STANDARD ANSWER TO SITUATIONAL PROBLEM N 17

1. Diagnosis . Acute gastroduodenal bleeding of moderate severity. Manifestations of acute anemia, hypotension, Algover index (HR/BP system) more than 1.0.

2. Does the victim require emergency assistance if evacuation is delayed?

Yes, it needs. Emergency care: complete rest, cold on the stomach, probe into the stomach, calcium chloride 10% – 10.0 intravenously, epsilon-aminocaproic acid 5% -100.0 intravenously drip, vikasol 1% – 5.0 intramuscularly. To ensure the safety of transportation, reopoliglyukin, gemodez, gelatinol, glucose-salt solutions, plasma are transfused intravenously, and cardiovascular agents are administered. If evacuation is delayed: probe into the stomach, cold on the stomach, small pieces of ice are allowed to be swallowed, hunger. Enter 4 ml of norepinephrine dissolved in 150 ml of fiziol into a nasogastric tube. solution, after which the probe is blocked for two hours. With continued bleeding, re-introduction of norepinephrine at half the dose.

With a delay in evacuation, hemostatic, antishock, infusion therapy is continued. In hemostatic therapy, etamsylate (dicynone) is included at a dose of 4 ml intravenously, then every 6 hours, 2 ml intravenously or intramuscularly.

3. Does the victim need to be sent to the next stage for qualified and specialized assistance? Emergency hospitalization, accompanied by medical staff on a stretcher, to the surgical or intensive care unit of a hospital.

STANDARD ANSWER TO SITUATIONAL PROBLEM N 18

1. Diagnosis . Penetrating stab (knife) wound of the left half of the chest in the VI intercostal space along the posterior axillary line, complicated by hemopneumothorax. Hemorrhagic shock of moderate severity. Subcutaneous emphysema in the area of the wound speaks of the penetrating nature of the injury with lung damage, and a box shade of percussion sound speaks of pneumothorax. Dullness of percussion sound in the lower parts of the left lung, tachycardia and hypotension (Algover index more than 1.0) indicate internal bleeding (hemothorax).

2. Does the casualty require emergency assistance if evacuation is delayed?

Yes, it needs. Emergency assistance consists in applying an aseptic bandage to the wound, administering painkillers (promedol from a syringe tube, analgin), sulfocamphocaine, giving oxygen, ensuring complete rest, intravenous administration of polyglucin, saline solutions. With a delay in evacuation, a pleural puncture is performed in the II and YII intercostal space to evacuate air and blood. Hemostatic, anti-shock therapy is carried out, broad-spectrum antibiotics are administered to prevent pleural empyema. As soon as possible, urgent evacuation to the hospital.

3. Does the victim need to be sent to the next stage for qualified and specialized assistance? The wounded needs emergency hospitalization in the surgical or intensive care unit of the hospital as a matter of priority. Transportation in the supine position, accompanied by medical personnel, with ongoing IV infusions and oxygen.

STANDARD ANSWER TO PROBLEM No. 19

1 affected – provision of I MT in the first place, evacuation in the first place

queue in a lying position on a stretcher;

2 affected – rendering of the 1st MP in the first place, evacuation in the first place lying down;

3 affected – the provision of MP in the second place, the evacuation in the second turn in the prone position;

4 affected – the provision of I MT in the second turn, evacuation in the second turn.

5 affected – the provision of I MP in the first place, evacuation in the second place, lying on a stretcher on his stomach.

STANDARD ANSWER TO PROBLEM No. 20

1 affected person – provision of the 1st MT in the second place, evacuation in the second place in the supine position on a stretcher;

2 affected – rendering of the 1st MP in the first place, evacuation in the first place, lying on a stretcher;

3 affected – rendering of the 1st MP in the first place, evacuation in the first place in the supine position with a raised shoulder girdle;

4 affected – the provision of I MT in the second turn, evacuation in the second turn.

STANDARD ANSWER TO PROBLEM No. 21

1 affected person – burns of 72% of the body area, the prognosis is relatively favorable, the affected person belongs to the second – third sorting group, the affected person has III degree of burn shock;

2 affected – burns of 9% of the body area, the prognosis is favorable, the affected person belongs to the fourth sorting group, the affected person has I degree of burn shock;

3 affected – burns of 54% of the body area, the prognosis is relatively favorable, the affected belongs to the fourth sorting group, the affected has II degree of burn shock.

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