Transcript Document

Karazin National University
Department of general practice - family medicine
Valeological basics of formation
of health and life safety
The human body: a systematic approach
The main systems are the respiratory system, circulatory system,
nervous system, musculoskeletal system
and integument (skin), gastrointestinal tract, urogenital system and
the endocrine system.
All these systems come together in complex relationships, forming a
human body.
Respiratory System
Carries oxygen from the blood into the tissues of the body
Blood carries oxygen and replaces it with carbon dioxide
Carbon dioxide is excreted through the lungs
Respiratory tract
The mouth and nasal cavity
The pharynx (throat): nasopharynx and oropharynx, the
general path for food and air: a typical place of airway obstruction
Epiglottis: thing that prevents of food getting into the
trachea during swallowing
The larynx: before epiglottis there are vocal folds
trachea
bronchi
lungs
Physiology
Ventilation: the movement of air into the lungs and from lungs
The diaphragm and intercostal muscles: mechanical ventilation
Breath: the diaphragm and intercostal muscles stretch
Exhalation: diaphragm and intercostal muscles relax
Gas exchange: oxygen is replaced with carbon dioxide in the
alveolar sacs through the capillaries
Oxygen enters the blood into cells that secrete into the blood to deliver
carbon dioxide to the lungs
Respiratory system:
children under one year and 1 to 8 years
Smaller diameter of the airway
Tongue is proportionally bigger
The trachea is softer
Breathing way obturate easier
The main cause of cardiac arrest is a cessation of breathing
Circulatory system: heart
Heart is a unique tissue which provides nerve
conduction and automatism;
Delivers blood enriched by oxygen and nutrients in
the tissue and has:
- Two atria: receive blood from the body and
pump it into the ventricles
- Two ventricles: the right pumps blood to the lungs,
the left - in other organs and body systems
Circulatory system: arteries
Artery: muscular tubular structures that carry blood from the heart to
the rest of bodies
aorta
carotid artery
The femoral artery
radial artery
brachial artery
The arteries divide into smaller vessels and capillaries that end with
thin walls that provides gas exchange of oxygen and carbon dioxide
Circulatory system: veins
•Vessels with a thin muscle layer, carrying blood enriched with carbon
dioxide from the various tissues to the lungs for gas exchange.
•Mostly they are made to provide venous access for insertion of fluids
and medications.
•The biggest:
The upper vein
The lower vein
Physiology
•The left ventricle, contracting, pushes blood into the arteries,
forming a pulse wave. Pulse is defined in the carotid, femoral,
radial, brachial artery
• In the absence of pulse a cardiac arrest is probable
Brain damage begins 4-6 minutes after the cessation of blood
flow
Irreversible brain damage occurs within 8-10 minutes
In order to deliver oxygenated blood to vital organs, a closed
heart massage and artificial ventilation (AV) - cardiopulmonary
resuscitation(CPR) is performed
Physiology (continued)
A man of medium build has 5-6 liters of blood that delivers
oxygen and removes carbon dioxide, has the blood coagulation
factor and protective factor
Perfusion: The process of getting oxygen-rich blood and
nutrients into tissues and excretion of waste products
Shock: State of reduced perfusion of body tissues
Musculoskeletal system: skeleton
The bones give the body a shape and protect vital organs
Muscles, tendons and ligaments are attached to bones in joints to
provide movement
Skull protects the brain
The spinal column contains 33 bones that protect the spinal cord
Chest: 12 pairs of ribs, sternum, and xiphoid process to protect the
heart and lungs
Basin: attachment of the lower extremities
The bones of the upper and lower extremities
Musculoskeletal system: muscle system
•Three types: skeletal, smooth muscle and cardiac muscle
Skeletal muscle: random twitch muscles, enabling the movement
Smooth muscle: involuntary twitch muscles that provide blood
circulation, respiration, digestion and urination
Cardiac muscle: involuntary muscle shortening, which may fall on its own
Nervous system
Central nervous system (CNS): cognitive function, as well as voluntary
andinvoluntary body functions
CNS: brain and spinal cord
The peripheral nervous system: motor and sensory nerves that carry
information sharing between the central nervous system and muscles
andorgans of the body
Other systems of the body
The skin (integument): a protective barrier,
sensor body temperature regulation
Digestive System: mouth, esophagus, stomach,
liver, pancreas, small and large intestines, rectum
Endocrine system: hormones that regulate various body
functions
The first emergency medical services
Emergency medical care - a complex of the simplest activities
to protect life and prevent complications in case of
accident, injury or sudden illness
Problems in the provision of emergency
Personal security
Patient’s safety
Evaluation of the patient’s condition and help
Transportation and transfer of patient
Encouragement and comfort the patient and relatives if necessary
Ensuring continuity of care by informing more specialized staff
Security of the occurrence location
The priority is personal safety
On second place is protection of the patient
The third is the protection of other persons
If the ocurence location is unsafe, it must be secure.
Preventing transmission
of infectious diseases
Minimizing contact with body fluids, particles transmitted through
the air, hazardous materials:
Hand washing - the most important method
eye protection
gloves
masks
robes
immunization
General inspection
The purpose is to identify the signs and symptoms of illness
or injury (visible deformation, open injuries, areas of pain,
swelling).
Parts of the body, which should be examined: the head, neck,
chest, abdomen, pelvis, extremities.
Survey and medical history of an event, about
possible diseases andmedication, allergies and allergies to
medications.
The initial assessment
• General impression
• Examination of the situation on the spot
• Assessment of threat to life of the victim
• Establishment of illness or injury
Assessing the level of
consciousness of the victim
•
In conscience
• Responds to verbal stimulus
• Responds to painful stimulus
• unconscious
History taking
allergies
medicines
life history
The events preceding the injury / illness
Assessment of breathing
Is the victim breathing?
- Look
- Listen
- Feel
If not breathing: mechanical ventilation
If breathing: examine breathing effort
Airway Management
Airway Management is one of the most important tasks to help
Tongue is a common cause of airway obstruction
Methods of tilting the head and moving out the jaw
Moving out of the jaw, without tilting the head
Methods of tilting the head and moving
out the jaw
Moving out of the jaw, without tilting the
head
Releasing and maintaining airway
•Three ways by which you can clean and maintain
the airway:
The optimal position
Releasing manually
Aspiration
Protocol assistance in case of violation
of breath (8 years or older)
•To call for ambulance
• To make sure is the victim is unconscious or
concious
• Provide the airway by tilting the head and moving out the jaw, or moving out the jaw
without tilting of the head (in case of trauma)
• Check breathing: watch, listen and feel
• Carry two primary artificial breaths lasting 1.5 - 2 seconds each (12 artificial breaths /
min.)
• Apply reception of Heimlich in case of airway obstruction with a foreign body
• If the victim is breathing or has restored normal breathing, place the victim in the
optimal position
Heimlich’s method
Attempting to
remove the foreign
body using fingers
Safe position
Artificial ventilation of lungs
Mouth to mouth through a mask
Mouth to mouth through the barrier device
Mouth to mouth
Adequate ventilation is determined by:
- Excursion of the chest
- Audible and feelable exhalation
Artificial ventilation of lungs «Mouth to
mouth»
Artificial ventilation of lungs «Mouth to
nose»
Causes of cardiac arrest
•Sudden death caused by cardiac arrhythmias, heart disease
• Respiratory failure (especially children)
• Emergency Conditions (nontraumatic): stroke, epilepsy,
diabetes, allergic reaction, electric shock, poisoning, etc.
• Drowning, suffocation
• Trauma and bleeding
Assessment of circulation
•Check the pulse of the arteries:
- Ray
- Sleepy
- femur
Check for external bleeding
• Check the color and temperature of the skin: is there any signs
of shock
Lifting and moving victims
Lifting and moving the victims is extremely important,
constantly occurring duty, which is often overlooked.
The main objective is the prevention of injury and aiding patient
safety.
Primary prevention: risk factors
Risk factors are additional endogenous or exogenous
adverse effects on the body, which increases the likelihood of illness
or death.
Risk Factors
Endogenous:
Managed: hypertension, dislipidozy, dysmenorrhea
Unmanaged: age, gender, heredity
exogenous:
Managed: environment, lifestyle, medical errors
Unmanaged: climate, natural conditions
RISK FACTORS OF DISEASE HVS
СС
Prevention of HVS
RISK FACTORS OF DISEASE HVS
Prevention of HVS
Food Security
Historical background
Nutrition of patients has received considerable attention during all periods
of human development. Hippocrates believed that treatment
should consist in the fact that at different stages of the disease to be
able to choose the right foods in the quantitative and
qualitative respects. The Roman physician Asclepiades (128-56 BC),
which is considered the founder of the Diet, at odds with the views of the
time rejected the pharmacotherapy and thetreatment is considered on
the basis of the diet. Together with his students, he has
developed detailed guidance on the use of nutrients in the treatment
of various diseases.
Terminology
Dietetics (from diet and ... ology), dietetics, the science of nutrition of
patients, studies, and validating the principles of nutrition in various
diseases. (Power healthy people engaged in food hygiene.) In the
past, the whole science of dietetics called on health
care, modern hygiene, since the beginning of the 19th century. limited
to questions of dietetics and nutrition rationalization of the 20th
century. almost become synonymous with nutrition.
Nutritional care
Therapeutic nutrition is an important part of the treatment.
The purpose of clinical nutrition is to ensure the body's physiological
needs for nutrients and the normalization of the functional state of
various organs and metabolic processes, disrupted due to illness.
Exacerbation of many diseases are associated with
various excesses in the diet: chronic pancreatitis after eating a
fatty cream, pancakes, alcoholic beverages, fried foods, violations of
the diet in diabetes lead to a sharp rise in blood sugar, dry mouth,
increased thirst, progressive fatty infiltration liver and
pancreas, increased blood pressure in patients with essential
hypertension is observed in the use of salty
foods, appointed withtreatment of low efficiency.
Basic principles of nutrition
-Nutritional care should contribute to directional effects on metabolism, and it
should heal, and prevent the worsening of many diseases.
Observe correct diet: eat regularly, at the same time. In this case, produced a
conditioned reflex in the time allocated the most active gastric juice and the
most conducive conditions for the digestion of food. For health care facilities
recommended by the four meals: breakfast at 8-9 h and 13-14 h lunch, dinner
in 17-18 hours, eating at night at 21 pm The choice of this time due to a
physiological feature of the human body, activity its enzyme systems.
Calorie meals: breakfast - 30%, lunch - 40%, Dinner - 25%, eating at night 5%. It is desirable that the last meal was for 4-5 hours before bedtime.
- It is necessary to diversify the diet. If the food is varied, includes food and
animal (meat, fish, eggs, milk, cottage cheese), and plant origin (vegetables,
fruit, cereal, bread), you can be sure that the body receives all the necessary
for life.
The main food groups
The
first group - milk and dairy products (milk, yogurt, buttermilk,
cottage cheese, etc.).
The second group - vegetables, fruits, berries (fresh
cabbage andsauerkraut, potatoes, carrots, beets, tomatoes,
cucumbers, lettuce, pumpkins, apples, currants, strawberries, etc.).
The third group - meat, poultry, fish, eggs (animal protein sources).
The fourth group - bread, pasta, cereals.
The fifth group - fats (butter and vegetable oil).
The sixth group - sweet (sugar, honey, confectionery).
In cases of various diseases it is limited to use certain food groups. For
example, in the diets used in obesity, diabetes, eating sweets is
severely limited or prohibited.
Fasting diet
Unloading (contrast) diet used periodically to partial starvation and
unloading of the affected organs and body systems.
They are used with obesity, hypertension, heart failure, liver disease
and kidney failure, gout, colitis, etc.
Assign contrasting diets occasionally 2-4 times a month for 1-2 days
Clinical dietetics
It is very popular all over the world to go on so-called
"fashion diet" proposed by various authors (doctors, artists,
writers, etc.) to achieve any important task.
"Trendy diets" are designed to reduce body
weight, longevity, better health.
Most of these diets non-physiological, deficient in
many nutrients and can not be recognized by official medicine.
Incorrect nutrition
Anorexia affects mainly young
women (only 10% of patients are male).
Most often it is the result of compliance
with various diets.
Gradually the diet is becoming
increasingly strict, she eats less and less
until, finally, to recover the fear of not
becoming intrusive. Psychologically, at
this stage, the woman is
still considered the
weight excess, although in factit has been
a lack of weight gain and begin to
show signs of malnutrition.
The most common causes of heartburn
Among healthy individuals:
poor nutrition
overeating
Quick meal "on the fly" in a stressful environment
Abuse of butter and fatty foods
Drinking large amounts of sweets and foods containing caffeine (coffee,
tea, chocolate)
Abuse of acute and spicy food
Alcohol abuse, smoking, stress
Sleep or rest lying down after meals
Lack of exercise. Obesity. constipation
Wearing tight clothing
Individual sensitivity to foods - citrus
fruits, onions, garlic, tomato products(juice, pasta, sauces)
The first half of pregnancy
CLASSIFICATION OF BODY MASS IN
TERMS OF IBW
Body weight
IBW
Defective
< 18,5
normal
18,5-24,9
excessive
25,0-29,9
obesity
30,0-34,9
I
35,0-39,9
II
40 and more
III
extreme obesity
IBW= kg/m2
stage of obesity
An assessment of liquid needs
Human requires more and more liquid because of:
- Diarrhea, vomiting,
- Sweating,
- Fever - each C0 increases the fluid requirements by 13%
- Dehydration.
An assessment of liquid needs
- are several methods to assess the basic needs of the organism in
the fluid:
Adults:
1. 1500 ml/m2
2. 1500 ml for the first 20
kg body
weight 20 ml/kg over
20 kg
3. 30-35 ml/kg (18-65),
25 ml/kg (over 65)
4. 1 ml/kcal
Body weight (kg)
1-10
11-20
>20
Children
Basic needs of fluid a day
100-150 ml / kg
1000 ml 50 ml for each
kg over 10 kg
1500 ml 20 ml for each
kg over 20 kg