Principles of first aid to severely injured persons at the scene of the accident

Abstract

The therapy-free intervals after an accident have been considerably shortened by the introduction of an emergency system ensuring the treatment of the injured person by a physician on emergency duty already at the place of accident. Injuries threatening life have to be treated first in order to maintain the vital functions. Due to the lack of time and the insufficient equipment available at the place of accident, a precise diagnosis is possible only in exceptional cases. The most dangerous complications are respiratory deficiency, loss of blood, inconsciousness and lack of skeletal stability, and these are to be treated in this order. Intubation and artificial respiration are the most adequate methods to maintain the respiratory function. Exterior bleedings have to be staunched , losses of blood must be compensated by administration of colloidal solutions and electrolyte solutions. Urgent admission to a hospital is necessary in case of interior hemorrhages and in case of inconsciousness , especially if an intracranial hemorrhage is suspected. Fractures and luxations are not primarily threatening life, nevertheless the provisional reposition and immobilization of the injured extremities belong to the task of a physician on emergency duty. The reanimation of patients injured in an accident has a poor prognosis; if a cardiac arrest persists more than ten minutes, further reanimation measures are nearly never successful.