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«Белое» утопление развивается у лиц, в легкие которых вода не попала - по при­чине спазма голосовой щели в гортани (асфиксическое утопление) или остановки сердца (синкопальное утопление). Кожа пострадавших имеет бледно-серый оттенок. В дыхатель­ных путях может содержаться небольшое количество пены, образовавшейся за счет слю­ны и воды, находящейся в верхней части гортани. Эти выделения незначительны и удаля­ются быстро. Признаком данного вида утопления является отсутствие синюшности кож­ных покровов и выделений воды в положении вниз головой «на колене» спасателя.
После профилактической очистки ротовой полости (не забывать про стимуляцию корта языка!) пострадавшего следует положить спиной на жесткую ровную поверхность, положить под плечи валик, откинуть голову назад и начать делать искусственное дыхание в сочетании с искусственным кровообращением (непрямым массажем сердца). После вос­становления дыхания в качестве препаратов поддерживающей терапии (на ранних этапах) при «белом» утоплении используют кофеин (в виде таблетки кофетина, кофетамина или внутримышечного укола кофеина) и кордиамин (капли, внутримышечный укол) - для ак­тивизации сердечной деятельности и центральной нервной системы. При нестабильном состоянии пострадавшего следует начать гормонотерапию в больших дозировках (пред- низолон и т.п.). Прочие действия - пострадавшего надо переодеть в сухую теплую одежду, провести массаж, укутать в спальный мешок, дать горячий сладкий чай, обеспечить по­кой. При переохлаждении следует обратить особое внимание на согревание пострадавше­го. При отсутствии медицинских препаратов следует проводить все иные доступные ме­роприятия. Заметим, что состав медицинской аптечки отражает готовность группы к ре­анимационным мероприятиям при утоплении.
Заметим, что не все туристы (альпинисты, спелеологи и т.д.), и даже не все руково­дители детских туристских групп при утолении готовы и могут провести адекватные ре­анимационные мероприятия. Об этом, в частности, свидетельствует следующий пример.
Под напором рассвирепевшего потока одна из школьниц упала и выпустила шест из рук. Вода мгновенно унесла ее на противоположную сторону реки и затянула под ку­сты. Через несколько минут захлебнувшуюся школьницу вытащили на берег. Потерпев­шей стали делать искусственное дыхание, не удалив воду из дыхательных путей. По до­роге в больницу девочка скончалась.
 

 

 


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RE: Первая помощь при «Беломутоплении»
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Отправлен: 16.01.2013 19:58:59

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