First aid for heart failure in adults and emergency care for children

Chickenpox is so called because it can be carried by the wind, that is, by airborne droplets. Let’s see how chickenpox manifests itself in children. Someone sneezes next to you contagious, you already forget about this minor episode in your life. And after 1-3 weeks, the temperature suddenly rises. This is the initial stage of chickenpox in children.

“Acyclovir” with chickenpox in children

In order to remove such a symptom of chickenpox as itching, you can ask the pediatrician to prescribe an antihistamine in a safe dosage. When rashes pass to the eyes, you can use the special Acyclovir eye gel for chickenpox in children, which effectively fights against the herpes virus.

Many parents are absolutely sure that the treatment of chickenpox in children is the lubrication of vesicles with green. Even now, walking along the street in this way, you can easily identify a child who has had chickenpox – according to the characteristic “spots” of greenery. In fact, zelenka does not treat the symptoms of chickenpox, but performs only a disinfecting function, protects against the penetration of bacterial infection into the wound.

This is especially important for the child. It is convenient for doctors to determine by these spots whether the child is contagious. That is, zelenka is not a treatment for chickenpox in children, but serves to fix new rashes. It is very convenient, first of all, for doctors. In addition, zelenka somewhat reduces itching. In addition to brilliant green, rashes can simply be lubricated with a weak solution of manganese. This option is more suitable for an adult who does not want to go covered in greens. In no case should you lubricate alcohol.

Causes of fainting in children and first aid

The classification of types of heart failure is based on the criteria for its occurrence (Fig. 1).

The most common reasons for the occurrence and development of heart failure are considered to be hypertension (high blood pressure), valvular defects, heart attacks, coronary heart disease, inflammation and damage to the heart muscle (myocardium). It is when the affected myocardium is not able to properly pump blood from the left ventricle of the heart that chronic heart failure develops.

In this case, oxygen starvation of the body occurs and a person complains of increased fatigue, rapid heartbeat, shortness of breath, poor sleep. Diabetes mellitus refers to diseases that increase the risk of a disorder of the cardiovascular system, directly affect the myocardium and disrupt the functioning of the left ventricle, which entails the risk of being subjected to a chronic form of heart failure.

serdechn nedostatok1 - First aid for heart failure in adults and emergency care for children

Damage to the arteries and aorta, which occurs with hypertension, atherosclerosis, and some other diseases, also lead to the development of a chronic form. If the myocardium has been in a state of increased stress for a long time, for example, with arterial hypertension, it, like other muscles, builds muscle mass, which leads to an abnormal enlargement of the heart.

Other symptoms appear depending on which part of the heart is most affected. In addition to the above symptoms, the patient may experience blurred eyes, dizziness, fainting, wheezing in the lungs, swelling of the veins and swelling of the extremities, accompanied by pain, enlarged liver and the presence of free fluid in the abdominal cavity, pallor of the skin, blueness of the extremities that are farthest from the heart ( fingers and toes, lips).

Enlarged liver and swelling of the extremities occurs when the right side of the heart functions poorly, and peripheral veins receive an excess blood flow. When the left side is affected, blood overflows the vascular system of the pulmonary circulation and heart and partially fills the lungs. This case is characterized by arrhythmia, shortness of breath, cough, wheezing, pallor or bluish skin tone. Fatal outcomes are possible depending on the severity of these symptoms.

Fainting – short-term sudden loss of consciousness.

The causes of syncope in children are divided into:

  • of cardiac origin – with acceleration of the heartbeat, arrhythmia, heart defects, etc.
  • vascular origin;
  • endocrine – a decrease in blood sugar;
  • infectious;
  • intoxication.

Emergency care for fainting in children begins with reflex effects – spraying your face with cold water, inhaling ammonia vapor, rubbing your temples with cotton wool moistened with ammonia. With prolonged syncope, an enema is administered with a 10% solution of caffeine (0,1 ml/year of life) or niketamide (0,1 ml/year of life), with a decrease in blood pressure, 1% phenylephrine (mesatone) (0,1 ml/year of life).

If syncope is associated with a decrease in sugar level (in children with diabetes), they give him a sucking sugar cube or injected with an enema 20-40% glucose (2 ml/kg). With a sharp slowdown of the heartbeat, helping children with fainting, a 0,1% solution of atropine (0,05 ml/year of life) is administered.

Acute heart failure in children. Classification, clinic, emergency care.

A dynamic condition in which cardiac output is not able to provide the body’s metabolic needs for oxygen and other substrates is acute heart failure in children.

In the occurrence of heart failure, there are two main mechanisms that lead to a decrease in myocardial contractility. In the first case, a decrease in myocardial function occurs as a result of heart overload, when it is unable to perform the work that is required of it, and the compensatory possibilities are exhausted.

serdechn nedostatok1 - First aid for heart failure in adults and emergency care for children

In the second case, myocardial metabolism is primarily impaired, mainly due to a disorder of metabolic and energy processes in the heart muscle as a result of acute hypoxia, intoxication, and allergic reactions. This type of heart failure is called energy-dynamic failure. It is much more common in children and is usually acute.

The division of DOS into energy-dynamic and hemodynamic is sometimes conditional.

Etiology. Acute heart failure in children most often develops due to bacterial and toxic myocardial damage with toxic pneumonia, influenza, intestinal infections, rheumatic myocarditis and heart defects, diphtheria and typhoid myocarditis, acute nephritis, and long-term anemia.

Causes of heart failure can be congenital and acquired heart defects, vitamin deficiency (B vitamins), electrolyte deficiency (potassium deficiency) with peritonitis and intestinal toxicosis, acute hypoxia, various types of exogenous poisoning and initial myocardial weakness (congenital carditis and cardiomyopathy).

Right ventricular heart failure can develop with severe bronchial asthma, chronic pneumonia, defects in the right heart, emphysema, spontaneous pneumothorax. Excessive intravenous administration during infusion of saline solutions, plasma, blood, etc. without control of venous pressure can also lead to acute cardiac overload, especially in patients with pneumonia.

OCH develops according to the left, right ventricular and combined type. Right ventricular failure develops with severe pulmonary pathology, during surgery with rapid infusion therapy without monitoring central venous pressure. Left ventricular failure is more common in children with rheumatic heart disease, acute myocarditis and nephritis.

In assessing heart failure, its severity is of great importance. G.F. Lang (1934) proposed to distinguish 4 degrees of heart failure (H1, H2A, H2B, H3). This classification with minor modifications is used in pediatrics at the present time. In intensive care, it is more convenient to divide the OSN into compensated and decompensated (I and II degrees).

Pathogenesis. For a correct understanding of the pathogenesis and treatment of cardiovascular failure, it is necessary to know the metabolic biochemical processes that underlie cardiac activity. The metabolic processes in the heart muscle have three main phases: 1) the release of energy; 2) energy conservation;

3) energy use. Energy is generated as a result of glycolysis, oxidation of fatty acids and pyruvic acid and dehydrogenation in the Krebs cycle of tricarboxylic acids. Energy conservation is carried out through the activity of enzymes that carry hydrogen. In the process of oxidative phosphorylation, hydrogen energy is converted into ATP final bond energy and through creatine kinase into creatine phosphate.

The contraction of cardiac myofibrils occurs under the influence of the movement of ions in the heart cells as a result of depolarization and repolarization of the membrane. Sodium ions enter the cell, the membrane is depolarized, followed by sodium, chlorine and calcium ions enter the cell, and potassium ions begin to escape from the cell – the repolarization phase.

With heart failure, the water-electrolyte balance is disturbed, which leads to a delay in the body of water and salts, and sodium ions are retained more than water. Sodium ions, accumulating inside the cells, displace potassium ions from there. These shifts are amplified due to impaired renal excretion of sodium and potassium.

serdechnaya nedostatochnost1 - First aid for heart failure in adults and emergency care for children

Heart failure leads to impaired blood circulation in the kidneys, resulting in lower filtration and increased reabsorption of sodium in the body, which in turn leads to increased excretion of potassium by the kidneys. The leading role in these disorders belongs to extracardiac, especially nervous and hormonal factors.

As a result of metabolic disorders in the myocardium and the resulting deterioration in the contractility of the heart muscle, the ejection of blood from the heart cavity decreases, which leads to complex hemodynamic disorders, a decrease in minute blood volume, an increase in venous pressure, and an increase in circulating blood volume (BCC).

During hypoxia, the content of macroergic phosphorus compounds and glycogen in the heart muscle decreases, the amount of lactic and pyruvic acid increases, the activity of tissue enzymes is inhibited, the balance of electrolytes changes – the content of intracellular sodium increases and the intracellular potassium decreases. Oxygen starvation has an adverse effect on the conduction system of the heart.

1) Tachycardia, which occurs initially as a compensatory reaction of the heart with a decrease in myocardial contractility and a decrease in stroke volume of the heart, in order to maintain an adequate minute volume of blood circulation;

2) Shortness of breath, which also occurs as a compensatory reaction. The growth of heart failure, leading to a violation of pulmonary gas exchange, further increases shortness of breath with the involvement of auxiliary muscles in breathing;

3) The expansion of the borders of the heart. It is practically important not only to determine the expansion of the heart, but also to establish whether this is a consequence of dilatation, compensatory or myogenic hypertrophy;

4) Cyanosis of the skin and mucous membranes due to reduced blood supply to tissues and their insufficient supply of oxygen. As a result of this, metabolic processes are disturbed in the tissues, the proportion of anaerobic glycolysis increases with the accumulation of products of incomplete cleavage and a shift of the reaction to the acid side;

5) Pastosis of the skin and tissue swelling. Of the various pathogenetic mechanisms for the development of these symptoms, stagnation of blood in a large circle of blood circulation, a change in hydrostatic and colloid osmotic pressure, an increase in the permeability of the vascular wall, a decrease in renal blood flow, electrolyte shifts due to increased secretion of aldosterone are important;

6) An increase in the liver, which indicates a violation of the venous outflow, stagnation of blood in a large circle of blood circulation and is accompanied by an increase in CVP, an expansion of the venous network on the face and chest;

serdechn nedostatok2 - First aid for heart failure in adults and emergency care for children

Simple omphalitis or, in other words, a “wet navel” is the most common type of omphalitis. With good care, the umbilical wound completely heals by the 10-14th day of the baby’s life, and if microbes enter the wound and the inflammation begins, this process can be very delayed. At the same time, either transparent or yellowish discharge is allocated from the baby’s navel, often with streaks of blood.

Sometimes a slight redness of the umbilical ring itself joins these symptoms. From time to time, the umbilical wound becomes crusty, but this does not mean that the inflammation has ended. Under the crust, liquid gradually accumulates, in which microbes and bacteria still multiply. The general condition of the “wet navel” in the crumbs most often does not suffer. Sometimes there may be a slight increase in temperature.

Phlegmonous form of omphalitis is the second most severe form of this childhood disease. As a rule, the disease begins with a “wet navel”, but gradually pus begins to stand out from the umbilical wound instead of the transparent contents. On examination, a bulging navel is noticeable, its strong redness and swelling.

Phlegmonous omphalitis is very scary for its complications. Many young mothers simply do not understand and do not see the whole true picture of the disease, since the manifestations of the disease are minimal and very weakly expressed. But phlegmonous omphalitis can be complicated in very short time by such serious problems as:

  • Phlegmon of the abdominal wall;
  • Peritonitis;
  • Abscess of the liver;
  • Sepsis.

Necrotic or gangrenous omphalitis is a fairly rare form of the disease. As a rule, this disease occurs only in children with low body weight at birth and with low immunity.

With necrotic omphalitis, superficial inflammation very quickly passes to the inner layers of the navel and reaches the umbilical vessels. The skin of the navel and its fiber turn blue and necrotic, that is, they are rejected. Necrosis can affect the deeper layers of the skin and the anterior abdominal wall. The general condition of the child with this form of omphalitis remains severe.

Diagnosis of pertussis in children

1.
Intravenously inject insulin
at a dose of 0,1 U/kg in 150-300 ml of isotonic
sodium chloride solution (at large
Prescription of diabetes is administered 0,2 U/kg). At
the need to introduce strophanthin.

2.
Empty stomach by applying warm 5%
sodium bicarbonate solution (after
empty the stomach 100
ml of solution).

3.
Perform urinary catheterization
the bubble.

serdechn nedostatok3 - First aid for heart failure in adults and emergency care for children

4.
An enema with a warm 4% solution
sodium bicarbonate (300 ml).

Late
sugar diagnosis

Insufficient
insulin dose

Violation
diet
(insufficient
food, pass
reception
food)

Violation
diet (abuse

Labile
course of the disease

Much
exercise stress
Related
diseases with vomiting
and diarrhea

Phase
prodromes – precomatous

Fast
condition development

gradual
loss of consciousness

fast
loss of consciousness

Dryness
and cyanosis of the skin and mucous membranes

Pallor
and sweating

Language
dry with a touch

Rigidity
muscle trism chewing
muscles

Tone
eyeballs lowered

Tone
eyeballs normal

Pulse
frequent, weak filling

Tachycardia,
sometimes bradycardia

Absence of
appetite, nausea, vomiting

В
early development of hypoglycemia

noted
increased appetite

Sometimes
abdominal syndrome

Abdominal
there is no syndrome

Smell
exhaled acetone

Odorless
there is no acetone in exhaled air

Hypoglycaemia
(but there may be a norm and even hyperglycemia)

Drop
reserve alkalinity

Reserve
normal blood alkalinity

Acetonuria
and glycosuria

Acetonuria
and no glycosuria

5. Adjust
isotonic dropper
sodium chloride, heated to 370 ° C.
She is prescribed intravenously from
calculation of 20 ml/kg body weight. With increase
osmolarity of blood is administered 0,45% solution
sodium chloride. In a dropper add
50-200 mg cocarboxylase, 5 ml ascorbic
acid, 5000 PIECES of heparin (2 times a day).

6.
Subsequent insulin therapy: a
dropper add insulin from the calculation
0,1 PIECES/kg/h (with a long duration
diabetes – 0,2 U/kg/h).

1.
Examine Sugar Hourly
in blood, blood pH, blood pressure, register
ECG. With a decrease in blood sugar
up to 10 mmol/l switch to subcutaneous
or intramuscular administration of insulin
at a dose of 0,1-0,25 U/kg every 4 hours, followed by
transfer to a 5-time introduction.

2.
Continue Intravenous Administration
liquids at the rate of 50-150 ml/kg/day. IN
the average daily requirement of children in
liquids up to 1 year – 1000 ml, 1-5 years – 1500,
5-10 years – 2000, 10-15 years – 2000-3000 ml.

В
the first 6 hours you need to enter 50%, in
the next 6 hours – 25% and in the remaining 12 hours –
25% of the daily estimated dose.

Introduction
isotonic sodium chloride solution
or ringer’s solution continue to
blood sugar concentration of 14 mmol/l,
after which they switch to alternate
the introduction of a 5% glucose solution and
isotonic sodium chloride solution
in a ratio of 1: 1.

3.
Low blood pressure and shock symptoms
5% serum albumin is administered or
plasma substitutes (dextran) in a dose
10-20 ml/kg jet fast.

RџSЂRё
use 10% solution if necessary
caffeine (0,05-0,1 ml), alternating with 1% solution
mesatone every 3-4 hours (0,15-0,6 ml depending
on age) if it remains low
blood pressure level.

4.
Sodium bicarbonate is administered at blood pH
below 7,0 based on 2,5 ml of 4% solution per 1
kg body weight intravenously drip into
1-3 hours (no
in no case jet!).

5.
Potassium chloride is added to a dropper
2-4 hours from the start of insulin treatment
(or earlier in the presence of electrocardiographic
signs of hypokalemia) at a dose of 1,5-3 ml/kg
10% solution. Do not exceed the dose
potassium in solution above 40-60 mmol/l, which
is 30-45 ml of a 10% chloride solution
potassium per 1 liter of intravenously administered
liquids. You can not enter potassium if
the child is in shock, or there is anuria, or
elevated blood potassium levels due to
metabolic acidosis.

6.
Intramuscularly administered vitamin B12
(200Y) and Vitamin B6
(1 ml of 1% solution).

7.
Antibiotic therapy is carried out in age
doses for 7 days (with inflammatory
processes).

8.
Be sure to inhale moistened
oxygen.

With a heart attack in a child, the general algorithm of first aid is maintained, but there are some differences.

Firstly, it is forbidden to give any medication. Secondly, heart massage is done with less force. The bone skeleton in children is very fragile, strong pressure can lead to fractures and injury from fragments of internal organs.

Thirdly, the place, number and depth of clicks will differ at different ages:

  • In children up to a year and newborns, massage is performed with the middle and index fingers 10 mm below the nipples. The depth of their immersion should not exceed 1,5 centimeters. In a minute you need to do 120 light pressure. For every 5 decompression movements, there are 5 breaths.
  • In children under 7 years old, resuscitation is performed with the palm of one hand. Point of pressing – an area located 2 fingers below the sternum. It is necessary to ensure that the chest does not fall below 4 cm. 100 clicks are made per minute. There should be 5 pressures per breath.
  • For children 8-12 years old, the number of decompressions is reduced to 80 in 60 seconds, during which time you need to take 20 breaths. The chest moves 4 cm in depth.

As a rule, the result will be noticeable after 30-60 seconds: the skin will begin to turn pink, the pupils will expand, a weak pulse and independent breathing will appear. If this does not happen, the action must be continued until the arrival of the doctors. They can be stopped after the pulse is normalized, and the condition stabilizes.

After stopping breathing, the likelihood of resuscitation persists for half an hour. The sooner this is done, the less internal organs and the nervous system will suffer.

Emergency care for heart failure is a chance to save a person’s life. Everyone should know the rules for its provision, because an exacerbation can occur at any time.

The first signs of chickenpox and how it looks in children in the photo

  • pre-syncope – weakness, dizziness, nausea, discomfort in the region of the heart, in the stomach;
  • actually fainting – a partial narrowing of consciousness with its subsequent loss, decrease in muscle tone, blanching of the skin and visible mucous membranes, instability of breathing, pulse, blood pressure; short-term convulsions are possible;
  • post-syncope – a quick recovery of consciousness, there may be residual effects in the form of weakness, nausea, slowing of the heartbeat.

1) the child is excited, inadequate; his skin is pale, “marble”, hands and feet are cold; muscle tone is increased, breathing is quickened, blood pressure can be within the age norm or increased. A characteristic clinical sign of collapse at this stage is an increased heart rate;

2) the child is inhibited; the skin and mucous membranes take a gray-cyanotic shade, the limbs become cyanotic; muscle tone is reduced, heart rate slows down, blood pressure decreases, urination decreases;

3) consciousness and reflexes are oppressed; the skin is cold, in blue-purple spots; breathing and palpitations are slowed, blood pressure drops to a critical level, urination stops.

Emergency care for collapse in children begins with laying a child with raised lower limbs and a thrown back head; provide fresh air.

In case of collapse, in addition to the above, prednisone (2-20 mg/kg), hydrocortisone (4-20 mg/kg), dexamethasone (0,3-0,6 mg/kg) are administered.

Article read 3 times (a).

Quincke’s edema is one of the varieties of a severe allergic reaction. In this condition, widespread subcutaneous tissue edema develops very quickly. Most often, fiber of the lips, eyelids, cheeks, larynx, and mouth is affected. The most dangerous swelling of the larynx, as it can cause death by suffocation.

The cause of this emergency condition can be any severe form of allergy, however, most often it develops in response to intramuscular or intravenous administration of any drugs or insect bites, as well as when the allergen is inhaled (most often it is paints, varnishes, perfumes).

The first clinical sign of this emergency is hoarseness or hoarseness. Then a strong painful “barking” cough appears, after which breathing is difficult, shortness of breath increases. The patient’s face becomes cyanotic, then turns pale. In the absence of adequate assistance, a person loses consciousness and dies.

Quincke’s edema can affect the mucous membranes of the gastrointestinal tract, in which case the patient has a sharp pain in the abdomen, nausea, vomiting, and sometimes defecation is disturbed.

Help with this emergency condition begins with the elimination of the allergen, after which you need to immediately begin medication. Adrenaline (1 ml of a 1% solution) is injected subcutaneously, suprastin or diphenhydramine (1 ml), as well as prednisone (30-60 mg) intramuscularly. To prevent bronchospasm during emergency medical care, salbutamol is inhaled during this emergency.

Hepatic colic is one of the acute manifestations of gallstone disease. It develops in violation of the outflow of bile from the gallbladder. Most often, the cause of pain is a blockage of the excretory duct of the gallbladder with a stone.

Typically, colic develops on the background of the consumption of a large amount of spicy, fatty, fried, smoked, salty foods, alcoholic beverages.

In addition, the attack can be triggered by nervous experiences, physical exertion, weight lifting, riding on rough roads.

The main symptom of this emergency condition is severe pain in the right hypochondrium, extending to the right shoulder, right shoulder blade, i.e. up and back. Sometimes it can give to the left, simulating an attack of angina pectoris. The intensity of the pain is so great that the patient groans, rushes about and cannot find a position in which he will feel at least a little easier. Very often during an attack, nausea and repeated vomiting occur, which does not bring relief. The front wall of the abdomen is usually tense.

In some cases, hepatic colic passes on its own as the stone passes through the duct back into the gall bladder or into the duodenum. But most often the patient requires first aid in this emergency condition: the best effect in this case is exerted by antispasmodic and painkillers: papaverine (2 ml) and baralgin (5 ml) are administered intramuscularly.

If there is no doubt about the cause of pain, then during first aid in this emergency condition, you can try to relieve spasm with a heating pad placed on the liver, but if the cause of the pain is an inflammatory process, heat only worsens the situation. In any case, regardless of the success of the relief of pain, the patient must be taken to a surgical hospital, since colic can become a symptom of the development of acute cholecystitis.

!  How to strengthen the heart muscle in heart failure

The following periods of pertussis in children are distinguished:

  • catarrhal, which disguises itself as a typical SARS with concomitant runny nose, sore throat, dry cough and fever;
  • convulsive with spasms of muscle tissue clinically manifests itself in typical coughing attacks with a previous aura in the form of anxiety and lack of air;
  • the recovery period, in which symptoms subside and seizures are becoming less frequent, can last up to 2 months.

The first signs of pertussis appear after the end of the incubation period, which can last from 3 days to 2 weeks.

The initial signs of pertussis in children are disguised as a typical catarrhal disease:

  • body temperature rises, severe chills, sweating;
  • the child complains of headaches and muscle pain, weakness;
  • swelling of the mucous membrane of the nasal passages occurs, accompanied by nasal congestion and the release of transparent mucus;
  • the cough joins quickly enough, has a dry character and does not stop with the usual means.

On examination, pronounced hyperemia of the pharynx, pallor of the skin, rapid pulse and breathing are visible. Vesicular or hard breathing is heard in the lungs. The catarrhal period lasts an average of 7 to 10 days. In the newborn period, a fulminant course of the disease is observed, the spastic period occurs after 48 – 72 hours.

Symptoms of pertussis in children in the convulsive period are pronounced and leave no doubt in the diagnosis of infection. Several times a day there are attacks of dry unproductive cough.

  • preliminary strong feeling of the presence of a foreign object in the throat with difficulty breathing;
  • a sequential series of coughing tremors in the form of exhalations;
  • prolonged reprise on inspiration with a whistling unpleasant sound;
  • following coughing exhalation;
  • discharge of thick mucous secretion (streaks of blood may be observed).

Sometimes the attack ends with vomiting due to a sharp spasm of the glottis and trachea. A series of coughing seizures lead to a characteristic change in the appearance of the patient. Puffiness of the face, hemorrhage under the eyes and in the corners of the mouth appears. The tongue can be covered with dense white sores. Hemorrhages and hyperemia are visible in the throat.

An increase in the severity of seizures and general symptoms occurs within 2 weeks. At this time, it can be shown if severe symptoms of pertussis appear, treatment in a hospital. This is necessary in view of the possibility of connecting the baby to the artificial respiration apparatus.

On average, the duration of the spasmodic period can be 15 to 25 days. With a good level of immune protection, these periods can be reduced to 12 days.

In the recovery period, the number of coughing attacks per day is gradually reduced, the condition of the child is restored. After about 2 weeks, the cough persists already without seizures. Complete recovery may occur within the next 2 weeks. At this time, the baby should be protected from contacts with any bacterial and viral infections. Any catarrhal diseases can provoke the return of spasmodic coughing attacks and prolong the period of pertussis.

It is necessary to distinguish various forms of the course of infection. In approximately 30% of cases in previously vaccinated children, an erased or mild form of whooping cough is detected in which there are no paroxysms of coughing attacks. The disease occurs in the form of a usually protracted ARI. However, such patients pose a serious threat to the spread of pertussis pathogen.

How to recognize an attack of heart failure?

Heart failure – a chronic or acute disruption of the heart, as a result of which there is a failure of the blood supply to the most important organs. Usually, the disease is diagnosed in elderly people over 55 years old, less often in middle age and in children.

An attack of acute heart failure occurs unexpectedly, most often after emotional, physical stress or at night.

External signs of the syndrome:

  • chest pain while lying down;
  • labored breathing;
  • weakness;
  • dizziness;
  • intense fear for no apparent reason.

These symptoms become weaker when a person sits down.

  • the skin becomes very pale;
  • lips and fingers acquire a bluish tint;
  • the whole body is covered with cold sweat;
  • a strong cough with sputum begins, in which blood is visible;
  • blood vessels on the neck increase, appear under the skin;
  • arms and legs swell.

In children it is more difficult to determine an attack; they cannot describe how they feel. If the child suddenly becomes pale, limbs feel colder, and foam comes out of the mouth, an ambulance must be called.

Depending on the degree of damage to the heart muscle and blood vessels, death in adults and children occurs within a few minutes or days. Relatives of patients should be ready to provide first aid at any time.

Characteristic symptomatology

Symptoms of an acute attack will be different depending on the stage, as well as the disease that provoked it. Knowing these signs will help you quickly navigate and provide the necessary urgent actions to save a person.

Three stages of a cardiovascular attack and their corresponding symptoms are distinguished.

The last stage can develop in three ways:

  1. Instant. A person dies 2-3 minutes after the onset of edema.
  2. Acute. A fatal outcome occurs from half an hour to 3 hours of an attack.
  3. Protracted. An acute course without urgent action can last more than a day, after which the patient dies.

With the manifestation of this symptomatology, first aid should be immediately provided and a medical team called. Only quick and correct first aid measures will save the patient.

Separately, we should dwell on the distinguishing features of the manifestation of symptoms in a child.

As the disease develops, children feel fatigued even after minor physical exertion, they have a restless sleep and a strong cough, which is accompanied by vomiting or wheezing.

Acute heart failure in children is characterized by the presence of such signs:

  • Hard breath;
  • Shortness of breath
  • Fainting
  • Severe dizziness;
  • Pallor of the skin;
  • Fingers and lips become darker;
  • Cardiopalmus.

The child has a low body weight, he can not play sports: the most insignificant physical activities cause a sharp deterioration.

The teaching staff should be well aware of what to do when symptoms of attacks are manifested, and conduct appropriate classes of the course “Fundamentals of Safety and Life.”

The primary manifestations of the onset of the process are expressed:

  • sudden onset of weakness;
  • short, frequent, shallow breaths and exhalations;
  • dizziness;
  • pain in the sternum.

The clinical picture of the problem is determined by the characteristic symptoms and allows you to determine the type of pathological process.

Itching with chickenpox in children can cause secondary bacterial infection. The most unpleasant thing is that this rash is also very itchy, but it is impossible to comb it, in order to prevent infection from entering the wound. Some bubbles pass – new ones appear. Chickenpox in children is wave-like. New rashes usually appear within 3-4 days.

Differential diagnosis of ketoacidotic and hypoglycemic coma in children

The initial diagnosis is based on the clinical picture. In the composition of peripheral blood changes are not significant. Leukocytosis and changes in the erythrocyte sedimentation rate may be observed. The number of lymphocytes increases. In the spasmodic period, a decrease in hemoglobin and hematocrit levels can be detected.

To clarify the diagnosis, bacteriological culture of sputum or a smear from the throat is performed. For a quicker final diagnosis, a serological blood test can be performed for specific antibodies. Agglutination reaction is being studied. At an early stage, an intradermal test method helps to identify pathology.

Treatment of pertussis in children: drugs and antibiotics

Emergency care in identifying acute heart failure is very important in order to avoid the worst consequences, that is, a possible fatal outcome. After calling an ambulance or cardiopulmonary rescue team, first aid should be immediately provided. The patient should be fixed in a half-sitting or sitting position, ensuring normal blood supply to all limbs, and, having opened all windows and doors, provide fresh air.

On the lower extremities 5-10 minutes after the above fixation of the position, the patient needs to apply tourniquets in the hips to exclude a small amount of blood from the blood circulation. It is important to relieve emotional stress by reassuring the victim as much as possible. Feet should be dipped in hot water.

When the value of the upper blood pressure is not lower than 90 mm Hg subject to the perception by the body of nitrates, the patient can be given a nitroglycerin tablet under the tongue, which will contribute to the expansion of the vascular system and improve blood flow to the heart. Tablets should be given every 3 minutes, but not more than 3-4 pcs.

At such blood pressure values, an intravenous slow jet infusion of pentamine ganglion blocker is also indicated (0,5-1,0 ml of a 5% solution in 10 ml of a 0,9% sodium chloride solution under the control of blood pressure or benzohexonium (0,5- 1,0 ml of 2,5% solution)). The introduction of 2 to 8 ml of 1% furosemide is recommended.

If the blood pressure does not exceed 80 mmHg the patient needs to slowly inject a solution of 200 mg of dopamine and 400 ml of reopoliglukin or 5% glucose solution. If the pressure remains low, the administration of norepinephrine must be added.

Nitroglycerin and other drugs can be contraindicated to the patient and lead to a worsening of his condition.

Common therapy measures include:

  • isolation of a sick baby;
  • ensuring a high level of humidity in the room where it is located;
  • reducing the air temperature in the room to 20 degrees Celsius (this measure reduces the number of seizures);
  • the use of antibiotics and antitussive drugs;
  • the use of specific globulins;
  • restoration of immunity;
  • elimination of negative consequences.

Further, treatment methods and drugs used are discussed in more detail.

The most commonly used antibiotic for whooping cough is Chloramphenicol, which can be replaced by Ampicillin or Erythromycin. Drugs are prescribed for oral administration. Intramuscular and intravenous administration of antibiotics for whooping cough is indicated only in severe cases of the disease and a pronounced gag reflex against the background of coughing attacks. The daily dosage is calculated based on the formula: 0,05 mg per kilogram of the child’s weight, divided into 4 single doses.

In the absence of a visible effect 48 hours after the administration of the drug, the treatment regimen is changed by adding 1 or two drugs from the allowed groups.

In the early stage of the disease, specific treatment with globulinin with antitussive properties is possible. The standard administration schedule is intramuscularly three times 1 time per day, 3 ml each.

An excellent tool is oxygen therapy using oxygen pads and masks. In parallel, it is necessary to use Reopoliglyukin, a solution of Glucose for intravenous administration. These measures contribute to the relief of pathological changes in the lung tissue and heart muscle.

Neuroleptic drugs for whooping cough are used exclusively in the spasmodic period of the disease. Most often, “Aminazine”, “Atropine”, “Propazine” are prescribed. They affect the frequency and depth of coughing attacks.

The most effective antitussive is Synecod syrup. Can also be used “Codelac Fito”, “Libexin”, “Ambroxol” and many others. Dosages are calculated based on the age and body weight of the child.

Complex vitamin therapy, the use of drugs that have an immunostimulating effect are shown. Glucocorticosteroids are used only in extreme cases. The drug “Prednisone” is strictly contraindicated, which can have an exciting effect on the respiratory center.

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Although the symptoms of chickenpox are not so unbearable for a child, it is still advisable to maintain bed rest for the duration of the illness (about a week). There is no specific treatment for chickenpox. There is no cure for it. But it is possible to minimize the discomfort caused by this disease. In order to prevent new rashes, often change bed and underwear

Treatment for omphalitis will depend on its form. Simple omphalitis can be tried to cure at home under the supervision of a doctor. In this case, the mother should rinse the baby’s navel 3–4 times a day with hydrogen peroxide, and then instill an antiseptic solution based on alcohol or water. most often this is dioxidine or chlorophyllipt. It is recommended to bathe a child with simple omphalitis in a slightly pink solution of potassium permanganate.

Treatment of phlegmonous omphalitis is carried out by a surgeon. Here, the navel is also treated with hydrogen peroxide, but antibacterial ointments, for example, bacitracin, polymyxin or Vishnevsky ointment, are used to quickly cure.

The necrotic form is treated with the use of antibiotics and with excision of the dead tissue. A child is given droppers with a glucose solution, and dressings with antibacterial ointments and wound healing solutions are applied to the wound. Treatment is carried out strictly in a hospital.

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Folk remedies for an attack

Experts are prejudiced against any home-based primary care methods for developing acute heart failure. Healers believe that their methods can have a positive effect on the patient’s state of health at the time of the attack.

A vinegar solution is taken – in a ratio of 1 to 20 – the patient’s chest is moistened with it. Next, in the same solution, a dense tissue is soaked, a compress is applied to the chest, aged about half an hour. After it is replaced with a fresh one, the manipulations are repeated up to five times – until the patient is completely relieved.

To prevent the development of an attack of acute heart failure, traditional medicine recommends following the rules:

  • the constant alternation of physical and psycho-emotional relaxation – relaxation with the help of scented candles, bathing with healing solutions;
  • constant use of specialized herbal teas – a drink with St. John’s wort, peppermint or lemon balm has a great influence on the normative work of the heart;
  • protection against hypothermia – clothing should be fully seasonally and prevent freezing;
  • special attention is paid to the daily menu – vegetables and fruits should be included in it, all harmful food products are strictly prohibited;
  • homemade pickles and preservation should be removed from the patient’s diet – their use worsens the condition and allows the tissues to accumulate excess fluid.

Instructions for first aid in heart failure

Standard help for heart failure should be provided immediately – time delays can lead to death for a poorly feeling person. The action algorithm includes simple rules:

  • emergency team call;
  • providing access to fresh air – open windows, vents or take the victim out to the street, ask them to go to the distance of gathered onlookers;
  • unfasten all tight clothing;
  • arrange the patient in a half-sitting position, lower the lower parts of the upper and lower extremities into hot water – to reduce the flow of blood to the heart muscle;
  • offer the patient a drug from a subgroup of nitrates (Nitroglycerin, etc.) – for artificial influence on the coronary vessels (their expansion will allow the blood to move freely through the arteries).

First aid and treatment

Given that acute heart failure can develop at lightning speed, emergency care is sometimes the only way to save the patient, because in this case there may not be time before providing medical care.

The main task of pre-medical actions for manifestations of an attack accompanied by heart failure is to call doctors, eliminate collapse and reduce heart load.

When providing emergency care, clearly adhere to the sequence of the following:

  1. Call an ambulance medical team. Quickly, clearly and consistently tell about the symptoms that have manifested, the age of the patient, indicate the exact address where the victim is located.
  2. Give the patient a half-sitting position by placing pillows or blankets under his back. This technique allows you to reduce the heart load, as the blood flow begins to move faster to the legs.
  3. Ensure maximum fresh air: open the windows, open the doors, free the victim from the pressing elements of clothing. With such a vascular disorder, a person needs a lot of oxygen.
  4. If the provision of first aid is carried out indoors, dip the patient’s hands and feet in hot water. So relieve stress from the heart.
  5. Urgent medical assistance consists in taking nitroglycerin under the tongue. After 15 minutes, check your blood pressure. If they exceed the norm, you can repeat the medication.
  6. If within 15 minutes after the onset of the attack, the medical team did not arrive, begin an emergency reduction in heart load: bandage the lower limbs of the patient with a very tight bandage.

If a person begins to suffocate or loses consciousness, you need to proceed to emergency resuscitation, consisting in artificial respiration and heart massage. Do them until the medical staff arrives.

First aid for acute heart failure and stroke is provided by doctors from the ambulance team and includes the following resuscitation:

  • First of all, with the help of special masks they carry out oxygen nutrition of the lungs;
  • Emergency relief of bronchospasm is carried out by venous administration of Eufillin;
  • Reduce blood pressure with ganglion blockers or vasodilators;
  • Mandatory is the use of diuretics to relieve swelling;
  • If the blood pressure is normal, use vasodilators intravenously;
  • With reduced pressure, sympathomimetic amines are introduced, with the help of which arrhythmia is also eliminated;
  • To reduce the risk of shock or damage to the alveoli, corticosteroids are used;
  • If a person can suffocate in a severe attack of cough, Morphine or Droperidol in the form of a solution is used to restore respiratory functions.

Acute heart failure is being treated, emergency care was provided correctly, in the conditions of the intensive care unit of cardiology.

Attacks of rapidly developing heart failure are dangerous due to their suddenness and serious threat to people’s lives. Therefore, in the presence of diseases associated with blood vessels and the heart, one should strictly observe medical recommendations, adhere to a balanced diet and avoid excessive physical and emotional stress.

Acute heart failure is a pathological condition that can develop over a relatively short period of time of several hours or days. It is characterized by a decrease in myocardial contractility with a deterioration in blood flow, which does not provide an adequate supply of nutrients and oxygen to the tissues.

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Causes

Acute heart failure is not an independent pathological process, it develops as a result of other diseases, which most often include:

  • Congenital heart diseases.
  • Acute exogenous poisoning, characterized by the influx of toxins into the body of the child from the outside.
  • Myocarditis.
  • Acquired heart defects.
  • Pathology of the lungs.
  • Severe systemic allergic reactions.
  • Arrhythmia – a violation of the rhythm of heart contractions.
  • Thyrotoxicosis – an increase in the functional activity of the thyroid gland with a significant increase in the secretion of its hormones.
  • Acute circulatory disturbance in the brain with a change in the functional activity of the centers that regulate the functioning of the heart and blood vessels.

Also, a pathological decrease in the contractility of the heart can develop due to improper choice of the volume of infusion (intravenous infusion) of salt and hyperosmolar (glucose) solutions, and an excess of the dosage of radiopaque compounds.

Clinical options

Depending on which part of the heart a decrease in contractile activity is more pronounced, several clinical options for this pathological condition are distinguished:

  • Acute left ventricular failure.
  • Acute right ventricular failure.
  • Total heart failure.

These clinical forms of the pathological process in a child have distinctive symptoms, and also require various therapeutic approaches at the hospital stage of care.

clinical picture

Manifestations of the development of a decrease in myocardial contractility depend on which part of the heart was affected to a greater extent:

  • Damage to the left heart – the main manifestation is the symptoms of cardiac asthma, which includes pulmonary edema with a pronounced attack of suffocation, persistent cough with pink foamy sputum, which intensifies at night. The child is very scared, he is trying to take the sublime half-sitting position. Breathing is noisy, bubbling, distance rales can be heard. The skin at the beginning of the attack becomes pale, then it acquires a bluish color, more pronounced on the fingers of the limbs, lips, in the region of the nasolabial triangle.
  • The defeat of the right heart – clinical symptoms develop suddenly, there is a feeling of suffocation, pain and a feeling of tightness in the heart, the skin acquires a pronounced bluish color, it becomes cold to the touch, covered with sticky sweat. Against this background, signs and signs of an increase in the level of central venous pressure appear with pulsation of large veins (jugular veins in the neck) and the development of edema of peripheral tissues.
  • Total damage to all parts of the heart is a very serious condition, which often develops in young children and is characterized by a deterioration in blood circulation in the small and large circle of blood circulation.

Knowledge of symptoms facilitates the subsequent diagnosis of the causes and nature of heart failure, and also allows you to choose the most optimal therapeutic tactics at the hospital stage of care.

When the first signs of heart failure develop, you should immediately call an ambulance. Prior to the arrival of medical specialists, it is important to perform several first aid measures:

  • Give the child an elevated semi-sitting position of the body, in which the severity of pulmonary edema, an attack of coughing and suffocation is reduced.
  • Unfasten the collar of clothing to facilitate breathing.
  • Prov />(you can use the cuff of the tonometer) on the middle third of the shoulder and hips (3 tows or cuffs). The duration of application of the tourniquets should not exceed 20 minutes, after this period of time, the tourniquets are loosened to resume blood flow in the tissues, then they are applied again.
  • The use of nitroglycerin (tablets that improve blood flow in the heart tissue by expanding the lumen of the coronary arteries), which is placed under the child’s tongue. ½ or 1 tablet (0,5 mg) may be used depending on age.
  • The use of furosemide is a diuretic, which, due to an increase in diuresis, reduces the severity of pulmonary edema.

Such measures will help improve blood flow, as well as reduce the severity of pulmonary edema and hypoxia (reduced oxygen supply) of the child’s body. Medical specialists begin to carry out further therapeutic measures already in the ambulance.

After a long winter, we all love to get out into the countryside, out of town. But there mosquitoes and midges lie in wait for us. Their bites are especially dangerous for young children who have sensitive skin, and besides, they cannot protect themselves from these insects. Therefore, children need help.

Firstly, the room where the child sleeps should have mosquito nets on windows and doors. Secondly, you can use fumigators with special tablets indoors. Third, remember that insects fly into the light. Therefore, if you turned on the electricity in the evening, then make sure that the insects do not have access to the room where the child will sleep.

Harder on the street. The use of repellents (insect repellent substances) for young children is undesirable. In extreme cases, some of them (those that are not contraindicated in children) can be applied to clothing. But if mosquitoes did bite the child and itchy spots appeared on the skin, then treat them with Fenistil gel, which reduces swelling and itching.

Encephalitis tick is a carrier of two diseases: tick-borne encephalitis and tick-borne borreliosis (Lyme disease). Approximately one hundredth of a tick carries the virus of encephalitis, and every tenth – borrelia. To prevent ticks from spoiling your vacation, it is advisable to dress in such a way that the tick cannot get to the skin.

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Ticks wake up at the end of April, and it is from this time that security measures must be taken. If the tick nevertheless bites the child, then during the first emergency medical care it is necessary to administer the victim anti-mite gamma globulin to the first 48 hours after the bite. It is also advisable to examine the tick for the presence of borrelia, so do not try to immediately throw it away, even if you yourself removed it, take it to the laboratory for research.

The fact is that anti-tick-borne gamma globulin only protects against tick-borne encephalitis virus. If the tick also contained borrelia, then antibiotic therapy is prescribed, since Lyme disease is very long and quite difficult. The temperature may rise, the joints and skin become inflamed at the site of the bite.

National vaccination schedule for epidemiological indications for 2018 year with table

The vaccination schedule for epidemic indications begins its operation in the conditions of the threat of the epidemic of this or that disease. In the table below the national vaccination schedule is accompanied by special instructions to this effect. The national vaccination schedule for 2018 year in the table takes into account the bulk of contact infections transmitted, including from blood-sucking insects.

Categories of citizens subject to preventive vaccinations for epidemiological indications, and the procedure for their conduct

The timing of preventive vaccinations for epidemic indications

The population living in the territories enzootic for tularemia, as well as those who arrived in these territories, performing the following works: agricultural, irrigation, land reclamation, construction, other work on excavating and moving soil, harvesting, fishing, geological, surveying, expeditionary, deratization and pest control; logging, clearing and improvement of the forest, zones of rehabilitation and recreation of the population. Persons working with live cultures of tularemia

In accordance with the instructions for the use of vaccines

The population residing in the enzootic territories of the plague. Persons working with live cultures of the causative agent of the plague

In accordance with the instructions for the use of vaccines

In foci of a goat-sheep type, persons performing the following work: on the procurement, storage, processing of raw materials and livestock products obtained from farms where brucellosis cattle diseases are recorded; slaughter of cattle sick with brucellosis, harvesting and processing of meat and meat products received from it. Breeders, veterinarians, livestock specialists in farms enzootic for brucellosis. Persons working with live cultures of the pathogen of brucellosis

In accordance with the instructions for the use of vaccines

Persons performing the following works: animal workers and other persons professionally engaged in pre-slaughter maintenance of livestock, as well as slaughtering, skinning and cutting carcasses; collection, storage, transportation and primary processing of raw materials of animal origin; agricultural, hydromeliorative, construction, for excavating and moving soil, harvesting, fishing, geological, prospecting, expeditionary on enzootic in the Siberian ancestral territories. Workers of laboratories working with material suspected of being infected with anthrax

In accordance with the instructions for the use of vaccines

For prophylactic purposes, immunized persons who have a high risk of rabies: laboratory workers who work with a street rabies virus; veterinary workers; huntsmen, hunters, foresters; Persons performing work on catching and keeping animals

In accordance with the instructions for the use of vaccines

Persons performing the following works: for the procurement, storage, processing of raw materials and livestock products obtained from farms located on sites enzootic on leptospirosis; slaughter of livestock, patient with leptospirosis, preparation and processing of meat and meat products obtained from leptospirosis patients; on the capture and maintenance of neglected animals. Persons working with live cultures of the causative agent of leptospirosis

In accordance with the instructions for the use of vaccines

Against tick-borne viral encephalitis

The population living on enzootic territories in tick-borne encephalitis territory, as well as persons arriving on these territories, performing the following works: agricultural, irrigation and reclamation, construction, excavation and transfer of soil, harvesting, fishing, geological, prospecting, expedition, deratization and disinsection; logging, clearing and improvement of the forest, recreation and recreation areas of the population. Persons working with live cultures of the causative agent of tick-borne encephalitis. Persons visiting enzootic in tick-borne encephalitis territory for the purpose of recreation, tourism, work in the country and garden areas

In accordance with the instructions for the use of vaccines

Against the fever of Ku

Persons performing work on harvesting, storage, processing of raw materials and livestock products obtained from farms, where diseases are registered with fever of Koo cattle. Persons performing work on the procurement, storage and processing of agricultural products in the enzootic territories for the fever of Ku. Persons working with live cultures of causative agents of fever Ku

In accordance with the instructions for the use of vaccines

Against yellow fever

Persons traveling abroad in the areas of yellow fever enzootic. Persons working with live cultures of yellow fever

In accordance with the instructions for the use of vaccines

Persons traveling to the dysfunctional country according to cholera. Citizens of the Russian Federation in case of complication of the sanitary and epidemiological situation in cholera in adjacent countries, as well as in the territory of the Russian Federation

In accordance with the instructions for the use of vaccines

Against typhoid fever

Persons engaged in the sphere of public amenities (workers serving sewerage networks, structures and equipment, as well as enterprises for sanitary cleaning of populated areas – collection, transportation and disposal of domestic waste). Persons working with live cultures of pathogens of typhoid fever. Population living in areas with chronic aquatic epidemics of typhoid fever. Persons leaving for hyperendemic by typhoid regions and countries. Contact persons in the centers of typhoid fever on epidemics. According to epidemic indications, vaccinations are carried out at the threat of an epidemic or an outbreak (natural disasters, major accidents at the water and sewerage network), as well as during the epidemic, with a massive immunization of the population in the threatened area

In accordance with the instructions for the use of vaccines

Against viral hepatitis A

Persons at risk of infection (doctors, nursing staff, public service workers employed at food industry enterprises, catering organizations, as well as servicing water and sewerage facilities, equipment and networks.) Persons traveling to disadvantaged regions and country where the outbreak morbidity is registered Contact in the foci of hepatitis A

In accordance with the instructions for the use of vaccines

Workers of infectious hospitals and bacteriological laboratories. Persons engaged in public catering and public amenities. Children attending children’s institutions and going to health camps (according to indications). According to epidemic indications, vaccinations are carried out at the threat of an epidemic or an outbreak (natural disasters, major accidents at the water and sewerage network), as well as during the epidemic, with mass immunization of the population in the threatened area. Preventive vaccinations are preferably performed before the seasonal rise in the incidence of shigellosis

In accordance with the instructions for the use of vaccines

Against meningococcal infection

Children, adolescents, adults in the foci of meningococcal infection caused by meningococcal serogroup A or C. Vaccination is carried out in endemic regions, as well as in the case of an epidemic caused by meningococcal serogroup A or C

In accordance with the instructions for the use of vaccines

Contact persons from foci of the disease, who have not been sick, not vaccinated and who do not have information about preventive measles vaccinations, who are once vaccinated without age restriction

In accordance with the instructions for the use of vaccines

Against hepatitis B

Contact persons from foci of the disease, who have not been sick, not vaccinated and who do not have information about preventive vaccinations against hepatitis B

In accordance with the instructions for the use of vaccines

Contact persons from the foci of the disease, who have not been sick, are not vaccinated and have no information about preventive vaccinations against diphtheria

In accordance with the instructions for the use of vaccines

Contact persons from foci of the disease, who have not been sick, not vaccinated and who do not have information about preventive vaccinations against mumps

In accordance with the instructions for the use of vaccines

Vaccinations are subject to contact persons in the outbreaks of poliomyelitis, including those caused by wild poliovirus (or suspected of the disease):

children from 3 months to 18 years

Children who have come from endemic (unfavorable) poliomyelitis countries (territories) from 3 months. up to 15 years

Once (in the presence of reliable data on previous vaccinations) or three times (in their absence)

Persons without a specific place of residence (if they were identified) from 3 months. up to 15 years

Once (in the presence of reliable data on previous vaccinations) or three times (in their absence)

Persons who came in contact with those who arrived from endemic (unsuccessful) poliomyelitis countries (territories), from 3 months of life without age restriction

Persons working with live poliovirus, with materials infected (potentially infected) with wild poliovirus without age limitation. Immunization against poliomyelitis for epidemic indications is carried out by an oral polio vaccine. Indications for the immunization of children with oral poliomyelitis vaccine for epidemic indications are the registration of a case of poliomyelitis caused by wild poliovirus, the isolation of wild poliovirus in bioassay materials from people or from environmental objects. In these cases, immunization is carried out in accordance with the decision of the Chief State Sanitary Doctor of the subject of the Russian Federation, which determines the age of children subject to immunization, the timing, order and frequency of its conduct

Once when hiring

The consequences and complications of pertussis disease

The consequences of the disease do not belong to the category of specific phenomena and can occur depending on the degree of damage to the organ and the stage of the ongoing process. Frequently recorded include:

  • disturbances in the rhythm of contractions of the heart muscle and the final lethal outcome – the syndrome provokes this development of events 44% more often than other pathologies;
  • infectious lesions – congestion in the lung tissue provokes the development of favorable conditions for the penetration of pathogenic microflora;
  • bleeding from the lungs – swelling and cardiac asthma is the root cause of this complication;
  • insufficiency of liver functionality – develops at the level of cellular structures due to passing venous stasis;
  • in the terminal stages of heart failure, metabolic disorders occur that provoke the formation of cardiac cachexia (against the background of generalized anorexia due to poor absorption of lipids);
  • heart attacks, strokes, embolism of tissues of internal organs – arise due to blood stasis;
  • chronic type of renal failure.

Severe pertussis disease can lead to prolonged hypoxia, which manifests itself in a violation of the blood supply to the brain and myocardium. This can provoke severe consequences of whooping cough in the form of structural changes, including expansion of the ventricles and atria, impaired brain activity.

complications of pertussis occur against the background of the wrong tactics for treating the disease. It can be pneumonia, bronchiolitis, emphysema, pleurisy. Often a secondary asthmatic complex develops, in which there are regular attacks of suffocation, which are provoked by viral colds.

Almost all complications of pertussis are related to secondary infections. Against the background of weakened immunity and a decrease in the intensity of lymph movement in the lung tissue, stagnation begins. It is possible to attach staphylococcal, streptococcal, pneumococcus and Pseudomonas pathogenic microflora.

Prevention of pertussis in infants up to a year

To prevent the occurrence of diseases of the cardiovascular department, it is necessary to conduct timely treatment of concomitant pathological processes. In order to avoid the symptomatic manifestations of insufficient heart performance, the following preventive measures should be followed:

  • principles of recommended nutrition – with the restriction of salt (total volumes should not exceed three grams per day), sugar, animal fats;
  • constant weight control and the use of diet tables to reduce it;
  • constant physical activity within reasonable limits – according to the recommendations of specialists, with a course of exercise therapy;
  • periodic long walks in the fresh air – if possible, in the territory of forest zones;
  • treatment of chronic nicotine addiction;
  • refusal of abuse of alcoholic and low alcohol drinks;
  • avoid strong coffee, tea, energy drinks;
  • the exclusion of chocolate, smoked meats and spicy dishes;
  • timely use of drugs prescribed by the attending physician – to suppress the symptoms of the underlying disease.

The study of measures for the provision of first aid will help save the lives of not only loved ones, but also casual passers-by.

Early detection of pathology, topical treatment and moral support are necessary for patients with heart lesions. In addition to standard medical procedures, such patients need palliative care – during the transition of the disease to the terminal stage, to improve the quality of life.

Particular attention should be paid to the vaccination calendar for children up to a year – this category of babies is most vulnerable to various infections. The vaccination calendar in Russia undergoes some changes annually, therefore, if vaccination was started a year earlier, then it continues according to the standard schedule. The new national vaccination calendar in Russia begins to operate in January and applies to everyone who is vaccinated for the first time.

Very often, pertussis in infants occurs in the so-called masked form. There are no pronounced reprise in coughing attacks. Instead, there is a sudden stop of breathing after a prolonged attack of screaming and hysteria after a few coughing shocks. There is a violation of the blood supply to the brain structures and heart muscle. Convulsive syndrome occurs, the baby’s face turns blue.

Prevention of pertussis in children under one year of age is the most important measure in preventing child mortality from various infections.

First of all, care should be taken to limit the contact of the baby with unauthorized persons. If an infection is detected in a kindergarten, a complete diagnosis of all contact persons and removal of a possible source of pertussis bacillus is provided. The quarantine period is at least 2 weeks from the moment of the last infection.

The most effective means of preventing pertussis in children under one year of age and older is vaccination in strict accordance with the national vaccination calendar. Primary vaccination is carried out at the age of 3 months. Then a 3-fold booster dose is required with an interval of 45 days. To restore specific immunity against pertussis requires another booster vaccination at the age of 2 – 2,5 years.

National vaccination schedule for epidemiological indications for 2018 year with table

Next is the calendar of the vaccination calendar-2018, in which all necessary information is presented in a convenient form. The vaccination schedule in the table is accompanied by explanations on the order of vaccination.

Categories and age of citizens subject to preventive vaccinations

The order of carrying out preventive vaccinations

Newborns in the first 24 hours of life

First vaccination against viral hepatitis B

It is carried out in accordance with the instructions for the use of vaccines for newborns, including those at risk: born from mothers who carry HBsAg; patients with viral hepatitis B or who underwent viral hepatitis B in the third trimester of pregnancy; not having results of examination for markers of hepatitis B; drug addicts, in families in which there is a carrier of HBsAg or a patient with acute viral hepatitis B and chronic viral hepatitis (hereinafter – at-risk groups).

Newborns on 3 – 7 day of life

Vaccination against tuberculosis

It is carried out by newborn vaccines for the prevention of tuberculosis (for gentle primary immunization) in accordance with the instructions for their use. In the subjects of the Russian Federation with incidence rates exceeding 80 per 100 thousand people, as well as in the presence of newborn patients with tuberculosis – a vaccine for the prevention of tuberculosis.

The second vaccination against viral hepatitis B

It is carried out in accordance with the instructions for the use of vaccines for children of this age group, including those at risk.

The third vaccination against viral hepatitis B

It is carried out in accordance with the instructions for the use of vaccines for children at risk.

First vaccination against diphtheria, pertussis, tetanus

Carried out in accordance with the instructions for the use of vaccines for children of this age group

Children from 3 to 6 months

The first vaccination against hemophilia infection

It is carried out in accordance with the instructions for the use of vaccines for children belonging to risk groups: with immunodeficiency conditions or anatomical defects, leading to a sharply increased risk of Hib infection; with oncohematological diseases and/or long-term receiving immunosuppressive therapy; HIV-infected or born to HIV-infected mothers; located in closed preschool institutions (orphanages, orphanages, specialized boarding schools (for children with neuropsychiatric diseases, etc.), anti-tuberculosis sanitary-improving institutions). Note. Hemophilus influenza vaccination course for children aged 3 to 6 months. consists of 3 injections of 0,5 ml with an interval of 1-1,5 months. For children who have not received their first vaccination in 3 months, immunization is carried out according to the following scheme: for children aged 6 to 12 months. from 2 injections of 0,5 ml with an interval of 1 – 1,5 months. for children from 1 year to 5 years, a single injection of 0,5 ml

First vaccination against poliomyelitis

Carried out by vaccines for the prevention of poliomyelitis (inactivated) in accordance with instructions for their use

The second vaccination against diphtheria, pertussis, tetanus

It is carried out in accordance with the instructions for the use of vaccines for children of this age group who received the first vaccination at 3 months.

The second vaccination against hemophilia infection

It is carried out in accordance with the instructions for the use of vaccines for children of this age group who received the first vaccination at 3 months.

Second vaccination against poliomyelitis

Carried out by vaccines for the prevention of poliomyelitis (inactivated) in accordance with instructions for their use

Third vaccination against diphtheria, pertussis, tetanus

It is carried out in accordance with the instructions for the use of vaccines for children of this age group who received the first and second vaccination in 3 and 4,5 months. respectively

The third vaccination against viral hepatitis B

It is carried out in accordance with the instructions for the use of vaccines for children of this age group who are not at risk, who received the first and second vaccinations at 0 and 1 months. respectively

The third vaccination against hemophilia infection

It is carried out in accordance with the instructions for the use of vaccines for children who received the first and second vaccination in 3 and 4,5 months. respectively

Third vaccination against poliomyelitis

Children of this age group are given vaccines for poliomyelitis prevention (live) in accordance with the instructions for their use. Children who are in closed children’s pre-school establishments (children’s homes, orphanages, specialized boarding schools for children with psychoneurological diseases, etc.), tuberculosis sanitation facilities) are vaccinated three times with vaccines for poliomyelitis prevention (inactivated)

Vaccination against measles, rubella, mumps

Carried out in accordance with the instructions for the use of vaccines for children of this age group

The fourth vaccination against viral hepatitis B

It is carried out in accordance with the instructions for the use of vaccines for children at risk

First revaccination against diphtheria, pertussis, tetanus

Carried out in accordance with the instructions for the use of vaccines for children of this age group

First revaccination against poliomyelitis

Children of this age group are given vaccines for poliomyelitis prophylaxis (live) in accordance with the instructions for their use

Revaccination against haemophilus infection

Revaccinations are carried out only once for children vaccinated in the first year of life in accordance with the instructions for the use of vaccines

Second revaccination against poliomyelitis

Children of this age group are given vaccines for poliomyelitis prophylaxis (live) in accordance with the instructions for their use

Revaccination against measles, rubella, mumps

It is carried out in accordance with the instructions for the use of vaccines for children of this age group who received vaccination against measles, rubella, mumps

Second revaccination against diphtheria, tetanus

Carried out in accordance with the instructions for the use of toxoids with a reduced content of antigens to children of this age group

Revaccination against tuberculosis

It is carried out by non-infected tuberculosis mycobacteria tuberculin-negative children of this age group with vaccines for the prevention of tuberculosis in accordance with the instructions for their use

Third revaccination against diphtheria, tetanus

Carried out in accordance with the instructions for the use of toxoids with a reduced content of antigens to children of this age group

Third revaccination against poliomyelitis

Children of this age group are given vaccines for poliomyelitis prophylaxis (live) in accordance with the instructions for their use

Adults 18 years old

Revaccination against tuberculosis

Unprotected mycobacteria tuberculosis tuberculin-negative children of this age group with vaccines for the prevention of tuberculosis in accordance with the instructions for their use. In subjects of the Russian Federation with incidence rates of tuberculosis not exceeding 40 per 100 thousand of population, revaccination against tuberculosis in 14 years is performed by tuberculin-negative children who were not vaccinated at 7 years

Revaccination against diphtheria, tetanus

It is carried out in accordance with the instructions for the use of toxoids with reduced antigen content for adults from 18 years every 10 years from the time of the last booster

Children from 1 year to 18 years, adults from 18 to 55 years, not vaccinated earlier

Vaccination against viral hepatitis B

Carried out in accordance with the instructions for the use of vaccines for children and adults of age groups according to the scheme 0-1-6 (1 dose – at the time of vaccination, 2 dose – one month after the 1 vaccination, 3 dose – after 6 months from the beginning immunization)

Children from 1 year to 18 years, girls from 18 to 25 years

Immunization against rubella

It is carried out in accordance with the instructions for the use of vaccines for children from 1 year to 18 years, not sick, not vaccinated, vaccinated against rubella, and girls from 18 to 25 years who were not ill, not vaccinated before

Children with 6 months, students 1-11 classes; students of higher professional and secondary professional educational institutions; adults working for certain professions and positions (employees of medical and educational institutions, transport, communal sphere, etc.); older than 60 years

Vaccination against influenza

It is carried out in accordance with the instructions for the use of vaccines annually to these categories of citizens

Children aged 15-17 years and adults under 35 years

Immunization against measles

Immunization against measles for children aged 15-17 years and adults under the age of 35 years who were not vaccinated before, who does not have information about measles vaccines and who have not had measles before, is carried out in accordance with the instructions for the use of vaccines twice with an interval of at least 3 months between vaccinations. Persons vaccinated earlier once, are subject to a single immunization with an interval of at least 3 months between vaccinations

Immunization within the national calendar of preventive vaccinations is carried out by medical immunobiological preparations registered in accordance with the legislation of the Russian Federation, according to the instructions for use.

If the timing of immunization is violated, it is carried out according to the schemes prescribed by the national calendar of preventive vaccinations and in accordance with the instructions for the use of drugs. It is allowed to administer vaccines (except for vaccines for the prevention of tuberculosis), used in the national calendar of vaccinations, on the same day with different syringes in different parts of the body.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

Detonic