessation of blood circulation in it is accompanied by necrosis (dying away) tissue of the lower limb. Urgent need drug treatment.

Abscess - limited purulent fusion of subcutaneous fat. Got under the skin bacteria, meeting no resistance, begin to multiply rapidly, "digest" cellulose and the result is a "pouch" containing pus. Outwardly it looks like a painful abscess, bright red, swollen area of ​​skin in a confined place where used to be a shot. It is usually accompanied by fever. If the "pouch" will erupt in the deeply lying tissues, it will abscess, and if the blood vessel breaks inside - is sepsis.
Cellulitis - almost the same as that of an abscess, but not in the form of a "bag," but in the form of free software intermuscular intervals streaks of pus. Externally similar to an abscess, but takes a limited region, and covers a significant part of the limb. It is also accompanied by pain, swelling, fever, and even interfere with the movements of the limbs. All these diagnoses are found most often in dezomorfinovyh addicts. Dangerous, besides of sepsis, purulent fusion of nerves, blood vessels, muscles, bones and everything that gets in her way. You see, as a result of any of purulent processes may develop sepsis. Sepsis - a very difficult and very dangerous condition. At home, it will inevitably lead to death, and in the hospital with him extremely difficult to fight. Signs of sepsis are severe weakness; heat that is lost, then jumps to 39,50S and above; perspiration; drop in blood pressure.

May be optional features like rash all over the skin. As a rule, sepsis is the "gate of infection" - those thrombophlebitis, phlegmon or abscess, from which all started. If you suspect that your loved one developed thrombophlebitis, abscess or cellulitis immediately in until it turned to the surgeon (because addicts usually try to treat them yourself). For when these sores lead to sepsis, need to call "soon" - and still do not know whether to keep his life emergency hospitalization in the intensive care unit. There is a complication that is experiencing virtually every regular injecting drug users. On freaky language it is called "shaking" or "vibrating conveyor." On health - hyperthermic response, or hyperthermia. Hyperthermia occurs because a huge dose of microbes goes directly into the blood with a solution of the drug. This means that when hyperthermia (though very rarely) Sepsis can occur immediately, without prior thrombophlebitis, abscess or cellulitis. If a patient tells you that immediately after the injection felt not good, but rather, bad - there shivering, malaise, weakness, aching joints, nausea, headache - so he introduced himself substandard drug solution and a hyperthermic response. Perhaps this is the only situation where irreconcilable fighter against drug addiction advise you to do everything to ensure that the addict immediately received a "qualitative" drug in sufficient dose - for health reasons. For after hyperthermia can occur not only sepsis and severe renal failure and heart disease. And the introduction of the drug makes it good. Do not kupites - a patient should be a temperature not less than 38 C.
And look - if he understands that in this way can you get money for drugs, he will start to use it. So keep in mind: twice hyperthermia practically does not happen, and every week she is unlikely to occur. If the addict is not really bad, you can substitute drug to aspirin or analgin with tavegilom (alternative is intravenous antibiotics along with hormones of the adrenal glands, such as prednisone - but this advice for physicians). Usually hyperthermic reaction is fairly short-lived, especially if it is "treat". If the patient's condition is very bad and it is not uluchaetsya for 6 hours or more, it is necessary to cause "fast" - let doctors understand what was going on.
Injuries happen with everyone. The problem is that drug addicts they happen once in 15 more often than other people. The main reason is clear - when the mind clouded or changed is not easy to avoid dangerous situations. In addition, the life of an addict too close to the criminal world, where unexpected "adventures" at every step. And injuries are sometimes very serious, moreover, life-threatening. What to do in case of an injury? It depends on its type and severity. Bleeding is a dangerous condition, especially if the blood is flowing very strongly - from an artery or a large vein. Bleeding from the artery it is characterized by the fact that blood is bright scarlet color and flows shocks (corresponding to pulse frequency).
Sometimes, you can even notice a pulsating stream of the wound. Even if such a very thin stream, with arterial bleeding must be applied tourniquet (otherwise the bleeding will not stop). Wiring can be made from scrap materials (rope or cloth) or use ready - rubber. The main thing is tighter tighten it to lower his pulse is not detectable (and hence efforts are needed!). The rules are: 1. Wiring should be cast as soon as you realize that the bleeding - blood, that is, before applying bandage. 2. The harness should not impose too high - just above the wound, the closer it is, the better. 3. Wiring not impose on the bare skin, and a bandage made of fabric or clothing, to avoid infringement of the skin. 4. Wiring should be visible, that is, on top of the harness should not apply a bandage. It is better if you write down on paper the time tourniquet and throw at a note directly below the tourniquet. On the wound, of course, it is necessary to apply a bandage. 5. Of course, that tourniquet better immobilize (immobilize), ie primotat to her bus. The tire can be made of sticks. 6. This certainly it is necessary to wrap up warm as it is not supplied with blood. 7. The harness should not pull the vessel over 2 hours at an air temperature above 100C, and more than 1 hour at a temperature below this. 8. Therefore, once you have left a tourniquet, you should immediately call "soon" - still have a wound at least sew.
If the blood is not too much, and it flows more or less steady stream of dark color, it is - venous bleeding. It can be stopped by putting a tight bandage. If for any reason you can not stop the heavy bleeding described means, just try to shut tightly wound improvised material (cloth), or even to pinch your fingers. Blood poisoning - even when it happens, and if the victim dies from blood loss, doctors simply have no one to treat sepsis. Burn - a fairly common injury in drug addicts dependent on opioid drugs.They "cook" drugs with the use of flammable substances like warm up, smoke and sleep at the same time, also in the intoxication do not feel pain. Therefore, they are often fired heaters on and, as a result of fires caused by cigarettes and ignition of the solvent during the "cooking".
The burns are dangerous to life when burned surface occupies a large part of the body (for example, the entire arm or leg). Deep burns, even small size, heal very badly and sometimes require skin grafting. Besides, always become infected burn wound. Therefore, I advise you not to treat burns on their own, unless your goal is not to the formation of painful scar ugly burn on the spot. With extensive burns cause "fast" immediately! Or go to the surgeon immediately if the burn is small. Many people try to use means of pain relief before visiting the doctor. In my experience I can say that it is best to place the burned area under cold water, and keep it as long as possible.
If the burn is extensive, close the burned surface with a damp cloth and constantly moisten it. In no case do not lubricate with oil or fat fresh burn! Especially, do not fall asleep salt thereof as did one of my friends to help his friend. Only cold water and call a doctor as soon as possible! Head injury is also common among drug abusers. About head injuries, remember the following: If immediately after the trauma victim is unconscious; if he were dizziness, weakness, nausea, vomiting, and even more so - a concussion. So he should lie, and do not walk and it is best to call a doctor. If the patient's condition after the injury did not matter, but, in general, tolerant, and after a few hours or even 1-2 days it got worse, there were weakness, drowsiness, nausea or vomiting - perhaps this is an intracranial hemorrhage. In this case, the victim should be packed and urgently call "ambulance."
The trauma of the spine - a rare phenomenon, and usually happens to those who fall out of the windows of the upper floors. If you happen to fall from a great height and the victim complains of back pain, it is better not to touch it - let it lie like lying, and quickly call the "ambulance." If you must move the victim or explore, then it must be put on a firm, flat surface (shield or ground). Do not carry it on your hands or a blanket! This could worsen his condition. Fractures are life-threatening only in case of severe bleeding (requiring bandaging or harness to splint), or if a broken hip. In any case, no plaster is not properly broken srastetsya, so will have to go to the doctor is necessary. Suspect fracture should always, when after a painful injury limb work or move it. Pneumonia (pneumonia) in drug addicts is developed quickly and runs hard. In addition, it is sometimes complicated by pulmonary edema, which is a fatal condition. Moreover, at present very real risk of tuberculosis. Therefore, I advise you not taken lightly coughing and a temperature of a drug addict. In a typical background of reduced immunity cough and temperature have a few days can turn into a serious illness. Devices imaging veins - the diagnostic lamp RAY-M200

First aid

CPR resuscitation. Providing first some help. Cardiovascular pulmonary reanimatsiya.Odnovremennoe artificial respiration and chest compressions. When embarking on intensive care. The death of clinical, biological death. MUST NOT waste time clarifying the circumstances of what happened and amenable to panic! Artificial respiration, chest compressions. Rules for making resuscitation: one rescuer, two rescuers. Signs of effective resuscitation. COMPLEX CARDIO resuscitation.

First aid.
Stop the bleeding.
Surfacing wounds.
General rules imposing a soft bandage.
Bandage on his head and neck.
The immobilization of fractures and dislocations.
Transportation victims zhelutka washing, first aid kit. First aid - is: 1. Provide immediate medical care until the arrival of qualified doctors. 2. This treatment for victims before the arrival of skilled care. 3. Most often, first aid involves maintenance of life of the victim until help arrives. When there is a need for first aid is necessary priderzhivatsya the following rules: 1. Do not panic. Stay calm. 2. Do not move seriously injured victim, except in cases where the victim needs the fresh air, or in order to protect from further injury. 3. Spend a careful examination of the victim. 4. If you need to take immediate measures to save the lives of (artificial breathing, stop bleeding, etc.) to provide relevant assistance without delay. 5. Call the required services.