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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