What are the signs of a collapsed lung. How is a pneumothorax diagnosed and treated. Can a collapsed lung heal on its own. What is the recovery process like after lung surgery for pneumothorax. How does cystic fibrosis affect the risk of lung collapse.

Understanding Pneumothorax: The Basics of a Collapsed Lung

A collapsed lung, medically known as pneumothorax, is a condition where air enters the space between the lung and the chest wall. This intrusion of air exerts pressure on the lung, causing it to collapse partially or fully. The result is an impaired ability of the lung to expand properly, which hinders the efficient transfer of oxygen into the bloodstream.

Pneumothorax can occur spontaneously or as a result of trauma, such as a car accident. It’s a serious condition that requires immediate medical attention, as it can potentially be life-threatening if left untreated.

Types of Pneumothorax

• Spontaneous pneumothorax: Occurs without any apparent cause or injury
• Traumatic pneumothorax: Results from chest injury or medical procedures
• Tension pneumothorax: A severe form where air continues to accumulate, causing increasing pressure

Recognizing the Symptoms: What Does a Collapsed Lung Feel Like?

Identifying the symptoms of a collapsed lung is crucial for seeking timely medical intervention. While the experience can vary from person to person, there are several common indicators to be aware of:

• Sudden, sharp chest pain that worsens with deep breathing or coughing
• Shortness of breath or difficulty breathing
• Rapid heart rate
• Bluish skin color due to lack of oxygen
• Fatigue and weakness
• Dry, hacking cough

In some cases, particularly with small collapses, symptoms may be mild or even absent. However, any persistent chest discomfort or breathing difficulties should be evaluated by a medical professional.

Can you breathe with a collapsed lung?

Contrary to popular belief, it is possible to breathe with a collapsed lung. The severity of breathing difficulties depends on the extent of the collapse. With a partial collapse, breathing may be labored but still possible. However, a complete collapse of one lung can cause significant respiratory distress, as the remaining lung must work harder to compensate.

Causes and Risk Factors: Who’s at Risk for a Pneumothorax?

Understanding the causes and risk factors associated with pneumothorax can help in prevention and early detection. While anyone can experience a collapsed lung, certain factors increase the likelihood:

1. Smoking: Cigarette smoking is a significant risk factor for spontaneous pneumothorax
2. Underlying lung diseases: Conditions like COPD, asthma, and cystic fibrosis increase risk
3. Previous pneumothorax: Having experienced one increases the chances of recurrence
4. Tall, thin body type: This physical characteristic is associated with a higher risk
5. Genetic factors: Some inherited disorders can weaken lung tissue
6. Mechanical ventilation: Patients on ventilators are at increased risk
7. Trauma: Chest injuries from accidents or medical procedures can cause pneumothorax

The Connection Between Cystic Fibrosis and Pneumothorax

Cystic fibrosis (CF) patients have an increased risk of experiencing a pneumothorax. While CF doesn’t directly cause lung collapses, it creates an environment that makes them more likely to occur. The constant inflammation and irritation of lung tissue in CF patients can lead to the formation of blebs – small air blisters on the lung’s surface. These blebs can rupture spontaneously, creating a hole in the lung lining and allowing air to escape into the pleural space.

Diagnosis and Treatment: From ER to Recovery

When a pneumothorax is suspected, prompt medical evaluation is essential. The diagnostic process typically involves:

• Physical examination: Listening to breath sounds and assessing vital signs
• Chest X-ray: The primary tool for diagnosing pneumothorax
• CT scan: For more detailed imaging if needed
• Arterial blood gas analysis: To assess oxygen levels in the blood

Treatment options depend on the severity of the collapse and the patient’s overall health. They may include:

1. Observation: For small, uncomplicated pneumothoraces
2. Needle aspiration: Removing air with a needle and syringe
3. Chest tube insertion: Placing a tube to continuously remove air
4. Surgery: For recurrent or complicated cases

What is the recovery time for a collapsed lung?

Recovery time varies depending on the severity of the collapse and the treatment method. A small pneumothorax treated with observation may resolve in a few days to weeks. More severe cases requiring chest tube insertion or surgery may take several weeks to months for full recovery. During this time, patients are advised to avoid activities that could stress the lungs, such as air travel or scuba diving.

Living with Cystic Fibrosis: Navigating Pneumothorax Risks

For individuals with cystic fibrosis, the risk of pneumothorax adds another layer of complexity to managing their condition. Being aware of the symptoms and maintaining open communication with healthcare providers is crucial. Some strategies for CF patients to manage pneumothorax risk include:

• Adhering to prescribed CF treatments to minimize lung inflammation
• Regular lung function monitoring
• Avoiding activities that dramatically change air pressure in the lungs
• Quitting smoking and avoiding secondhand smoke
• Promptly reporting any new or worsening respiratory symptoms

How does pneumothorax affect CF treatment?

A pneumothorax can complicate CF treatment by temporarily limiting certain therapies. Airway clearance techniques may need to be modified, and some medications might be adjusted. The focus shifts to healing the collapsed lung while managing CF symptoms. Close collaboration between pulmonologists and CF specialists is essential to navigate this challenging period.

Surgical Interventions: When is Surgery Necessary for Pneumothorax?

While many cases of pneumothorax can be managed conservatively, surgery becomes necessary in certain situations:

1. Recurrent pneumothorax
2. Persistent air leak despite chest tube drainage
3. Bilateral pneumothorax (affecting both lungs)
4. Occupational requirements (e.g., pilots, scuba divers)
5. Large pneumothorax causing significant lung compression

The most common surgical procedure for pneumothorax is video-assisted thoracoscopic surgery (VATS). This minimally invasive approach allows surgeons to repair the damaged lung tissue and prevent future collapses.

What are the long-term effects of lung surgery for pneumothorax?

Long-term effects of lung surgery for pneumothorax are generally minimal. Most patients experience a full recovery and return to normal activities. However, some may notice a slight decrease in lung function, which is usually not significant enough to impact daily life. The surgery also leaves small scars, but these typically fade over time. The most important long-term effect is the reduced risk of recurrence, which greatly outweighs any potential drawbacks for most patients.

Prevention and Lifestyle Adjustments: Minimizing Pneumothorax Risk

While not all cases of pneumothorax can be prevented, certain lifestyle changes and precautions can help reduce the risk:

• Quit smoking and avoid exposure to secondhand smoke
• Manage underlying lung conditions effectively
• Avoid sudden changes in air pressure (e.g., scuba diving, unpressurized air travel)
• Use protective gear during contact sports or activities with a risk of chest trauma
• Practice deep breathing exercises to maintain lung health
• Maintain a healthy weight and overall fitness level

For individuals with a history of pneumothorax or those at higher risk due to conditions like CF, additional precautions may be recommended by healthcare providers.

Can exercise help prevent pneumothorax?

While exercise itself doesn’t directly prevent pneumothorax, maintaining good overall lung health through regular physical activity can be beneficial. Exercise strengthens respiratory muscles, improves lung capacity, and enhances overall fitness. However, it’s crucial for individuals at high risk of pneumothorax to consult with their healthcare provider before starting any new exercise regimen. Some high-impact or extreme sports may need to be avoided or modified to reduce the risk of lung injury.

Emotional and Psychological Impact: Coping with Pneumothorax

Experiencing a collapsed lung can be a frightening and stressful event, often leaving a lasting emotional impact. The sudden onset of symptoms, hospitalization, and recovery process can lead to anxiety, depression, or post-traumatic stress in some individuals. It’s important to recognize and address these psychological aspects of pneumothorax:

• Fear of recurrence: Many patients worry about experiencing another collapse
• Anxiety about physical activities: Concerns about triggering another episode
• Body image issues: Surgical scars or chest tube sites may affect self-esteem
• Frustration with recovery time: Impatience with physical limitations during healing
• Increased health anxiety: Heightened awareness of bodily sensations

How can patients cope with the emotional aftermath of pneumothorax?

Coping strategies for the emotional impact of pneumothorax include:

1. Seeking support from mental health professionals
2. Joining support groups or online communities for pneumothorax survivors
3. Practicing relaxation techniques and mindfulness
4. Educating oneself about the condition to reduce fear of the unknown
5. Gradually returning to normal activities with medical guidance
6. Open communication with healthcare providers about concerns and fears

Remember, it’s normal to experience a range of emotions after a significant health event. Seeking help and support is a sign of strength, not weakness.

Research and Future Directions: Advancing Pneumothorax Treatment

The field of pneumothorax research is dynamic, with ongoing efforts to improve diagnosis, treatment, and prevention. Some exciting areas of current research include:

• Genetic studies to identify risk factors for spontaneous pneumothorax
• Development of new, less invasive treatment techniques
• Improved imaging technologies for early detection of lung blebs
• Novel approaches to prevent recurrence in high-risk individuals
• Investigation of biomarkers to predict pneumothorax risk in CF patients

What new treatments are on the horizon for pneumothorax?

Emerging treatments and technologies for pneumothorax include:

1. Endobronchial valves: One-way valves placed in the airways to help seal air leaks
2. Autologous blood patch: Using the patient’s own blood to seal persistent air leaks
3. Biomaterial sealants: Advanced materials to repair lung tissue and prevent air leaks
4. Minimally invasive surgical techniques: Further refinements to reduce recovery time
5. Personalized risk assessment tools: To identify individuals at high risk for recurrence

These advancements hold promise for improving outcomes and quality of life for individuals affected by pneumothorax, particularly those with underlying conditions like cystic fibrosis.

When Lungs Collapse | Cystic Fibrosis Foundation

I knew I had lousy lungs, but I never expected them to blow out like a tire on the highway. Before 2015, a pneumothorax (collapsed lung) was not in my medical vocabulary and I associated it only with action movies and the Discovery Health Channel, not with me or cystic fibrosis. I am now far too familiar with the signs, treatments, and recovery stages of a spontaneous lung collapse — I might even call myself an expert.

In 2015, I was a senior in high school when my left lung spontaneously collapsed, and I was vividly reminded that life is unpredictable. Fast forward to this summer (a rising senior in college) and my body reminds me, once again, that the unexpected can happen. This time it was my right lung that gave out, randomly, or as my doctor said, “dropped.” Both experiences were complicated and resulted in two-week hospital stays, many chest tubes, and required lung surgery to stop the air leak.

Me waking up in the ER after my chest tube placement. July 2018.

Before my first one, I knew absolutely nothing about pneumothoraces, or their relationship with CF, and that is why I was so afraid when it happened. I did not even know what the symptoms of a collapsed lung were. Was it the sudden inability to breathe? Nope! I could still breathe, walk, and talk when one lung was collapsed. I felt chest discomfort, tightness, shortness of breath, shoulder pain, and exhaustion — symptoms that I had experienced before with CF, but not all at once.

In 2015, it took me a few hours of feeling weird before I called my doctor who told me to go to the emergency room (ER) for an X-ray.

This summer, I ended up working an entire shift before realizing something was seriously wrong and telling my doctor I needed a chest X-ray. Those experiences taught me the importance of listening to my body and not ignoring the warning signs. If something feels wrong, something probably is wrong.

I later learned that CF did not cause the collapses directly. They were caused by a pulmonary bleb rupturing. Blebs are small air blisters that can develop on the lung’s surface — anyone can develop them! Although CF does not cause them, it is thought to provoke them because of the constant inflammation and irritation of the lung tissue. A bleb can pop randomly, leaving a hole in the lung lining — yikes! This is what happened to me, twice.

Because a thoracic surgeon repaired my pneumothorax, I was sent to the thoracic floor of the hospital to recover. I had to be my biggest advocate there as the nurses and doctors, who did not specialize in CF, were making decisions about me and my lungs.

This was difficult when I was on pain meds and wanted to sleep all day, but I used my best judgment and challenged the doctors’ orders if they seemed wrong. CF lungs are not regular lungs. They often need extra attention or care. In my experience, the standard procedure is not always the right procedure for people with CF.

After I was finally allowed outside post lung surgery. July 2018.

The two lung collapses were very low points in my 21-year life, mainly because of the uncertainty and fear I felt. The immobility and constant pain I dealt with was a nightmare at the time but left me with a lasting appreciation of my healthier days. It’s funny how hardship can lead to a new, uplifting perspective. If nothing else, at least now I have matching scars on both sides!

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Hogan was diagnosed with cystic fibrosis at age three and has been smiling, laughing, and coughing her entire life. She is a strong believer in the benefits of optimism and loves spreading enthusiasm and positivity. Hogan grew up on the coast of Maine and recently graduated from the University of Vermont. She is the leader of her Great Strides team, “Hogan’s Heroes,” and spends her springs fundraising for CF. Reach out to her on the Hogan’s Heroes team Facebook page.

Symptoms, Treatments, and Recovery in 2022

When you think of the potential injuries you can suffer due to a car accident, things like whiplash or a concussion may come to mind first. While these are common, there is a wide range of possible car accident injuries you may not think about. For example, a punctured lung or collapsed lung can occur as a result of a car accident and have severe consequences. Read on to learn more about this injury and what it means.

What Is a Punctured Lung?

A punctured lung, also known as a collapsed lung or a pneumothorax injury, occurs when air enters the space between the lung and the chest wall. This air presses on the outside of your lung, causing it to collapse in full or in a portion. The lung can then not expand properly, preventing oxygen from entering the bloodstream efficiently.

Depending on the cause of a punctured lung, it may be categorized in one of three ways:

Traumatic pneumothorax: A direct trauma to the chest, like a broken rib or an injury from a stab wound or gunshot, causes this type of pneumothorax. There are also medical procedures that deliberately collapse the lung in a controlled environment, which would also be considered this form of the condition.

Primary spontaneous pneumothorax: This occurs when the punctured lung happens without an exact known cause. It commonly is a result of a rupture in a small air sac on the outside of the lung, which allows air to leak into the surrounding cavity.

Secondary spontaneous pneumothorax: When a punctured lung is caused by a pre-existing lung disease, it is classified this way. Common conditions that induce a collapse may include cancer, asthma, or chronic obstructive pulmonary disease (COPD).

Causes of Punctured Lungs

While it is not always clear what caused a punctured lung, there are a number of known causes.
A chest injury can cause a lung to collapse, including a car accident. The impact itself of blunt force to the chest can be a factor, or a broken rib may puncture the lung. Other physical assaults, use of weapons, and sports injuries can have similar outcomes. It is also possible for a medical procedure to purposefully or accidentally cause a puncture, such as during the insertion of a needle into the chest.

Damaged lungs are more likely to collapse. Underlying diseases like pneumonia or cystic fibrosis are, therefore, potential causes. Cystic lung diseases, like Birt-Hogg-Dube syndrome, can cause round, thin-walled air sacs in the lung tissue to rupture and cause pneumothorax. People who need mechanical assistance to breathe can also experience an imbalance of air pressure within the chest that causes the lungs to collapse completely.

Ruptured air blisters can also be a cause when small air blisters known as blebs develop on the top of the lungs. When they burst, air leaks into the space surrounding the lungs and causes a collapse.

In general, men are more likely to suffer a pneumothorax than women. People between 20 and 40 are the most likely to have an incident caused by ruptured air blisters, especially when they are tall or underweight. Other risk factors can include genetic predisposition, previous pneumothorax, and smoking cigarettes.

Symptoms of a Collapsed Lung

It is critical to identify a collapsed lung as soon as possible to seek early treatment and avoid the injury becoming life-threatening. If you have experienced any trauma to the chest or have existing lung conditions, look for these signs:

• Chest pain that worsens with coughing or breathing deeply
• Shortness of breath
• Abnormalities in breathing patterns
• Tightness in the chest
• A rapid heart rate
• Pale or blue skin (due to reduced oxygen)
• Fatigue

A punctured lung may cause soreness in the chest, usually on one side, as only one lung is usually affected.

If tension pneumothorax is present, you may experience signs of cardiovascular collapse and should treat this as a life-threatening emergency. In this case, large veins in the neck may stick out, the pulse may be rapid, and blood pressure may be low. Anxiety and difficulty speaking are also common. If untreated for more than several minutes, loss of consciousness, shock, and death can occur.

Diagnosis of a Punctured Lung

If it is suspected that you have suffered from a punctured lung, your doctor will first specifically listen to your chest using a stethoscope. They may tap your chest while you breathe in order to listen for hollow sounds. They may also suggest an arterial gas test to assess if you are experiencing high levels of carbon dioxide and low levels of oxygen, which can indicate a problem.

In order to get a definite diagnosis, you will need to undergo imaging like an x-ray, an ultrasound, or a CT scan. Very small cases can be missed on a routine chest x-ray, and a doctor may take multiple films, including x-rays in full expiration to ensure they identify any signs of a collapsed lung.

Treatment Options

The treatment for a punctured lung will vary based on the severity of the trauma, cause of the condition, and amount of damage to the lung. The goal is to reduce pressure on the lung and allow it to re-inflate.

In the case of a small pneumothorax, it may heal on its own under the supervision of your doctor. Oxygen and rest are often prescribed as the primary treatment in these cases, or a doctor may release additional air by sucking it out through a needle and allowing the chest to expand fully. If this isn’t performed, the excess air can be re-absorbed over time. Repeated x-rays are used to monitor the condition and ensure it has resolved.

When the pneumothorax is larger and requires intervention, a chest tube is placed through the ribs and into the area around the lungs to help drain the air. This tube may be left in place for both drainage and to help inflate the lung. Severe cases may require the tube to be left in for several days before the chest begins to expand.

To prevent a future collapse, a doctor may also perform chemical pleurodesis, in which chemicals are sent through the tube that help the lung attach to the chest cavity and eliminate extra space.

If the air is not removed by the tube or a patient suffers from repeated punctured lungs, surgery would be the next step. Large puncture wounds may also require surgery if the lung tissue cannot close immediately and repair itself. These repairs would be done by a surgeon who places a tube down the throat into the bronchial airways or makes an incision into the skin. Depending on the injury, a surgeon may also place a tube to remove excess air and suction out blood cells and fluid in the pleural space.

Recovery and Aftercare

It will usually take about 6 to 8 weeks to fully recover from a collapsed lung. However, the severity of the injury and the treatment method may make this period longer or shorter.
Some things you can do to aid recovery and prevent complications include:

• Get plenty of sleep. You may feel weak and tired for a while, and that is okay.
  Take any medication your doctor prescribes exactly as directed. Ask about over-the-counter medication before taking any.
• If you need to cough or take deep breaths, hold a pillow against your chest for added support and to decrease pain.
• If you are prescribed antibiotics, take them as directed. Do not stop if you feel better and the full course has not yet been completed.
• If you have a bandage over a tube or the area where a tube was, keep it clean and dry. Follow all instructions on care.
• When you have a tube in place at home, follow all directions and do not adjust the tube in any way. This could break the seal or cause other problems. Ensure the tube is dry at all times.
• Avoid movements that require your muscles, especially in the chest, to strain. This includes laughing hard, bearing down to have a bowel movement, and heavy lifting.
• Do not fly in an airplane unless you are given the okay by your doctor.
• Stay active with low-impact movement and incorporate rest.
• Sleep in a position that elevates your torso in the first days.
• Avoid unnecessary pressure being placed on the ribcage.
• Wear loose-fitting clothing.
• Avoid smoking and do not let others smoke around you.
• Avoid any sudden changes in air pressure.
• Avoid driving until you are fully recovered.
• Closely monitor for signs of recurrence.
• Follow your doctor’s instructions for breathing exercises.
• Attend all follow-up appointments.

If you undergo surgery, recovery may be longer and more intensive. It is common to be recommended physical therapy after surgery to help you regain strength and lung capacity, especially if you are immobilized during immediate recovery. Any activity should be done under the supervision of your doctor and a licensed physical therapist to avoid further injury.

During recovery, if you begin to experience any symptoms again or notice a fever, new and worse pain, new and worsening trouble breathing, coughing up blood, or your chest tube coming out, you should seek immediate care. If you pass out for any amount of time or have severe trouble breathing, place a call to 911.

Potential Complications and Patient Outlook

While punctured lungs are serious, they are not fatal in most cases, and treatment is usually effective. The most common complication related to a punctured lung is the increased risk of suffering another one in the future. About 35% of people who have a punctured lung will have another one at some point.

Shock is also a common complication, especially when there is a serious injury or infection, severe inflammation, or fluid accumulation in the lung. Tension pneumothorax, which can cause cardiac arrest, is also a potential issue.

A healed pneumothorax usually does not have any long-term health implications if it is treated quickly, though trauma-induced collapses increase the risk of recurrence and may require more monitoring on an ongoing basis.

Can You Prevent a Punctured Lung?

There is no known way to prevent all pneumothorax, especially in patients with a family history of the condition. When trauma is the source, it may also be unavoidable. However, there are ways to reduce the chances of suffering from a punctured lung for those who may be at risk. Avoiding smoking is highly recommended, for example.

If you engage in activities that involve a drastic change in air pressure, like flying or diving, you may speak with your doctor about how to manage this.
For those with underlying lung conditions, continue to monitor appropriately with your physician.

Punctured Lungs and Car Accidents

While it is not the most common cause of punctured lungs, they are a potential outcome of motor vehicle collisions. This can occur in a variety of ways:

• Seatbelts and airbags can cause a rib or multiple to break, and the jagged bone can puncture the lung.
• Glass fragments from a windshield or window can puncture the lung.

Because of the traumatic nature of a car accident, many people experience shock and adrenaline rushes that hide symptoms of serious injuries. You may not notice chest pain or shortness of breath immediately following your crash and not be taken to a hospital for observation, even though your lung has been punctured. This is why it is critical to seek medical care as soon as possible after your accident.

A skilled doctor like those at AICA Lithia Springs will assess the entire body for injuries, even those there are no symptoms of yet. During a physical examination, if we notice a punctured lung, we will be able to use imaging technology to determine the next steps. This early intervention may be the difference between simple intervention and requiring surgery as the condition is allowed to worsen.

If you have recently been in an accident, contact AICA Lithia Springs today to schedule a consultation and gain peace of mind.

Category: Accident Prevention, Accident Recovery

Lung cancer metastases

How often does lung cancer metastasize? In which organs are metastases most often found? Are there effective treatments? What are the predictions? Is remission possible?

The ability to metastasize is one of the key features of malignant tumors. Cancer cells can break away from the primary, “maternal” tumor, spread throughout the body with blood or lymph flow and give rise to secondary foci in other organs. Actually, this process is called metastasis.

Metastases are always named after the primary tumor. For example, if lung cancer has metastasized to the bone, then it is called lung cancer with bone metastases, but not bone cancer.

How often does lung cancer metastasize?

Fairly common. According to statistics, 40% of patients who have recently been diagnosed with lung cancer have metastases. With this picture, the fourth stage of a malignant tumor is diagnosed. Naturally, the prognosis in this case is significantly worse than in the early stages, when there are no metastases.

The reason for such a frequent late diagnosis is that in the early stages lung cancer does not manifest itself, or there are symptoms, but they resemble another disease, for example, chronic bronchitis or COPD. Many smokers do not pay attention to constant coughing and shortness of breath, taking them for granted – but these may be the very “first bells”.

Small cell and non-small cell lung cancer metastases: is there a difference?

The rarer small cell type of lung cancer differs from the more common non-small cell type in higher aggressiveness. Usually, it grows faster into neighboring organs and metastasizes earlier. As a rule, patients with small cell cancer experience symptoms such as increased fatigue, weight loss, and bone pain more quickly.

In what organs are most often found lung cancer metastases?

Metastases in the lymph nodes

Most often, malignant lung tumors metastasize to the lymph nodes, bones, brain, liver and adrenal glands.

If tumor cells spread to regional lymph nodes located in the chest close to the lungs, such cancer is not yet considered metastatic. It usually does not cause any symptoms.

Having overcome the regional lymph nodes, cancer cells continue to migrate with the lymph flow, and can penetrate into the lymph nodes located under the skin. Affected subcutaneous lymph nodes increase, become painful. They can be felt.

Methods of treatment. If the tumor has spread to nearby lymph nodes, they can be surgically removed. Apply chemotherapy, radiation therapy.

Bone metastases

Bone metastases occur in approximately 30-40% of patients with stage IV lung cancer. Most often, cancer cells spread to the vertebrae, pelvis, humerus, and femur.

The most common symptom of bone metastases is bone pain. At first, there is a feeling of discomfort, muscle tension, gradually it increases, the pain becomes more and more severe.

With the progression of the process, pathological fractures can occur, the bone breaks from minor trauma or even from normal everyday stress. Calcium is washed out of the bone tissue into the blood, because of this, appetite decreases, weakness in the muscles occurs.

Metastases in the vertebrae are the most dangerous, as they can cause compression of the spinal cord. Terrible symptoms of this condition: numbness, weakness in the muscles of the legs, urinary and stool incontinence.

Bone metastases in lung cancer are detected using CT, MRI, PET.

Methods of treatment. It is necessary to slow down the growth of metastases, prevent pathological fractures and save the patient from pain. To do this, use radiation therapy, painkillers, drugs that prevent the destruction of bone tissue. Sometimes surgery is indicated to stabilize the bones.

Brain metastases

Lung cancer is one of the most common malignant tumors that metastasize to the brain. At stage IV, brain metastases are found in about 40% of cases.

One third of these patients do not experience symptoms. Two-thirds experience manifestations associated with the destruction of brain tissue by metastases, inflammation and edema.

Worried about headaches and various neurological symptoms: convulsions, speech disorders, impaired coordination of movements and a sense of balance, blurred vision, memory, weakness in half of the body, as in a stroke, personality changes, chronic fatigue.

MRI and computed tomography are used to diagnose lung cancer metastases in the brain.

Methods of treatment. Provide palliative care to manage symptoms. To combat seizures and headaches, painkillers and anticonvulsants are used. Swelling and inflammation are removed with the help of steroid drugs.

Radiation therapy helps reduce the risk of brain metastases, and if they have already appeared, slow their growth and improve the patient’s condition. With single small foci, you can use the “gamma knife”.

Liver metastases

Most often, liver metastases from lung cancer are not accompanied by any symptoms. They are discovered during the examination. Some patients are concerned about the loss of appetite, nausea, pain under the right rib. If there are many metastases, and they severely impair liver function, jaundice develops.

Detect liver metastases during ultrasound, CT or positron emission tomography (PET).

Methods of treatment. If one small metastasis is found in the liver (which is rare), it can be removed surgically. In most cases, they are treated with chemotherapy drugs. In some cases, resort to the help of interventional surgery:

• Radiofrequency ablation is a procedure during which a thin metal needle is inserted into the tumor and a high frequency current is applied to it. It burns cancer cells.
• Intra-arterial chemotherapy – when the chemotherapy drug is not injected into the systemic circulation, but directly into the vessel that feeds the tumor.
• Chemoembolization is a procedure during which microspheres-emboli and a chemotherapy drug are injected into the vessel that feeds the tumor. Emboli block the lumen of the arteries, depriving cancer cells of nutrients and oxygen, and the chemotherapy drug destroys them.

Metastases in the adrenal glands

The adrenal glands are a small paired gland. They are located near the kidneys and produce some hormones, in particular, glucocorticosteroids and “stress hormones”. Metastases in them rarely give symptoms, most often detected during the examination.

Methods of treatment. If one small metastasis is found in the adrenal glands, it can be surgically removed. Often this helps to prolong the life of the patient.

How to treat lung cancer metastases?

Single small metastases can be removed. Unfortunately, most often lung cancer metastases are multiple, located in different organs, and surgical treatment is impossible.

Targeted therapy for lung cancer metastases

Molecular genetic testing helps to prescribe the most correct and effective treatment. If there are some mutations in cancer cells, targeted drugs help to cope with them:

• If there is a mutation in the ALK gene: crizotinib, ceritinib, alectinib, brigatinib.
• With a mutation in the EGFR gene: erlotinib, gefitinib, afatinib.
• With a mutation in the ROS1 gene: crizotinib.
• With a mutation in the BRAF gene: dabrafenib, trametinib.

Immunotherapy for lung cancer metastases

Immunotherapy helps the patient’s immune system recognize and attack tumor cells. If the tumor cells contain large amounts of a protein called PD-L1, treatment with certain immunotherapy drugs, such as pembrolizumab, may be effective.

Chemotherapy for metastatic lung cancer

Chemotherapy is used in most cases of stage IV lung cancer with metastases. Depending on the characteristics of the tumor and the condition of the patient, the doctor may prescribe therapy with one or a combination of drugs. Chemotherapy is often combined with targeted drugs such as pembrolizumab, bevacizumab, necitumumab.

In most cases, treatment for metastases is palliative. It cannot cure, but it can relieve pain and other symptoms, prolong life.

How long do these patients live?

Metastatic cancer is difficult to treat:

• Five-year survival (the percentage of patients who are still alive after 5 years from diagnosis) is 1-2%.
• Median survival (time after which half of the patients died, the other half remained alive) – 6-12 months (without treatment – 2-4 months).

However, such negative statistics are not a reason to give up.

Some patients (albeit a few out of a hundred) still remain alive for a very long time, many years. No one knows in advance which of those who have just been diagnosed with stage IV lung cancer will fall into the number of these survivors.

In addition, science does not stand still. Now doctors and scientists have high hopes for immunotherapy and targeted drugs. Treatment methods are improving, which means that the chances of defeating cancer are increasing.

What are lung metastases?

Lung metastases are foci that have appeared in the lung tissue as a result of metastasis, while the main, primary, tumor is located in another organ. Such lung cancer is called secondary or metastatic. Statistics show that it occurs in about 30-35% of cancer patients. Tumors from many organs metastasize to the lungs.

What are lung metastases?

Metastases in the lungs, depending on the form, are focal (nodes with more or less even edges, less aggressive option), infiltrative (when the tumor seems to “spread” over the lung tissue – such metastases are more aggressive) and mixed.

Depending on the number, solitary (one focus), single and multiple metastases are distinguished. They also differ in density (this can be estimated from x-rays), depending on where the tumor metastasized to the lungs from and what tissue it consists of. If one lung is affected, they speak of unilateral metastases, if both lungs are affected, they speak of bilateral. Depending on the size, the foci are divided into small and large.

How to diagnose lung metastases?

It is difficult to diagnose lung metastases by symptoms. Sometimes there are no symptoms at all, if there is only one focus, it is small and has even contours. Infiltrative metastases begin to appear earlier and brighter. Symptoms are non-specific, they occur in primary lung cancer and in other diseases. Worried about cough, shortness of breath, chest pain, sputum with blood, weakness, weight loss.

The following methods help diagnose lung metastases:

• Chest x-ray may show lesions in the lungs, but only if the diameter of the latter exceeds 1 cm.
• Computed tomography is a more informative diagnostic method that allows you to detect lesions smaller than 5 mm.
• Bronchoscopy is a procedure during which a bronchoscope is inserted into the bronchi – a special endoscopic instrument with a miniature video camera and a light source.
• If a suspicious mass is found during the examination, the doctor may perform a biopsy of it.
• A lung biopsy is an invasive examination during which a needle is inserted into the lung tissue through the chest wall and some tissue is taken from the lesion.

Treatment of lung metastases

Chemotherapy is the main treatment for lung metastases. If hormone-dependent breast cancer has metastasized, hormonal therapy is performed. Radiation therapy can be used for a single metastasis, but it helps much less than for primary lung tumors.

Surgical treatments are rarely used, although modern doctors operate on lung metastases more and more often. In order for surgical intervention to be possible, certain conditions must be met:

• One or no more than three small metastases in the lungs.
• No primary tumor or its recurrence.
• No metastases elsewhere in the body.
• 12 months or more passed from the moment of treatment of the main tumor to the appearance of metastasis.
• Within six months after a metastasis is detected, no other metastases should appear.
• The patient has no contraindications to surgical treatment due to concomitant health problems.

When metastases stop responding to chemotherapeutic agents, grow strongly and disrupt lung function, respiratory failure occurs. The patient requires oxygen therapy, and in more severe cases, artificial lung ventilation.

Prognosis for lung metastases

Prognosis for sustained remission in any metastatic cancer is poor. A very small percentage of patients recover, but in most cases such cancer cannot be cured. But a doctor can prolong the patient’s life and save him from painful symptoms. You can always help.

How is the development of metastases stopped?

First of all, early diagnosis plays a role. The ideal option is if the cancer is detected at an early stage, when there is no question not only of metastases, but also of germination into neighboring tissues. Unfortunately, this is a difficult task, because in the early stages, many oncological diseases do not manifest themselves in any way, a person does not suspect that he is sick.

Screening helps in the early detection of cancer of the lung and other organs. All high-risk people, especially long-term smokers, should be screened regularly. In Russia, this is traditionally fluorography, but data from scientific studies show that CT is the most effective.

Lung metastases may also occur after remission. Therefore, regular chest x-rays are included in the follow-up program after successful treatment. If a focus is found on radiographs, computed tomography is performed.

Nuclear weapons. Actions in case of danger of radioactive contamination. – Recommendations to the public

Nuclear weapons are the most powerful in terms of their damaging properties. Depending on the nature of the targets, high-altitude, air, ground, underground, surface and underwater nuclear explosions can be used

The damaging factors of a nuclear explosion are: shock wave, light radiation, penetrating radiation, radioactive contamination.

The shock wave is a powerful damaging factor in a nuclear explosion. It causes damage to people and animals of various nature and severity, destroys buildings and structures. With the distance from the center (epicenter) of the explosion, its destructive power weakens. From the impact of the shock wave, shelters protect, to a large extent weaken its impact by shelters. At a considerable distance from the site of the explosion, terrain folds and local objects can serve as protection.

Light radiation is a stream of radiant energy emanating from the luminous area of ​​a nuclear explosion and includes visible, ultraviolet and infrared rays. It causes skin burns and eye damage in unprotected people and animals, massive fires.

Shelters and shelters, as well as completely or partially – objects made of non-combustible materials, terrain folds protect from exposure to light radiation.

Penetrating radiation is a stream of gamma rays and neutrons emitted into the environment from a nuclear explosion zone within a few seconds. In humans and animals, penetrating radiation causes radiation sickness of varying severity. Shelters provide protection from penetrating radiation. Weaken the impact of penetrating radiation on a person shelters, terrain folds and local objects.

Radioactive contamination is the result of the fallout of radioactive substances from the cloud of a nuclear explosion (radioactive trace). It can be moderate, severe and dangerous. Radioactive contamination, like penetrating radiation, causes radiation sickness. Shelters, anti-radiation shelters serve as protection against radioactive contamination, and from the ingress of radioactive substances on the surface of the body and into the body, in addition, personal protective equipment.

The area where a nuclear explosion caused mass destruction of people and animals, destruction of buildings and structures, fires and radioactive contamination, is called the focus of nuclear damage. Its size depends on the power and type of nuclear explosion, on the terrain, the nature of buildings and a number of other factors.

Means and methods of protecting the population

Knowing the means and methods of protecting against weapons of mass destruction is one of the most important conditions for saving your life and the lives of many people. In a modern nuclear missile war, various methods will be used to protect the population from weapons of mass destruction. The main ones are: the shelter of the population in collective protective equipment – protective structures, the evacuation of the population from large cities to the suburban area, the use of personal protective equipment. In addition, everyone should be able to use the protective properties of the terrain and local items.

Collective protective equipment

You should know where the nearest shelters and shelters are located in your place of work and residence. Protective structures of civil defense are designed to protect people from modern weapons. They are divided into shelters and anti-radiation shelters.

Shelters

Shelters provide the most reliable protection for people from shock waves, light radiation, penetrating radiation and radioactive contamination during nuclear explosions, from poisonous substances and bacterial agents, as well as from high temperatures and harmful gases in fire zones. You can stay in shelters for a long time. Shelters are equipped in the recessed part of buildings or located outside buildings. In addition, existing buried structures (basements, tunnels), underground workings (mines, mines) can be adapted for shelters. The shelter consists of the main premises, lock chambers (tambours), a filter-ventilation chamber, a sanitary unit; has two entrances. Entrances are equipped with protective and hermetic doors. The built-in shelter, in addition, must have an emergency exit. Shelters use filter-ventilation units with electric or manual drive. With the help of such installations, the outside air is cleaned of radioactive, poisonous substances and bacterial agents and is supplied to the shelters. The filter-ventilation unit can operate in two modes – in clean ventilation mode (the air is cleaned only from dust in anti-dust filters) and filter ventilation mode (the air is cleaned of poisonous substances, bacterial agents and radioactive dust in absorber filters). Water supply and sewerage systems are equipped in the shelter , heating and lighting, radio and telephone are installed. In the main room there should be benches for sitting and bunk beds for lying. Each shelter must be equipped with a set of means for conducting reconnaissance in the contaminated area, equipment, including emergency equipment, and emergency lighting equipment. It is necessary to constantly monitor the health of the shelter equipment.

Radiation shelters

You must be able to equip or build a shelter. Anti-radiation shelters protect people from radioactive contamination and light radiation and weaken the impact of the shock wave and penetrating radiation of a nuclear explosion. They are usually equipped in the basement or ground floors of buildings and structures. It should be remembered that various buildings and structures weaken penetrating radiation in different ways: the premises of the first floor of wooden buildings weaken it by 2-3 times, the premises of the first floor of stone buildings by 10 times, the premises of the upper floors (with the exception of the topmost) of multi-storey buildings – 50 times, the middle part of the basement of a multi-storey stone building – 500-1000 times. The most suitable for anti-radiation shelters are the interiors of stone buildings with solid walls and a small area of ​​openings.

If there is a threat of radioactive contamination, these openings are sealed with improvised materials: bags with soil, bricks, etc. If necessary, separate anti-radiation shelters are built. When choosing a place to build a shelter, the terrain, the nature of the soil and the level of groundwater are taken into account. During the construction of shelters, industrial (prefabricated concrete elements, bricks, fittings, pipes, rolled metal) or local (wood, stone, adobe, brushwood, reeds) building materials are used. In winter, frozen soil, ice and snow can be used. For example, a compacted layer of snow 60 cm thick attenuates radiation by a factor of 2. Construction begins with tracing the shelter on the ground. Then the sod is removed and a trench is torn off 180-200 cm deep, 100 cm wide along the bottom with a single-row or 160 cm with a two-row arrangement of places. The length of the shelter for 10-15 people should be approximately 7-9m (with a single-row arrangement of places). In soft soils, clothes of coolness are arranged. Entrances should be at an angle of 90° to the longitudinal axis of the shelter. At the bottom, a drainage groove is torn off, a floor is laid and benches are placed at the rate of 0.5 m per person and bunk beds for lying. A drainage well (up to 50 cm deep) is torn off at the entrance, and a ventilation duct or a simple fan is installed at the opposite end from the entrance. After laying the floor, a layer of soil with a thickness of at least 60 cm is poured on it; the soil is covered with sod, and a ditch is cut off around the shelter to drain rainwater. The entrance is equipped with two curtains made of dense material; a waste container is installed between them in a special niche. The supply of water is stored in tanks.

The construction of an anti-radiation shelter, depending on its design, must be completed in the shortest possible time.

If there are underground workings or natural underground cavities in the area, they can also be adapted for radiation shelters.

Basic Shelter

You must be able to build basic Shelter. The most accessible means of protection against modern weapons are the simplest shelters.

They weaken the impact of the shock wave and radioactive radiation, protect against light radiation and debris from collapsing buildings, protect against direct contact with clothing and skin of radioactive, toxic substances and bacterial agents. The simplest shelter is a gap, which is usually torn off with a depth of 180-200 cm, a width of 100-120 cm on top and 80 cm along the bottom, with an entrance at an angle of 90° to its longitudinal axis. The length of the gap is determined at the rate of 0.5 m per one sheltered person. Subsequently, the protective properties of the open gap are enhanced by arranging steepness clothes, floors with soil sprinkling and a protective door. Such a cover is called a covered gap. The tracing, excerpt and arrangement of the sharpness of the crack are carried out in the same way as it is done during the construction of an anti-radiation shelter. The entrance to the slot can be made in the form of a vertical manhole with a hatch covered from the outside with a shield. If there is time and materials, the protective properties of the closed gap can be gradually brought up to the level of the protective properties of the anti-radiation shelter. In areas with dense buildings, there is not always enough space for the construction of slots. Therefore, it is possible to adapt basements, tunnels and other recessed rooms for shelters. When equipping a basement, first of all, it is necessary to strengthen the ceiling with the help of racks and girders so that it can withstand the load from the debris of the building in case of its destruction; then make an emergency exit in the form of a covered trench with access to the surface at a distance equal to the height of the building; close the openings in the outer and inner walls, leaving only the entrances and openings for ventilation.

Terrain defenses

You must know and be able to use terrain defenses. The protective properties of the terrain depend on its relief, on the shape of local objects and their location relative to the explosion. The best protection is provided by narrow, deep and winding ravines, quarries and especially underground workings. Hills with steep slopes, embankments, pits, low stone fences and other shelters of this type are also good protection against the damaging factors of a nuclear explosion. Small recesses, hollows, ditches have some protective properties. Forest areas weaken the effect of all damaging factors of a nuclear explosion. They reduce the force of impact of a shock wave, penetrating radiation, reduce radioactive contamination, and weaken the effect of light radiation. However, it should be remembered that light radiation causes a fire in the forest. The young deciduous forest is the least susceptible to fire, and it should be used primarily for protection purposes. Since a strong shock wave breaks and destroys trees, it is best to be located in the forest in clearings and clearings covered with shrubs. In the absence of clearings (cuttings) in the forest, one should hide in the depths of the forest at a distance of at least 30-50 m from roads and clearings and 150-200 m from the edges of the forest.

The simplest ways to protect yourself

Remember the simplest ways to protect yourself. If at the time of a nuclear explosion you find yourself outside a shelter or shelter, you must quickly lie face down on the ground, using low stone fences, ditches, ditches, pits, stumps, embankments of highways and railways, forest plantations for protection. You can not take cover near the walls of buildings and structures – they can collapse. When flashing, close your eyes – this can protect them from damage by light radiation. To avoid burns, open areas of the body must be covered with some kind of cloth. When the shock wave passes, you need to get up and put on personal protective equipment. If they are not there, you should cover your mouth and nose with any bandage (shawl, scarf, etc.) and dust off your clothes.

Child protection and adult responsibilities

Children must be supervised at all times when there is a threat of attack. First of all, it is necessary to provide children with respiratory protection equipment. It is advisable to issue gas masks and respirators to schoolchildren at school. In addition to a gas mask and a respirator, each child must be provided both at home and in a children’s institution, school with an anti-dust fabric mask or a cotton-gauze bandage. Then children’s clothes and shoes are prepared to protect against radioactive dust.

Adults should check that protective equipment is working and show children how to use it. It is desirable that children practice putting on and taking off a gas mask, a respirator. Parents, staff of schools and children’s institutions clarify the procedure for going to shelters or shelters, places for children to be placed in them. Parents, and especially the staff of nurseries, children’s homes, maternity hospitals, should be well aware of the device of the nursery’s protective camera and the rules for using it. During the child’s stay in the cell, the temperature in it, as a rule, is 3-4 ° higher than the outside temperature, which should be taken into account when choosing clothes for the baby. To avoid overheating, it is recommended to protect the camera from direct sunlight.

In case of rain, cover the camera with some kind of waterproof cloth, but not too tightly.

Protection of the apartment (house) from the penetration of radioactive dust and aerosols

To increase the tightness of the room, seal all cracks in the doors and door frames, putty the cracks in the window frames and openings, close the vents, chimneys and other openings. In this case, it is advisable to use a sticky polymer tape. Slots in the places where the door adjoins the door frame can be sealed with gaskets made of rubber, foam rubber or other similar material

A sealed room without special air purification devices must be ventilated. To do this, you will have to open a door or window curtained with fabric. Such preparation of an apartment (house) is necessary because in the event of radioactive contamination, after leaving the shelter or anti-radiation shelter, it will be necessary to spend some time indoors before receiving the appropriate order from the civil defense authorities.

Blackout

After receiving an order for blackout, immediately cover all light openings in residential, administrative, industrial, commercial and other buildings with light protection devices: curtains, shutters or shields. In stairwells, lobbies and other places where it is difficult to do without lighting, you can use special lamps or lighting fixtures. In a room with normal lighting, external doors must be equipped with vestibules or curtained with curtains. The quality of the blackout of an apartment, house, industrial, administrative building, etc. must be checked by examining the windows and doors of the building from the street. When leaving an apartment, house or other premises, do not forget to turn off the light.

Protecting food and water from contamination

The main way to protect food and water from contamination is to isolate them from the environment. Therefore, the sealing of apartments, houses, pantries and storage already creates a certain degree of protection. Wrap the products in parchment, cellophane and put them in protective bags made of rubberized fabric or plastic film, in wooden or plywood boxes lined with thick paper inside, in barrels with tight-fitting lids. Refrigerators and various household utensils can also be used for these purposes. To protect water and liquid products, use dishes with well-fitting lids, vessels with ground stoppers – thermoses, jars, bottles. Fresh vegetables and potatoes are safer to store in the basement, cellar, underground. To protect open wells, an clay castle up to 50 cm thick and up to 1.5–2 m wide is made around the upper part of the log house, and a layer of crushed stone, gravel or pebbles up to 10 cm thick is poured on it. close with a tight lid.

Evacuation procedure

First of all, take personal protective equipment with you, from things – only the most necessary things (clothing, shoes, underwear and bed linen, toiletries). You should also have a small supply of food, preferably those that do not spoil and do not require cooking, as well as the most necessary medicines. Put things and products in a backpack or bag, convenient for carrying. Be sure to wear shoes that are comfortable for walking. Attach a tag to each suitcase, backpack or bag with your name, address of permanent residence and place of evacuation. You must have a passport, military ID, documents on education and specialty, work book, birth certificates of children. When everything is ready, turn off electrical appliances, lights, close the apartment. By the set time, you should arrive with things at the assembly evacuation point. There you will be registered and the transport or convoy will be indicated, in which you will follow to your destination. Along the way, discipline and organization must be observed. When evacuating in vehicles, follow all the instructions of the heads of trains, convoys, ship captains. Do not get off at stops. Following on foot, keep your place in the column, follow all commands and signals, and help those who are lagging behind.

You will be given your place of residence at the accommodation point in the countryside. The supply of essential food and industrial goods, as well as public utilities and medical services will be organized.

Actions while in and out of the containment

While in the containment, follow all the instructions of its commandant (commander of the unit for maintenance of shelters). Follow the established order. Keep your personal protective equipment ready. It is forbidden to make noise in protective structures, to walk unnecessarily, to smoke, to light matches, candles, kerosene lamps without permission, to throw food waste in unspecified places. Monitor the behavior of children in protective structures. If it becomes necessary to wear respiratory protection, check that children are wearing it correctly. Control the amount of time children spend in protective equipment. If the defensive structure is damaged, remain calm and do not create a panic; remember that civil defense formations will come to the rescue. When necessary, join in the work to repair damage or provide access to the surface. You need to leave the lesion in the direction of the least damage or surviving buildings, structures, forest plantations, etc. Remember that surrounding objects can be contaminated with radioactive substances, so try not to touch them. Do not approach damaged buildings and structures – they may collapse. Provide assistance to the victims. Help bring out

from the lesion of the elderly, women, children.

Rescuing people from rubble and damaged protective structures

As a rule, military units and civil defense formations are engaged in rescuing people who find themselves in rubble, damaged shelters and shelters. But all able-bodied citizens can be involved in this work. During rescue work, first of all, it is necessary to locate the victims, for which it is necessary to carefully examine the rubble, damaged and destroyed buildings, road structures and other places where people may be. Particular attention should be paid to basements, staircases, near-wall and corner spaces of floors.

Do not forget about safety measures! Do not walk unnecessarily through rubble, do not enter damaged buildings if the walls threaten to collapse, do not touch bare wires, etc. To free people buried close to the surface, the blockage must be dismantled from above manually. If the victims are in the depths of the blockage, then a passage should be made on the side of the blockage, using voids and cracks for this, or the blockage should be disassembled from above using the technique. When dismantling the blockage, proceed carefully so as not to cause additional damage to people who are under it. First of all, try to free the head and chest of the victim. After extraction from the rubble, the victim must be given first aid. Having found a damaged protective structure, try to establish contact with the people in it, determine their condition and the degree of damage to the filter-ventilation equipment. If there is no connection, first of all it is necessary to supply air to the structure. To do this, you need to clear the blocked air intakes or, if they turn out to be faulty, punch a hole in the wall. The location of the head or hatch of the emergency exit, as well as the entrance to the protective structure, is determined by copying from the location plan of the structure or by questioning (with the help of signals) people who have taken refuge in the structure. For digging the entrance or emergency exit, equipment is used – bulldozers, excavators.

If there is no emergency exit (or it is under a high blockage), and the entrances are heavily blocked, you should break through the walls or, in extreme cases, the ceiling of the structure. This is done in the place where the blockage has the smallest height. To punch holes in walls or ceilings, electric and pneumatic jackhammers, concrete breakers, hand crowbars and other tools are used. If the equipment is not available or its use is difficult, the littered protective structure must be dug out manually. In these cases, first of all, your help is needed. During rescue operations, it is advisable to divide into small groups (3-4 people each). One group disassembles the debris and strengthens the passage, the other prepares and brings fastening material, the third takes out the debris removed from the rubble.

Keep the soil moist while working. This will keep your clothing from getting radioactive dust on it.

Providing first aid (self-help and mutual assistance) to the injured

First aid to the injured is carried out by sanitary teams, but you should also know the basic techniques of self-help and mutual assistance. To protect a wound or burn from infection and contamination, apply a bandage. For this, use an individual dressing bag, bandage, clean underwear, a napkin, a piece of cloth, etc. Strong pulsating bleeding must be stopped with a tourniquet or twist. First of all, press the artery with your finger against the bone above the wound to stop the bleeding, then, without removing your finger, apply a tourniquet or twist. A tourniquet or twist should not be applied to a naked body (make a soft lining from a piece of cloth), and also kept for more than 1.5-2 hours (in winter – 1 hour). Do not forget to put a note under the bandage indicating the time for applying the tourniquet (twist), so as not to overexpose it for more than the specified period.

If a tourniquet or twist cannot be applied, you need to press the artery with your fingers until the wounded person is taken to a medical facility, where measures are taken to finally stop the bleeding. In case of fractures and dislocations, it is necessary to ensure the immobility of the damaged bones. If the limb is damaged, a splint (board, stick, strip of plywood) should be bandaged to it. Apply the splint so that it captures the joints below and above the bone fracture. A pad of cotton, tow, leaves, moss, etc. should be placed between the tire and the body. If the fracture is open, it is necessary to first apply a bandage to the wound, and then a pad. In extreme cases, bandage the injured leg to a healthy one; if the arm is damaged, it can be bandaged to the body. In the event of a deep faint, as well as a sharp weakening or cessation of breathing, the victim must be given artificial respiration. The most effective method of artificial respiration – “mouth to mouth” – is based on the active blowing of air into the lungs of the victim (active inhalation) and passive exhalation. With a weakening of cardiac activity, an external heart massage is simultaneously performed by rhythmic pressure in the sternum. After providing first aid, the victim must be taken to the nearest medical center. This can be done using a stretcher or using straps and other available means, as well as transferring the victim on yourself.

Operations in areas contaminated with radioactive substances.

The order of actions and the rules of behavior of people in the contaminated area are determined by the civil defense authorities, which report on the nature of the radiation situation and explain how to act. With moderate infection, it is necessary to be in an anti-radiation shelter from several hours to a day, and then you can go to a regular room. When entering the room, do not forget to clean your shoes and clothes from radioactive dust. Leaving the premises on the first day is allowed for no more than 4 hours. Enterprises and institutions continue to work as usual. With a strong infection, you need to stay in the shelter for up to three days; in the next four days, it is permissible to stay in a normal room, you can leave it for no more than 3-4 hours a day. Enterprises and institutions operate under a special regime, while work in open areas is stopped for a period of several hours to several days.

In the event of a dangerous infection, the duration of stay in the shelter is at least three days, after which you can go to a normal room, but you should leave it only if absolutely necessary and for a short time. During the period of radioactive fallout, you should be in shelters. Being outside the shelter, one must remember that the area and all objects on it are contaminated with radioactive substances. In the presence of dust in the air, you need to use respiratory protection. Water for drinking and cooking can only be taken from piped water and protected wells. Water in open reservoirs covered with a thick layer of ice is also not dangerous. Do not use open water sources. In case of emergency, a hole should be dug 2-3 m from the shore of the reservoir, water will seep into it, which, having filtered through the soil layer, will become suitable for use.

Do not consume milk from animals that have grazed on contaminated pastures. It is better to use canned milk (powdered or condensed milk). Foodstuffs stored in refrigerators, kitchen tables, cabinets, underground, in glass and enameled dishes, in plastic bags are suitable for consumption. Potatoes, carrots and other root crops contaminated with radioactive substances should be thoroughly washed and cleaned.