Medical means of protecting the population. Medical remedies

Radiation damage

Radiation injuries to unprotected people occur as a result of external short-term or prolonged exposure to certain doses of penetrating radiation and when they are found in an area contaminated with products nuclear explosion.

The flow of penetrating radiation from a nuclear explosion consists of gamma rays and neutrons, which act on the human body at the moment of the explosion (within 10 - 15 seconds). In an area contaminated with the products of a nuclear explosion, unprotected people can be damaged by external exposure to mixed beta - gamma radiation and as a result of the ingestion of the products of a nuclear explosion inside the body and on the skin. At the first stage, the mechanism of occurrence of radiation damage to the body is based on physical processes associated with the absorption of radiation energy and the formation of ionized atoms and molecules. As a result, biological processes and functions in cells, organs and systems of the body are disrupted and radiation sickness develops. The most radiosensitive are the organs of hematopoiesis, the gastrointestinal tract, germ cells, the nervous and endocrine systems are irritated. Disruption of the central nervous system leads to changes in the activity of internal organs and tissues.

In conditions mass destruction of the population of the greatest practical importance is ACUTE RADIATION DISEASE. It occurs with a single exposure, starting with a dose of 100 rad. A dose of 1 rad is characterized by the energy of any type of ionizing radiation absorbed in one gram of the medium and equal to 100 erg. A single exposure is understood to mean a dose received simultaneously or in fractional parts for a time not exceeding 4 days. With an increase in the dose of a single exposure, the severity of acute radiation sickness increases.

During acute radiation sickness, 4 periods are distinguished:

Primary radiation reaction;

Hidden;

Pronounced clinical manifestations (the height of the disease);

Recovery (outcomes of the disease).

At the moment of irradiation, a person does not experience any sensations.

The period of the primary radiation reaction, depending on the magnitude of the radiation dose received, begins either immediately after the irradiation, or after 1-10 hours and lasts from several hours to 2-3 days. During this period, the victim is agitated, irritability, general weakness, nausea, vomiting, headache, fever. In the wake of the expressed excitement in the victim, there is an oppression of his mental activity.

The latent period begins with the moment, and the disappearance of the signs of the primary radiation reaction. The state of health of the affected person improves, there may be complaints of general weakness and decreased appetite, and sometimes unstable stools. Sleep is disturbed. the latent period lasts from several days to 2 - 54 weeks. The shorter it is, the more severe acute radiation sickness develops. In the most severe cases, the latent period is absent altogether, the height of acute radiation sickness immediately sets in.

This period is characterized by the manifestation of all its signs. The victim again develops headache, insomnia, nausea, general weakness increases, and gastrointestinal upset with severe abdominal pain often occurs. Body temperature rises to 380 - 400 and keeps long time... Depletion of the body develops, multiple punctate hemorrhages appear on the skin and mucous membranes, there may be bleeding from internal organs: pulmonary, gastrointestinal, renal. In the second or third week, hair begins to fall out. Infectious complications often occur: tonsillitis, pneumonia, lung abscess and general blood poisoning - sepsis.

With mild and extremely severe acute radiation sickness, the peak period is not long. In the first case, it quickly ends with recovery, in the second, with the onset of death.

The recovery period begins with a decrease in bleeding, an improvement in the patient's motor activity and appetite, normalization of temperature, and restoration of normal stool. The general condition improves, the patient's body weight increases.

Depending on the magnitude of the dose of a single uniform external irradiation of the entire human body, it is customary to distinguish four degrees of severe acute radiation sickness:

Light (?), Occurs at radiation doses of 100-200 rad;

Medium severity (??), when the radiation doses are equal to 200 - 400 rad;

Severe (???), occurs at radiation doses of 400 - 600 rad;

Extremely severe (? V), in which the dose received is more than 600 rad.

Anti-radiation protection of the population.

Anti-radiation protection of the population includes:

Radiation hazard warning;

Use of collective and individual protective equipment;

Compliance with the behavior of the population in the contaminated area;

Protection of food and water from radioactive contamination;

Use of medical devices individual protection;

Determination of the levels of contamination of the territory;

Dosimetric control over exposure of the population and examination of radioactive contamination of food and water;

Buildings and structures to varying degrees (several times) weaken the effects of penetrating radiation on people sheltered in them.

Radiation doses are determined depending on the specific conditions of the population's activity either by calculation, or with the help of special dosimetric devices. Preventive means of medical protection are anti-radiation drugs available in individual first aid kit.

Syringe tube with analgesic agent;

Antidote pills;

Antibacterial agents;

Radioprotective agent;

Antiemetic, etc.

On the inside of the lid of the first-aid kit there is a designation of medical devices and instructions for use are attached.

Anti-radiation protection of the population. Medical prevention and first aid for radiation injuries.

Anti-radiation protection of the population includes: notification of radiation hazard, the use of collective and individual funds protection, observance of the behavior of the population on the territory contaminated with radioactive substances, protection of food and water from radioactive contamination, the use of personal protective equipment, determination of the levels of contamination of the territory, dosimetric control over the exposure of the population and examination of radioactive contamination of food and water.

According to the warning signals of the Civil Defense "Radiation hazard", the population should take refuge in protective structures. As you know, they significantly (several times) weaken the effect of penetrating radiation.

Because of the danger of getting radiation damage, you can not start providing the first medical care population in the presence of high levels of radiation on the ground. In these conditions, the provision of self-and mutual assistance by the affected population itself, strict adherence to the rules of behavior in the contaminated territory is of great importance.

In the territory contaminated with radioactive substances, one must not eat, drink water from contaminated water sources, and lie on the ground. The procedure for cooking and feeding the population is determined by the Civil Defense authorities, taking into account the levels of radioactive contamination of the area.

When providing first aid in the territory with radioactive contamination in the centers of nuclear destruction, first of all, it is necessary to carry out those measures on which the preservation of the life of the injured person depends. Then it is necessary to eliminate or reduce external gamma irradiation, for which protective structures are used: shelters, buried rooms, brick, concrete and other buildings. To prevent further exposure to radioactive substances on the skin and mucous membranes, partial sanitization and partial decontamination of clothes and shoes are carried out. Partial sanitization is carried out by washing clean water or rubbing damp tampons on exposed skin. The affected person is washed with eyes, allowed to rinse the mouth. Then, putting on a respirator, a cotton-haze bandage or covering his mouth and nose with a towel, handkerchief, scarf, carry out a partial decontamination of his clothes. At the same time, the direction of the wind is taken into account so that dust swept from clothes does not fall on others.

When radioactive substances enter the body, the stomach is washed, and adsorbents (activated carbon) are given. When nausea occurs, an antiemetic agent is taken from an individual first-aid kit. In order to prevent infectious diseases to which the exposed person becomes susceptible, it is recommended to take antibacterial agents.

The first-aid kit is individual.

Designed for prophylaxis and first honey. help with radiation, chemical and bacterial injuries, as well as their combinations with injuries. Carry a first aid kit in your pocket. It contains:

Slot No. 1: syringe tube with pain reliever (with colorless cap). Not included in the first-aid kit, issued by the decision of the MSGD district.

It is used for sharp pain caused by bone fractures, extensive burns and wounds, in order to prevent shock by inserting it into the thigh or buttock (it is possible through clothing).

Nest N 2: in AI-2 there is a prophylactic agent for OP poisoning - taren. Taren begins to act 20 minutes after ingestion. Take one tablet at a time at the Chemical Alert signal. Children under 8 years old take a quarter of a tablet at a time, 8-15 years old - half a tablet. A single dose of Taren reduces the damaging dose of OPA by 10 times. With an increase in signs of poisoning, take another single dose, then take the drug after 4-6 hours. Instead of tarren or in addition to it, the drug P-6 can be used. A single dose of 2 tablets provides protection from 3-4 lethal doses within 12 hours. The personnel of the Armed Forces and non-military formations of civil defense are provided with AI-1 first-aid kits, in which there is a medicinal preparation of Athens in a syringe tube with a red cap, used for poisoning with OP.

Nest 3: the antibacterial agent N 2 (sulfadimethoxine) is intended for the prevention of infectious diseases after radiation exposure. It is taken after irradiation in case of gastrointestinal disorders, 7 tablets at a time, 4 tablets in the next 2 days. Children under 8 years old on the first day 2 tablets, in the next 2 days, 1 tablet; 8-15 years old on the first day, 3.5 tablets, in the next two - 2 tablets.

Nest No. 4: radioprotective agent No. 1 (PC-1, cystamine tablets) - has a prophylactic effect in case of lesions ionizing radiation... Dose reduction factor (FUD) - an indicator characterizing the degree of reduction of the biological effect of radiation - when taking RS-1 is 1.6. If there is a threat of exposure, at the signal "Radiation hazard" or before entering a territory with an increased level of radiation, drink 6 tablets with water in 35-40 minutes. The protective effect lasts 5-6 hours. If necessary (continued exposure or new threat) 4-5 hours after the first dose, drink another 6 tablets. Children under 8 years old are given 1.5 tablets at a time, 8-15 years old - 3 tablets.

Nest No. 5: antibacterial agent No. 1 (chlortetracycline tablets with nystatin) is intended for general emergency prevention of infectious diseases (plague, cholera, tularemia, anthrax, brucellosis, etc.), the pathogens of which can be used as biological weapons.

Take when there is a threat of bacteriological infection or the infection itself (even before the type of pathogen is established). Single dose - 5 tablets at a time with water. Repeated administration of the same dose after 6 hours. Children under 8 years old take 1 tablet at a time, 8-15 years old - 2.5 tablets. PBS-1 can also be used for the prevention of infectious complications of radiation sickness, extensive wounds and burns.

Nest 6: radioprotective agent N 2 (PC-2, potassium iodide tablets 0.25 each) is intended for persons in the drop-out zone radioactive fallout: Blocks the thyroid gland for radioactive iodine from breath, food and water. Take 1 tablet on an empty stomach for 10 days (in Peaceful time in the event of an accident at a nuclear power plant, take all the time and another 8 days after the last release). Children 2-5 years old are given half a tablet, less than 2 years old - a quarter of a tablet, infants - a quarter of a tablet only on the first day. If you start taking it in the first 2-3 hours after the fallout of radioactive iodine, protection is 90-95%, after 6 hours - by 50%, after 12 hours - by 30%, after 24 hours - there is no effect.

Nest 7: An antiemetic agent (eaperazine) is used after irradiation, as well as for symptoms of nausea as a result of a bruised head. You can take no more than 6 tablets per day.

Dangerous medicines found in first aid kit in case of nuclear war

God forbid we all survive nuclear war... But you need to be ready for everything. For these reasons, since the days of the USSR, special first-aid kits have been produced - orange plastic boxes with capsules. Inside - radioprotective and antibacterial agents. If, in the event of a disaster, you manage to take a couple of the necessary capsules, then there is a chance of survival. More precisely, there were. Now the AI-2 (as the first-aid kits are called) themselves are dangerous. The Metropolitan Health Department sounded the alarm and sent out warnings.

For the first time, the scandal with the AI-2 first aid kits broke out several years ago. It turned out that they began to enjoy wild popularity among drug addicts who "tasted" the drug Taren, which is part of their composition. And first-aid kits AI-2 regularly disappeared from warehouses, until the tarn was officially deleted from its composition. But then another attack came. The drug for radiological protection, cystamine, was discontinued in 2007 in Russia due to unprofitability. Manufacturers turned to the Ministry of Emergency Situations with a request to replace it with potassium iodide, without going into subtleties. And those were.

First, the drugs are still different.

“Potassium iodide is designed to protect the thyroid gland from radiation damage,” experts explain. - It is useless to protect other human organs. Cystamine, on the other hand, has a wider spectrum of effects: it compensates for the destructive effect of ionizing radiation on cellular level in various fabrics.

Secondly, their dosage is very different. Potassium iodide needs to be used several times less. For some reason, the merchants forgot about it and left the instructions the same.

“In the event of an accident at some nuclear power plant, people will take pills as indicated in the instructions,” says the deputy. Sergei Kovalev, director of an enterprise specializing in civil defense equipment. - That is, 13 tablets, 125 mg per day. Taking such a dose on the first day will lead to a malfunction of the entire endocrine system - and people can become disabled for life. Some (for example, those with chronic kidney failure) may die.

Only one business per recent times distributed throughout Russia about 500,000 potentially dangerous AI-2 first aid kits. When the Moscow Department of Health found out about this, they urgently sent out warnings to various institutions (primarily military and civil defense) - in case of an emergency, do not take drugs from the first-aid kit according to the instructions.

- We have prepared a memo to the population, - say the pharmacists of the organizational and methodological department of the department. - And they just indicated the correct dosage of potassium iodide - 1 tablet per day. We explain that if more, it can lead to a coma. In general, it only seems that the AI-2 first aid kit is rarely used and the danger of error is not terrible. The military, rescuers, workers of nuclear power plants always have it in their pockets.

Theoretically, some residents could already suffer from AI-2 Of the Far East... After the accident at a nuclear power plant in Japan, they bought the same orange boxes in the nearest pharmacies. For your information, at each enterprise, according to the law on civil defense such first-aid kits should be (designed for 100% of workers in organizations located near nuclear power plants, and 30% for the rest).

When the uproar arose, the manufacturers started talking that the replacement of the pharmaceutical content was agreed with the certification body ... of suture and polymer materials. Experts are outraged: this could have been agreed with the certification body for carpets or something!

Recently, the Ministry of Health issued an order to abolish AI-2 (instead of it there will be AI-4). But the first-aid kit is still being produced and sold. Some merchants, however, in the instructions reduced the dosage to 2 tablets per day. But this, according to doctors, is a lot. And experts are also amazed that, unlike AI-2, in modern drug cases, they have the same shape (in order to save money) and do not allow you to determine the desired drug by touch in the dark or with temporary loss of vision. So you can take the wrong remedy at all. And then let the descendants wonder - from what he actually died ...

In the complex of protective measures carried out by the civil defense, great importance has the provision of the population with means of special prevention and first aid, as well as training in the rules for using them. The use of personal protective equipment in combination with respiratory and skin PPE is one of the main ways to protect people in conditions of the use of weapons of mass destruction by the enemy, as well as in peacetime emergency situations. Considering that in a difficult situation it is necessary to provide prevention and first aid in the shortest possible time, the use of medical devices in the form of self-help and mutual assistance is of particular importance.

Medicines personal protection is medical drugs, materials and special means, intended for use in emergency situations in order to prevent damage or reduce the effect of exposure to damaging factors and prevent complications.

The standard medical personal protective equipment includes:

• individual first aid kit AI-2;
• universal first aid kit household for the population living in radiation-hazardous areas;
• individual anti-chemical packages - IPP-8, IPP-10, IPP-11;
• medical dressing bag- PPM

Individual first aid kit ai-2 intended for prevention and first honey. help with radiation, chemical and bacterial injuries, as well as their combinations with injuries.

Carry a first aid kit in your pocket. It contains:

Slot No. 1: syringe tube of pain reliever (with a colorless cap). Not included in the first-aid kit, issued by the decision of the MSGD district. It is used for sharp pains caused by bone fractures, extensive burns and wounds, in order to prevent shock by inserting it into the thigh or buttock (it is possible through clothing).

Nest 2: AI-2 contains a prophylactic agent for OP poisoning - taren. Taren begins to act 20 minutes after ingestion. Take one tablet at a time at the Chemical Alert signal. Children under 8 years old take a quarter of a tablet at a time, 8-15 years old - half a tablet. A single dose of Taren reduces the damaging dose of OPA by 10 times. With an increase in signs of poisoning, take another single dose, then take the drug after 4-6 hours. Instead of tarren or in addition to it, the drug P-6 can be used. A single dose of 2 tablets provides protection from 3-4 lethal doses within 12 hours. Personnel The Armed Forces and non-militarized formations of civil defense are provided with AI-1 first-aid kits, in which there is a medicinal preparation of Athens in a syringe tube with a red cap, used in case of poisoning with OP.

Nest 3: Antibacterial N 2 (sulfadimethoxine) intended for the prevention of infectious diseases after radiation exposure. It is taken after irradiation in case of gastrointestinal disorders, 7 tablets at a time, 4 tablets in the next 2 days. Children under 8 years old on the first day 2 tablets, in the next 2 days, 1 tablet; 8-15 years old on the first day, 3.5 tablets, in the next two - 2 tablets.

Nest 4: Radioprotective agent N 1 (PC-1, cystamine tablets) - has a prophylactic effect in case of damage by ionizing radiation. Dose Reduction Factor (FUD) - an indicator characterizing the degree of reduction of the biological effect of radiation - when receiving RS-1 is 1, 6. In case of a threat of exposure, at the signal "Radiation hazard" or before entering a territory with an increased level of radiation in 35-40 minutes drink 6 tablets with water. The protective effect lasts 5-6 hours. If necessary (continued radiation or a new threat), 4-5 hours after the first dose, drink another 6 tablets. Children under 8 years old are given 1, 5 tablets at a time, 8-15 years old - 3 tablets.

Nest 5: antibacterial agent N 1 (chlortetracycline tablets with nystatin) is intended for general emergency prevention of infectious diseases (plague, cholera, tularemia, anthrax, brucellosis, etc.), the causative agents of which can be used as a biological weapon. Take when there is a threat of bacteriological infection or the infection itself (even before the type of pathogen is established). Single dose - 5 tablets at a time with water. Repeated administration of the same dose after 6 hours. Children under 8 years old take 1 tablet at a time, 8-15 years old - 2, 5 tablets. PBS-1 can also be used for the prevention of infectious complications of radiation sickness, extensive wounds and burns.

Nest 6: radioprotective agent N 2 (PC-2, potassium iodide tablets 0.25 each) intended for persons in the area of ​​radioactive fallout: it blocks the thyroid gland for radioactive iodine, which comes from the breath, food and water. Take 1 tablet on an empty stomach for 10 days (in peacetime, in the event of an accident at a nuclear power plant, take all the time and another 8 days after the last discharge). Children 2-5 years old are given half a tablet, less than 2 years old - a quarter of a tablet, infants - a quarter of a tablet only on the first day. If you start taking it in the first 2-3 hours after the fallout of radioactive iodine, the protection is 90-95%, after 6 hours - by 50%, after 12 hours - by 30%, after 24 hours - there is no effect.

N 7 socket: antiemetic (eaperazine) it is used after irradiation, as well as for symptoms of nausea as a result of a head injury. You can take no more than 6 tablets per day.

Individual anti-chemical package IPP-11 contains a polydegassing formulation in a bottle and a set of napkins. Designed for decontamination of skin areas, clothing and PPE adjacent to them, the population over 7 years of age from combat agents and BS. Avoid getting liquids in the eyes. The sequence of processing: wipe open areas of the skin (neck, hands) with a moistened swab, as well as the outer surface of the gas mask that was worn. With another swab, wipe the collar and the edges of the cuffs of the garment adjacent to the exposed skin. The degassing liquid can be used for decontamination of the skin, contaminated with radioactive substances, when it is not possible with water and soap to reduce the presence of radioactive substances to acceptable limits.

Medical dressing package PPM

The PACKAGE BANDING PPM is used for dressing wounds, burns and stopping certain types of bleeding. It is a sterile bandage with two cotton - gauze pads, enclosed in an impermeable hermetic package. The order of using the PPM: break the outer shell along the notch and remove it; expand the inner shell; take the end with one hand, and the roll of the bandage with the other and unfold the bandage; apply on the wound surface so that their surfaces, stitched with colored thread, are at the top.

Universal first aid kit, household

Equipped with the following tools:

• radioprotective means,
• general therapeutic drugs (aspirin, sedalgin, ammonia, besalol, validol, nitroglycerin, papazol, diazolin, phenazepam),
• antiseptic and dressings (brilliant green, potassium permanganate, derinat, levominol or mafenidine acetate, cotton wool, bactericidal adhesive plaster, bandage).

In addition to individual ones, the following medical protective equipment is used:

• radioprotective,
• pain relievers and antibacterial drugs,
• medical formulations from OS (SDYAV),
• dressings.

Radioprotective drugs include:

radioprotectors (preventive medicines reducing the degree of radiation injury (cystamine in AI-2)

chelators - drugs that accelerate the elimination of radioactive substances from the body (EDTA, getacin-calcium, unitiol)

adaptogens - drugs that increase the general resistance of the body (eleutherococcus, ginseng, Chinese magnolia vine, dibazol)

adsorbents - substances capable of capturing radioactive and other harmful substances on their surface and with them being excreted from the body (activated carbon, adsobar, vacocin)

antihemorrhagic agents (gelatin, serotonin) and stimulants

hematopoiesis (leukocetin, leucogen, pentoxil). Drugs in this group are used only when providing medical care and hospital treatment

stimulants of the central nervous system (indopan, bemegrid, sydnocarb) - are used in the provision of medical care and treatment in a hospital.

Protection against bacterial (biological) means of destruction consists of two directions - general emergency (antibiotic prophylaxis) and special emergency prevention of infectious diseases (immunization) with bacterial preparations (vaccines, toxoids).

Medical means of protection against SDYAV, OS are represented by antidotes (antidotes) - drugs that are physiological antagonists of poisons. These include: Athene, Atropine, Budaxim, Taren - against FOV and FOS; amyl nitrite (propyl nitrite), anticyanogen, chromosmon, sodium thiosulfate, antidotes of hydrocyanic acid and other cyanide compounds; unitiol is an antidote to lewisite and arsenic-containing SDYAV.

Personal protective equipment- these are medical preparations, materials and special means intended for use in a combat situation and emergency situations in order to prevent damage or reduce the effect of damaging factors and prevent complications.
The standard medical personal protective equipment includes:

• individual first aid kit AI-1 (AI-2);
• individual anti-chemical packages (IPP-8, IPP-10);
• medical dressing package (PPM).

Individual first aid kit is intended for prophylaxis and first aid in radiation, chemical and bacterial injuries, as well as in their combinations with injuries. Carry the first aid kit in the outer breast pocket of the jacket.

In nest No. 1 of AI-1 there is a medicinal preparation of Athens in a syringe-tube with a red cap, used for poisoning with organophosphate toxic substances (OPO). The drug is taken on the signal "Chemical alarm".
In the individual first-aid kit AI-2 there is a prophylactic agent against OPP poisoning - taren, which is taken one tablet at a time (a single dose of the drug reduces the striking dose of OPV by 10 times). Taren begins to act 20 minutes after ingestion. With an increase in signs of poisoning, another single dose is taken, then the drug is taken after 4-6 hours.

Nests # 2 and # 6 are reserved.

In nest No. 3 there is a syringe tube with a colorless cap - an analgesic agent. The drug is used for sharp pains caused by bone fractures, extensive burns and wounds, in order to prevent shock by injecting it into the thigh or buttock (it is possible through clothing).

Nest No. 4 contains a radioprotective agent (cystamine tablets), which has a prophylactic effect in case of damage by ionizing radiation (the degree of reduction of the biological effect of radiation is 1.6 times). When there is a threat of exposure, at the signal "Radiation hazard" or before entering a territory with an increased level of radiation, in 35-40 minutes. 6 tablets are taken. The protective effect lasts 5-6 hours. If necessary (continued radiation or a new threat), 6 tablets are taken 4-5 hours after the first dose.

Nest 5 contains an antibacterial agent (chlortetracycline tablets with nystatin), which is intended for general emergency prevention of infectious diseases (plague, cholera, tularemia, anthrax, brucellosis, etc.). The agent is taken when there is a threat of bacteriological infection or directly during infection (until the type of pathogen is established). A single dose of administration is 5 tablets, and repeated administration of the same dose is after 6 hours. The tool can also be used to prevent infectious complications of radiation sickness, extensive wounds and burns.

Nest 7 contains an antiemetic agent (etaperazine), which is used after irradiation, as well as in cases of nausea as a result of a head injury. You can take no more than 6 tablets per day.

Individual anti-chemical the package (IPP-8) contains a polydegassing formulation in glass ampoules and a set of napkins (Fig. 4.29).

Rice. 29. Individual anti-chemical package IPP-8
(1 - tin case; 2 - paper napkins; 3 - glass ampoules;
4 - cover; 5 - a reminder for using the package)

The package is designed to decontaminate skin areas, clothing adjacent to them, and personal protective equipment against combat agents, as well as against bacterial agents.
First, open areas of the skin (neck, hands), as well as the outer surface of the gas mask that was worn, are wiped with a moistened swab. Another swab is used to wipe the collar and the edges of the cuffs of the garment, adjacent to the exposed skin.
The degassing liquid can also be used to decontaminate the skin, contaminated with radioactive substances, when other degassing solutions cannot reduce their presence to acceptable limits.
When using the package, avoid contact with eyes.
Harness(fig. 31) is a rubber strip 1 - 1.5 m long, with a hook attached to one end and a metal chain (or buttons) to the other.
Medical dressing package (PPM) It is used for dressing wounds, burns and stopping certain types of bleeding. It is a sterile bandage with two cotton-gauze pads, enclosed in an impermeable sealed package (Fig. 30).

Rice. 30. Medical dressing package
a - the order of opening the package;
b - unfolded package;
1 - colored threads; 2 - rolling up the bandage; 3 - movable pad; 4 - bandage; 5 - fixed pad; 6 - the end of the bandage

Rice. 31. Hemostatic tourniquet

The order of using the PPM: by the notch the outer shell is torn and removed; the inner shell is deployed; the end of the bandage is taken with one hand, and the bandage is rolled up with the other and the bandage is unfolded; the pads are applied to the wound so that their surfaces, stitched with colored thread, are at the top. A movable pad is used if the wound is through. At the same time, one pad closes the inlet, and the second closes the outlet, for which the pads are moved apart to the required distance.
The pads can only be touched with your hands from the side marked with colored thread. Back side pads are applied to the wound. They are fixed with circular moves of the bandage, and the end of the bandage is pinned with a pin. In the event that there is only one wound, the pads are placed side by side, and for small wounds, they are placed on top of each other.

* in the "combat" position, the gas mask is transferred at the signal "Radiation hazard", "Chemical alarm" and at the command of "Gases", as well as independently upon detection of the use of chemical or bacteriological weapons by the enemy, in case of radioactive substances fall out: hold your breath and close your eyes, remove hat, quickly take out the helmet-mask and put it on your head; after that, making a sharp exhalation, open your eyes and resume breathing; put on a hat.

They take off the gas mask by the command "Take off the gas masks" or on their own when it is established that the danger of injury has passed. To do this, you need to raise the hat with one hand, and with the other, taking the valve box, pull the helmet-mask down, then forward and up and take it off; put on a hat. The removed helmet-mask must be wiped with a dry cloth and put into a bag.

Respirators are used as the simplest means of protecting the respiratory system from radioactive dust, harmful gases, vapors and aerosols. Respirators are divided into two types:

1) in which a half mask and a filter element simultaneously serve as the front part of a gas mask

2) filter cartridges are attached to the half mask.

Depending on the service life, respirators can be disposable (ShB-1, "Petal", "Kama", R-2), which after working out are unsuitable for further use. In respirators reusable replacement of filters is provided. These include: a filtering gas mask (RPG-67, RPG-67A, RPG-67B), a filtering gas and dust respirator (RU-60M).

The simplest respiratory protection means also include PTM and VMP, which are able to protect the respiratory system from radioactive dust and some types of bacterial agents. They are not suitable for protection against toxic substances.

Anti-dust cloth mask (PTM) consists of 2 parts - body and attachment. The body is sewn from 4-5 layers of fabric. The inner layer - better fabric with pile. The fastening is a strip of fabric sewn to the body. Masks are made depending on the height of the face (the distance between the recess of the nose and the lower point of the chin). With face height:

* up to 80 mm 1st size

* 81-90 mm 2nd size

* 91-100 mm 3rd size

* 101-110 mm 4th size

* 111-120 mm 5th size

* 121-130 mm 6th size

* 131 mm and more 7th size

The eye windows should be covered with an unbreakable transparent material (mica, film, etc.).

In order to make a cotton-gauze bandage, take a piece of gauze 100x50 cm in size, spread it on the table, put a layer of cotton wool 1-2 cm thick in the middle on an area of ​​30x20 cm (if not, cotton wool can be replaced with 5-6 layers of gauze). The free edges of the gauze are folded onto cotton wool on both sides, and cuts 30-35 cm long are made at the ends. The bandage put on should cover the mouth and nose well. Therefore, the upper edge of it should be at eye level, and the lower one should go beyond the chin. The lower ends are tied at the crown, and the upper ends at the back of the head. To protect your eyes, you must wear special glasses that should fit snugly to your face.

Skin protection products.

According to their purpose, they are divided into special and henchmen.

Formations of civil society use special ones. These include: a light protective suit (L-1), a protective overalls complete with rubber boots and gloves, a protective OP-1 raincoat complete with protective stockings and gloves, protective filtering clothing (ZFO) complete with rubber boots and gloves.

The available means of skin protection, if necessary, are used by the entire population, as well as by the personnel of the formations in the absence of special means.

An insulating product for protecting the skin.

The protective effect of insulating materials, from which many special suits and overalls are made, is that the poisonous substance that has got on them lingers for some time.

Lightweight protective suit L-1 is made of rubberized fabric and consists of a shirt with a hood, trousers with stockings, two-fingered gloves and a comforter. In addition, a suit carrying bag and a spare pair of gloves are provided. The suits are made in 3 sizes for people of height:

* up to 165 cm - 1st size

* 165-172 cm - 2nd size

* above 172 cm - 3rd size

The size of the suit is affixed on the front of the shirt at the bottom, in the upper part of the trousers on the left, on the upper part of the gloves.

The protective overalls are made of rubberized fabric and consist of one-piece trousers, a jacket and a hood. Five-fingered rubber gloves of one size and rubber boots of six sizes (41-46) are used to protect hands and feet.

The period of stay in insulating protective clothing is limited depending on the air temperature:

* +30 and more 15-20 min.

* +25 +29 30 min.

* +20 +24 40-50 min.

* +15 +19 1.5-2 hours

* below +15 more than 3 hours.

As a rule, special protective equipment is worn before working in a non-contaminated area. Before putting on the L-1, it is necessary to spread it on the ground. Then put on trousers and tie the braid of the stocking; throw the straps of the trousers over the shoulders crosswise and fasten them to the trousers; put on a shirt and fold the hood over your head, and pick up the neck valve under the shirt. After that, fasten the crotch strap with a button; put on a gas mask, a comforter and a hood, wrap the valve around the neck and fasten it; put on the loops of the sleeves on thumbs hands and gloves, wrapping an elastic band around the wrist. Remove special protective equipment only in non-contaminated areas. In this case, it is necessary to pay special attention to the fact that unprotected parts of the body do not touch the outside. It is necessary to stand facing the wind. Before you take off protective clothing contaminated with OM or BS, it is necessary to treat the front part of the rubberized overalls and gloves with disinfecting solutions. In case of contamination of RV clothing, rubber gloves, boots, stockings must be washed with water and wiped off with a damp ladder.

Filtration means of skin protection.

The protective effect of filtering materials is that when contaminated air passes through them, OM vapors are retained by special substances with which the fabric is impregnated. Protective filtering clothing consists of a cotton overalls impregnated with special substances, men's underwear (shirt and underpants), a comforter and two pairs of footcloths (one of them is impregnated with a special substance). The clothing is used complete with rubber boots and gloves.

Suitable skin protection products.

To protect exposed areas of the body and clothing, it is advisable to use raincoats, preferably made of rubberized fabric or synthetic materials. For a short time, they can protect even against liquid droplets. There must be a hood. In its absence, you can use oilcloth, plastic wrap. Rubber boots are suitable for protecting the feet. Rubber gloves will help to protect hands from RV, and leather and fabric gloves from RV and BS. Pants at the bottom need to be tied with braid.

Home-made protective capes, stockings, gloves are well protected from radioactive dust, as well as drugs.

The protective cape is made of oilcloth, film materials, thick fabric.

Stockings are made from two layers of dense cotton fabric. For the sole, a tarpaulin or several layers of dense fabric is taken. Stockings should have two pairs of ties: upper and lower.

Gloves are made of cotton fabric; it is advisable that they have a long, over the elbow, leggings. To protect the neck, open areas of the head use a simplified hood made of dense cotton or woolen fabric. To seal the chest incision of the jacket, use a chest valve made of any dense fabric. The simplest skin protection products, after impregnation with special solutions, acquire the ability to protect against OM vapors and aerosols. Clothes made of fabric materials are subject to impregnation. To saturate one set of clothes, 2.5 liters of solution are required. Take 2 liters of water and 0.5 kg of detergent ("Astra", "Novost", "Don", etc.), heat up to 40-50 degrees and stir for 3-5 minutes. Then a protective suit is impregnated in this solution. Wring out, but not hard, and dry on outdoors... Do not iron with a hot iron. The protective kit is worn on underwear or summer clothes.

Medical remedies.

In the complex of protective measures carried out by GO, it is of great importance to provide the population with means of special prevention and first honey. help, as well as training in the rules for using them. The use of personal protective equipment in combination with respiratory and skin PPE is one of the main ways to protect people in conditions of the use of weapons of mass destruction by the enemy, as well as in peacetime emergency situations. Considering that in a difficult situation it is necessary to provide prevention and the first honey. assistance in the shortest possible time, the use of medical devices in the form of self-help and mutual assistance is of particular importance.

Medical personal protective equipment is medical preparations, materials and special means intended for use in emergency situations in order to prevent damage or reduce the effect of exposure to damaging factors and prevent complications.

The standard medical personal protective equipment includes:

* first aid kit individual AI-2;

* universal first-aid kit for household use for the population living in radiation-hazardous areas;

* individual anti-chemical packages - IPP-8, IPP-10;

* medical dressing package - PPM.

The first-aid kit is individual.

Designed for prophylaxis and first honey. help with radiation, chemical and bacterial injuries, as well as their combinations with injuries. Carry a first aid kit in your pocket. It contains:

Slot No. 1: syringe tube with pain reliever (with colorless cap). Not included in the first-aid kit, issued by the decision of the MSGD district. It is used for sharp pains caused by bone fractures, extensive burns and wounds, in order to prevent shock by inserting it into the thigh or buttock (it is possible through clothing).

Nest N 2: in AI-2 there is a prophylactic agent for OP poisoning - taren. Taren begins to act 20 minutes after ingestion. Take one tablet at a time at the Chemical Alert signal. Children under 8 years old take a quarter of a tablet at a time, 8-15 years old - half a tablet. A single dose of Taren reduces the damaging dose of OPA by 10 times. With an increase in signs of poisoning, take another single dose, then take the drug after 4-6 hours. Instead of tarren or in addition to it, the drug P-6 can be used. A single dose of 2 tablets provides protection from 3-4 lethal doses within 12 hours. The personnel of the Armed Forces and non-military formations of civil defense are provided with AI-1 first-aid kits, in which there is a medicinal preparation of Athens in a syringe tube with a red cap, used for poisoning with OP.

Nest 3: the antibacterial agent N 2 (sulfadimethoxine) is intended for the prevention of infectious diseases after radiation exposure. It is taken after irradiation in case of gastrointestinal disorders, 7 tablets at a time, 4 tablets in the next 2 days. Children under 8 years old on the first day 2 tablets, in the next 2 days, 1 tablet; 8-15 years old on the first day, 3.5 tablets, in the next two - 2 tablets.

Nest No. 4: radioprotective agent No. 1 (PC-1, cystamine tablets) - has a prophylactic effect in case of damage by ionizing radiation. Dose reduction factor (FUD) - an indicator characterizing the degree of reduction of the biological effect of radiation - when taking RS-1 is 1.6. If there is a threat of exposure, at the signal "Radiation hazard" or before entering a territory with an increased level of radiation, take 6 tablets with water in 35-40 minutes. The protective effect lasts 5-6 hours. If necessary (continued radiation or a new threat), 4-5 hours after the first dose, drink another 6 tablets. Children under 8 years old are given 1.5 tablets at a time, 8-15 years old - 3 tablets.

Nest No. 5: antibacterial agent No. 1 (chlortetracycline tablets with nystatin) is intended for general emergency prevention of infectious diseases (plague, cholera, tularemia, anthrax, brucellosis, etc.), the pathogens of which can be used as biological weapons. Take when there is a threat of bacteriological infection or the infection itself (even before the type of pathogen is established). Single dose - 5 tablets at a time with water. Repeated administration of the same dose after 6 hours. Children under 8 years old take 1 tablet at a time, 8-15 years old - 2.5 tablets. PBS-1 can also be used for the prevention of infectious complications of radiation sickness, extensive wounds and burns.

Nest No. 6: radioprotective agent No. 2 (PC-2, potassium iodide tablets 0.25 each) is intended for people in the fallout zone: it blocks the thyroid gland for radioactive iodine that comes in with respiration, food and water. Take 1 tablet on an empty stomach for 10 days (in peacetime, in the event of an accident at a nuclear power plant, take all the time and another 8 days after the last discharge). Children 2-5 years old are given half a tablet, less than 2 years old - a quarter of a tablet, infants - a quarter of a tablet only on the first day. If you start taking it in the first 2-3 hours after the fallout of radioactive iodine, the protection is 90-95%, after 6 hours - by 50%, after 12 hours - by 30%, after 24 hours - there is no effect.

Nest 7: An antiemetic agent (eaperazine) is used after irradiation, as well as for symptoms of nausea as a result of a bruised head. You can take no more than 6 tablets per day.

Individual anti-chemical package.

IPP-8 contains a polydegassing formulation in a bottle and a set of napkins. Designed for decontamination of skin areas, clothing and PPE adjacent to them, the population over 7 years of age from combat agents and BS. Avoid getting liquids in the eyes. The sequence of processing: wipe open areas of the skin (neck, hands) with a moistened swab, as well as the outer surface of the gas mask that was worn. With another swab, wipe the collar and the edges of the cuffs of the garment adjacent to the exposed skin. The degassing liquid can be used for decontamination of the skin, contaminated with radioactive substances, when it is not possible with water and soap to reduce the presence of radioactive substances to acceptable limits.

Medical dressing package.

PPM is used to dress wounds, burns and stop some types of bleeding. It is a sterile bandage with two cotton-gauze pads, enclosed in an impermeable sealed package. The order of using the PPM: break the outer shell along the notch and remove it; expand the inner shell; take the end with one hand, and with the other hand roll the bandage and unfold the bandage; apply on the wound surface so that their surfaces, stitched with colored thread, are at the top.

Universal first aid kit for household use.

Equipped with the following equipment: radioprotective agents, general therapeutic drugs (aspirin, sedalgin, ammonia, besalol, validol, nitroglycerin, papazol, diazolin, phenazepam), antiseptic and dressings (brilliant green, potassium permanganate, derinat, levominol, acetaminophen or mafeni bactericidal, bandage).

In addition to individual ones, the following medical protective equipment is used: radioprotective, analgesic and antibacterial drugs, medical formulations for OS (SDYAV) and dressings.

Radioprotective drugs include:

* radioprotectors (prophylactic drugs that reduce the degree of radiation injury (cystamine in AI-2)

* chelators - drugs that accelerate the elimination of radioactive substances from the body (EDTA, getacin-calcium, unitiol)

* adaptogens - drugs that increase the general resistance of the body (eleutherococcus, ginseng, Chinese magnolia vine, dibazol)

* adsorbents - substances capable of capturing radioactive and other harmful substances on their surface and with them excreted from the body (activated carbon, adsobar, vacocin)

* antihemorrhagic agents (gelatin, serotonin) and blood-forming stimulants (leukocetin, leucogen, pentoxil). The drugs of this group are used only in the provision of medical care and treatment in a hospital

* stimulants of the central nervous system (indopan, bemegrid, sydnocarb) - used in the provision of medical care and treatment in a hospital.

Protection against bacterial (biological) means of destruction consists of two directions - general emergency (antibiotic prophylaxis) and special emergency prevention of infectious diseases (immunization) with bacterial preparations (vaccines, toxoids).

Medical means of protection against SDYAV, OS are represented by antidotes (antidotes) - drugs that are physiological antagonists of poisons. These include: athen, atropine, budaxim, taren - against OP and OP; amyl nitrite (propyl nitrite), anticyanogen, chromosmon, sodium thiosulfate, antidotes of hydrocyanic acid and other cyanide compounds; unitiol is an antidote to lewisite and arsenic-containing SDYAV.

Dispersion and evacuation of the population is one of the methods of protection in emergency situations. In this way, the population density is reduced, which reduces the occurrence of losses.

Dispersal is an organized withdrawal (removal) from cities or settlements free from work change of workers and employees of economic facilities that continue their work, and their temporary placement outside the zone of possible destruction. Workers are delivered in shifts to their facilities in accordance with the production cycle.

Resettlement - an organized withdrawal of the disabled and unemployed population from areas contaminated with radioactive substances and dangerous for living, to safe places for permanent residence.

Dispersion and evacuation of the population (REW) is carried out not only from areas of possible destruction, but also from areas of probable catastrophic flooding.

The evacuation zone defines the territory outside the boundaries of possible destruction or contamination with harmful substances established in the emergency areas.

Evacuation is understood as an organized withdrawal or removal and placement outside the disaster zone of the affected population and those affected from places of possible severe destruction, contamination of the territory, as well as areas of possible catastrophic flooding.

When planning the evacuation of the population, the number of the affected population in the disaster areas, taken out on foot and taken out by transport, the sequence and timing of its withdrawal, the routes to the resettlement points or intermediate points are determined. To determine the sequence of withdrawal or removal of people and their placement in places (mobile complexes) of primary life support, the entire population is divided into groups.

Primary life support of the population in an emergency includes reception and temporary (from 3 to 45 days) accommodation of the population, organization of food, water supply, utilities, medical, social and legal support.

Evacuation is supervised by the headquarters of the Civil Defense and Emergencies of the administrative territories. With them, special evacuation bodies are created: evacuation commissions, prefabricated evacuation points, evacuation commissions, evacuation reception centers.

The dispersal and evacuation of the population from cities, as a rule, are carried out during the period of the threat of an enemy attack (threat of emergency) and are organized according to the production-territorial principle: according to production principle- for workers, employees, members of their families, university students and secondary students educational institutions and vocational schools (through the places where they work or study); on a territorial basis - for the population not related to production (at the place of residence, through housing authorities)

Further: