WORK HYGIENE AND SAFETY - HST

PROFESSOR: EDUARDO MARINHO BARBOSA Module II

COURSE:__________________________________ CLASS:____________________________
ALUNO(A):

Occupational Safety
PPE - PERSONAL PROTECTIVE EQUIPMENT (NR-06)

EPI is a personal use instrument, whose purpose is Whenever collective protective measures are
neutralize the action of certain accidents that could cause technically unfeasible, or not providing complete
injuries to the worker and protect him from possible harm to protection against the risks of workplace accidents or
health, caused by working conditions. The company is occupational diseases;
thank you for providing to employees, FREE OF CHARGE, As long as the collective protective measures are in place
the appropriate PPE for the risk and require the employee to use it being implemented;
even under the following circumstances: To address emergency situations.

Characteristics of PPE concerning body protection:

1 - Head protection: abrasive materials or scouring objects, abrasives,

a) Face shields and safety glasses intended for cutting or piercing;
protection of the face and eyes against particles, respin-
dust, fumes, chemical vapors and radiation
intense

corrosive, caustic, toxic chemical products,

allergens, oily, fatty, organic solvents and
petroleum derivatives;

b) Safety helmets, for protection of the skull in

work subject to weather agents, impacts
resulting from falls, projection of objects, burning-
hard or electric shock; heated or excessively cold materials or objects;
electric shock;
dangerous radiations
biological agents.

3 - Protection for the lower limbs: the legs and the

feet are parts of the body that, in addition to being subject to
even after the accident, it still maintains the body's balance.
For this reason, these PPEs gain double importance, or
2 - Protection for the upper limbs: these are gloves, be, directly protect the lower limbs and avoid the
protection sleeves or protective creams, which must be , which can have serious consequences. Examples are
used in work where there is a risk of injury of these devices:
given by 1
 leather safety shoes or boots, with or without
toe cap and steel insole;

masks for cleaning work by abrasion, through

of sandblasting;
rubber boots for wet surfaces; respirators and chemical filter masks for exposure-
leather scrap chaps. tion to chemical agents harmful to health;

4 - Fall protection against level differences:

safety belt for work at heights above 2
metros where there is a risk of falling;

isolation devices (autonomous or supply)

to workplaces where the concentration of
oxygen is less than 18% by volume.

suspended chair for working at heights where there is

need for vertical movement;
safety harness attached to the safety belt
independent branch, when there is movement of
any nature at heights.
7 - Trunk protection: These are the aprons, guard-posts, ca-
pants and jackets that are used for protection against risks of
5 - Hearing protection: Earplugs at the locations
thermal, radioactive, chemical, mechanical, and meteoric
in which the sound pressure level exceeds the limits
logic, being able to be made from leather scraps,
established in NR-15. There are two basic models:
canvas, brim, plastic, etc., according to the respective risk.
shell-type protector;

8 - Full body protection: isolation devices

(autonomous or air supply) and special overalls
insertion plug-type protector (foam or silicone). hermetically separated from the outside environment, indicated
for workplaces where there is exposure to chemical agents
micos, absorbable through the skin, through the respiratory tract and di-
gestational, harmful to health.

6 - Respiratory protection: When there are exposures to

environmental agents at concentrations harmful to health
of the worker. The following types are used:
dust respirators;

Obligations to be followed regarding PPE

a) All PPE, whether manufactured domestically or imported, only acquire the type suitable for the activity of the employer
it may be marketed or used when it has do;
The Certificate of Approval (CA), issued by the Mi- to provide the employee only with PPEs that have CA;
Ministry of Labor, whose number must be printed train the worker on its correct use;
no EPI in a legible way; make its use mandatory;
b) The appropriate indication of the PPE should be made by the replace it immediately when damaged or
SESMT, in its absence due to CIPA and, if not present, lost;
by the employer through technical consultancy. take responsibility for your hygiene and manu-
c) The employer is obliged to: attention;
2
 notify the MTE of any irregularity take responsibility for its custody and preservation;
stored in the PPE. inform the employer of any changes that
d) The employee is obligated to: or to make useless
use it only for its intended purpose; .

PREVENTION AND FIGHT AGAINST THE FIRE PRINCIPLE

A fire destroys in a few hours what took months and years to build. Its causes are the most
different, from a simple friction between metals, a short circuit, or even a candle left burning at home that
it can be knocked down by a pet. Its prevention involves a series of care and provisions.
measures that should be adopted in order to avoid the harmful consequences of uncontrolled fire, or of,
at least, to prevent the flames from spreading through the facilities. This can be achieved through a good
preventive planning, good protective installations, and qualified personnel. In the field of prevention, some know-
Basic cements are necessary in order to avoid the occurrence of the principle of flame.

THE CHARACTERISTICS OF FIRE

Fire can be defined as the consequence of interconnected points will form the "triangle of
fire.” Thus, the fuels after starting the co-
a chemical reaction called combustion, which pro-
there is heat and light. For this chemical reaction to occur,
burning generates more heat; this heat causes the des-
absorption of more combustible gases or vapors,
there must be, at least, three elements that from
generating a chain reaction. The interconnection of these
of the existence of a favorable circumstance (reaction
element constitutes the "tetrahedron of fire":
in a chain), they can combine and result in the incên-
God. The essential elements of fire are:
Fuel (wood, paper, flammable liquids
veins, etc.
Oxidizer (oxygen);
Heat (heated sources, sparks);
Chain reaction.
For combustion or burning to occur, there must be
to be present and three elements must act. The first
it's the fuel, that which will burn and transform
burning. The second is the heat, which initiates the burning.
so, which ignites the fire. The third is oxygen,
gas present in the air, breathable, which is called
oxidizer. These three elements are essential for
the existence of fire, and if represented by three

FIRE PREVENTION

Fire prevention is achieved through theprevention is only

application possible through the elimination of
favorable conditions, avoiding the chain reaction.
from a set of measures that prevent the occurrence
The methods are:
of fire. In processes that require material in with-
a) action on fuel;
bustão, prevention is achieved through control of
b) action on the heat source;
areas and, mainly, minimizing the amount
c) action on the oxidizer;
fuel necessary to maintain the operation of the
d) action on the fuel mixture -
system.
oxidizer.
Like, practically, the fire triangle (combust-
combustible heat can usually be found
traded in any environment, in most cases the

3
 FIGHTING THE PRINCIPLE OF FIRE

When, for any reason, prevention fails, a) there are fire fighting equipment
workers must be prepared for the com- in sufficient quantity and appropriate to the type
act on the fire outbreak as quickly as possible, of combustible material;
because the longer the fire lasts, the greater b) the people in the area know how to use this equipment
they will be the consequences. mentos and can assess the capacity for extinction-
For the combat to be effective, it is necessary that: ção.

Methods of extinction

Let's consider the fire triangle: From all this, it is concluded that, by preventing the link-
the points of the triangle, that is, the elements
essential, indispensable for fire, this does not arise
it will cease to exist, if it has already begun.
In places where there is combustible material and oxygen
No smoking is indicated by a warning sign;
so, it is intended to avoid the formation of the triangle of fo-
go, this is, fuel, oxidizer and heat. The ca-
then, in this case, is the embers of the cigarette. Without this heat, the
fuel and the oxidizer cannot transform
married in fire.
Basically, extinguishing a fire is done
Removing one of these elements will stop the by a cooling or smothering action, or by
combustion. There is a very important indication there a union of the two actions:
many ways to extinguish the fire. One can a) Cooling action: the temperature is reduced
remove the substance that is being burned (this is of material ignited at levels lower than the point
a solution that is not always possible), one can of the brightness or combustion of this substance. From
eliminate the heat, causing cooling at the point from this moment on, there will be no emission of vapors ne-
in which combustion and burning occur. It can still be, necessary for the continuation of the fire.
to remove or eliminate the oxidizer (oxygen) from b) Suppression action: it results from the removal of the
place of burning, by smothering, introducing another oxygen, through the application of an extinguishing agent that
gas that is not an oxidizer. will displace the air from the surface of the material in combustion
The fire triangle is like a tripod: eliminating- so.
if one of the legs ends the support, that is, the fire
is extinguished.

Extinguishing agents

They are considered extinguishing agents, by virtue of the interaction between the combustible material and oxygen (with-
your action on the fire, the following substances: burnt).
water Another agent that acts by suffocation is gas.
foam carbonic, also known as carbon dioxide
dry chemical powder you CO2It is heavier than air; however, it is not
carbon dioxide. efficient in open and ventilated places.
Water presents as its main characteristic the ca- Common dry chemical powder (sodium bicarbonate)
ability to lower the temperature of materials in acts by smothering; it is preferable to CO2in places
combustion, acting, therefore, by cooling, as- open, however, not indicated in firefighting
used in the form of a jet. It can also with- in high-value electronic equipment, due to the
to bin an action of damping, if sprayed in droplets- corrosive waste that can damage them. There are also
haze, that is, in the form of mist. well the ABC extinguisher based on monoammonium phosphate
Aespumapode can be chemistry, when resulting from with, indicated for the respective three classes of fires
mixture of two substances (e.g., sodium bicarbonate) God. When it comes to special deposits, used in the
God and aluminum sulfate, both in aqueous solution. called 'class D', they merge upon contact with
or mechanics (extract added to water, subsequently the pyrophoric metal, forming a "protective layer-
or agitation of the solution for foam formation. "that isolates the oxygen, interrupting the combustion."
Its main action is to muffle, creating a bar- 4
Since Sep/2015 the fire extinguisher has ceased to According to NR-23 (Regulatory Standard-
be mandatory equipment for vehicles co- report of the Ministry of Labor regarding the
trucks, such as cars, utility vehicles, vans, ca- Fire Protection), in all the establishments-
minivans and closed-cabin tricycles. But your mentos or workplaces should only be used
use will continue to be mandatory for trucks fire extinguishers that comply with the norms
pickups, tractor trucks, minibuses, buses, shelves or technical regulations of the National Institute
vehicles intended for the transportation of inflatable products of Metrology, Standardization and Industrial Quality
mobile, liquid, gaseous and for vehicles used trial (INMETRO), ensuring this requirement by
in public passenger transport, such as taxis by apposition in the identification devices of the organs
example. that are accredited by INMETRO to eat
specialize in the sale or recharging of these equipment.

Fire Classes

Fires, at their start, are much easier. which substances will cause the suffocation and the
to be controlled and extinguished. The more removal of the COMBUSTIBLE (O2).
the quicker the attack on the flames, the greater the possibilities c) CLASS 'C' fires: are those that reach
abilities to reduce them and eliminate them. And the main I like energized electrical equipment, such as
concern, in the attack, consists of breaking the tri- motors, conductors, transformers,
fire ghouls. But, what kind of attack is made against fire? electrical control boxes, etc., in which
at its outset? What solution should be attempted? Water or foam cannot be used by the ris-
Since fires are of various types, the solutions regarding electric shock. The extinguishers used
they will also be different and the equipment of com- in this class are the CO2 or PQS, acting
baits will also be of various types, such as the about the fire in the same way as the previous item.
presented below, according to the class of the in- d) Class 'D' Fires: are fires
candy. in pyrophoric metals like magnesium, sodium,
a) CLASS "A" Fires: these are the ones that titanium, lithium, potassium, etc. If there is contact
occur in materials such as wood, cloth, of substances applied in the extinction of the clas-
paper, leather, fibers, debris, etc. After the previous ones with these heated metals,
burns are characterized by leaving ashes dangerous explosions occur. It is necessary
and embers on site. The extinction of this type of fo- special extinguishing agents with specific charges
it should be done by water-based extinguishers, specifics for each metal or just direct application
in order to combat the HEAT. iron filing, graphite, or dry sand.
b) Class "B" Fires: are those that Class "K" fires: it is the fire that occurs
they occur in flammable substances such as ga- in oil and fat in kitchens. Generally, it occurs
solvents, grease, paint, etc. A characteristic- take in equipment such as fryers, grills,
the main purpose of this class is that the burning des- baking trays and frying pans. The most suitable fight
is with extinguishers based on a special solution of
the substances only interact at the surface.
Potassium acetate diluted in water.
In this type of fire, extinguishers should be used.
of foam, of CO2dry chemical powder (PQS),

Fire extinguishers

In accordance with NR-23 (Fire Protection 6 Kg for CO2and up to 10 Kg for chemical powder) and rebo-
god), in all establishments or places of tra- cables in reels, for larger sizes.
only fire extinguishers should be used Regarding the functioning process, they are
that comply with Brazilian standards or regulations generally of two species:
technicians from the National Institute of Metrology, Norma- a) inversion: occurs in foam extinguishers
standardization and Industrial Quality (INMETRO), ensures where inside the device is the bi- deposited
having this requirement for the placement on the devices of sodium carbonate and the stabilizer. Concen-
identification of the bodies that are accredited by Centrically to this reservoir, there is a cylinder.
INMETRO for selling or refilling that contains aluminum sulfate, which when being
of these equipment. the turn will come out of the cylinder and the mixture will occur
Regarding size, the fire extinguishers can be: by- with baking soda, processing it
tactile (up to 10 liters for foam and pressurized water; reaction that will form the foam.

5
 b) from the valve: occurs in water extinguishers Sprinklers
Surizada, CO2the Dry Chemical Powder, being more
They are automatic combat devices for
common trigger ones.
fire outbreak, consisting of pipelines in-
As for the sizing, the amount of ex-
connected to a main reservoir, arranged regularly
dry cleaners will be determined by the following conditions:
largely on the ceilings of buildings, with formed tips
for glass vials, which break with the pre-
sense of heat (around 70 C) and othat release
water or another extinguishing agent that fights fire,
even in the absence of people in the environment.
The fire protection system attracts
instead of automatic sprinklers, it constitutes
fixed pipelines, integrating underground network and
aerial where showers are arranged regularly
permanently connected to one or more supplies
to water. It allows, in case of the occurrence of in-
fire, the application of automatic extinguishing water and
directly at the accident site, through the rom-
to spice up the temperature sensor seal in each chu-
automated gate operated, allowing passage of
Area covered by Maximum distance water and the simultaneous activation of a device
Fire Hazard unit of fire extinguishers to be traveled of the alarm.
Small 500 m2 20 m
Medium 250 m2 10 m
Big 150 m2 10 m

Capacity of Number of fire extinguishers that

Substances fire extinguishers constitute 1 fire extinguisher
Foam 10 liters 1
Pressurized Water 10 liters 1
yes
6 Kg 1
Carbon Dioxide 4 Kg 2
(CO2) 2 Kg 3
1 Kg 4
4 Kg 1
Dry Chemical Powder 2 Kg 2
(PQS) 1 Kg 3

Emergency, Abandonment, and Contingency Plans

Companies must develop contingency plans, agency must have simulation systems
abandonment, emergency, abandonment and continuity of action, signaling, escape routes. It is a plan in-
service to face fires and disasters of integral, multidisciplinary, multi-level, technical and
of any nature. with a good communication strategy
a) Contingency plan: it is a set of b) Emergency plan: The emergency plans
general norms and procedures based on the cia devem atender aos requisitos das normas
vulnerability analysis of the facilities. issued by the firefighters, but in general they are
It is necessary to have defined objectives, strategies, re- made up of several plans for each of them.
courses and activities. In addition to including: antecede- specific emergency plan. It has a character
teeth, vulnerabilities, risks, organization more operational than the contingency plan.
preparation and attention to emergencies. In the an- They must contain the following elements for
background should not be forgotten to analyze cada subplano: descrição do edifício, da área
in addition to physical factors, also the mental ones and where it is located and the risk factors,
psychosocial. Regarding internal supports potentially affected population (permanent
must identify the firefighters and their assistants or floating), characteristic of operation
it must have an inventory of from the installation, number of people with ne-
civil, commercial, public organizations and the special needs, risk identification
organizations that are part of the systems of associated with the activity. Human resources
disaster response. A continuity plan 6 available to act in each case
 two different incidents, material resources, there are people with special needs,
basic procedures for customer service identification of meeting points.
case, mapping of specific external supports d) Continuity plan: there are facilities that
fics, first aid and mapping of even in an emergency situation they cannot
reference health units, procedures be immediately deactivated, so it is also
terms for the elimination of additional laughter, pro- it is necessary to develop a plan of accounts
surrender for abandonment of the area, isolation service unavailability, with reduced capacity
the confinement of the disaster areas, proce- of course, it's personal.

dimento for combating the disaster and proc- It should be emphasized that depending on the bibliographic reference-
data for further investigation about the graphic used, the terms "contingency plan" and
occurred. "emergency plans" are used in different senses
c) Abandonment plan: description of the procedure contrary to those exposed here. Thus, attention must be paid
guidance for partial or total abandonment of the ins- to the definitions used by the regulatory bodies of
translations, special care for spaces that your area to avoid problems.

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 FIRST AID
First aid is basic and simple care given to the victim at the scene of the accident. These are procedures that
most of the time it saves and/or reduces the suffering of the injured. There has been an observed significant reduction in hospitals of
death and disability rates among victims who received proper first aid.
Qualities of those who provide first aid: Give priority to the most serious victims, children,
To have knowledge about the subject adolescents, pregnant women, women and elderly.
To have emotional balance Basic First Aid Rules for all situations
Have a spirit of leadership actions
What should be done when faced with a situation of Always start by performing the primary assessment of
emergency? victim;
Call SAMU (192); Do not move the victim unnecessarily, nor
Check if there is any danger to the rescuer; allow her to move abruptly;
Take care of the matter; Do not offer liquids, food, or medications without
Be quick without being hasty; medical indication;
Do not make sudden maneuvers; Keep the victim comfortable;
Request help from people; Calm the victim by not allowing them to see their
Avoid crowding around the victim; more serious injuries;
Notify the hospital, family, police; Give emotional support.

PRIMARY ASSESSMENT OF THE VICTIM

In any emergency situation, always exe- Listen to the breath. Normal frequency values
first, the primary assessment is cute. It will help to understand. respiratória: Adulto: 16-20 rpm; Neonato: 40-45
if there is a risk to life and also the decisions to be made rpm;
loud. Feel the breath through the air that comes out through the nose and
[Link] the Conscience: call the victim, introduce yourself scoop mouth
by name; touch your shoulders and shake them gently If the victim is breathing, check for prosthetics, there-
you. mentos or liquids in the mouth that may hinder it
[Link] the Breathing: perform the opening of the airways and remove them, depending on the type of the object, one should
airways (the path of air from the nose and mouth to the lungs) make the victim lie down to remove them.
following the steps below: 3. Check to Circulation:
For cases where there is no suspicion of spinal injury Check for pulse. Normal values: Adult: 60-
cervical (neck region), position one of the 90 bpm Neonato: 120-140 bpm
hands on the victim's forehead; Prefer the carotid pulse (in the neck);
Position two fingers of the other hand under the chin; Check for any external bleeding in the cor-
Make a light movement with the victim's head. If it exists, control it quickly by placing
backwards. This procedure aims to prevent the a cloth directly over the injury, making a
the tongue can obstruct the passage of air, as it does- certain pressure.
relaxation of the muscles and with the victim lying down
lying on her back, she tends to fall backwards, CAUTION: If you suspect that there has been a fall,
which can lead to respiratory arrest and even death; violence or another type of trauma to the spine
Then observe the movements of the expansion of the tó- cervical, securely hold the head of the vine
rax; time, to prevent side movements
and back. With the help of another person,
just lift o victim's chin.

CARDIOPULMONARY RESUSCITATION (CPR)

It is a maneuver used to maintain, in a way that is ar- thoracic arteries are interrupted, blood flow ceases. Each
artificial, the blood and air circulation in the body. once the chest compressions are restarted, the pri-
In the event of cardiac arrest, there is no flow. further compressions are not as effective as the applications
sanguineous. Chest compressions produce a p- the following. The more interruptions of the compressions
maintains the amount of blood flow to the vital organs, thoracic, lower the survival chance of the victim of
like the brain and the heart. The better they are a cardiac arrest.
chest compressions performed (that is, with frequency Real case studies of resuscitation demonstrate
the appropriate depth and allowing for the full return of the RAM that 50% of chest compressions applied by
tórax), maior será o fluxo sanguíneo que produzem. As professional rescuers are very superficial. These es-
chest compressions that are too shallow or everyone also demonstrated that chest compressions
sloths do not produce a blood flow as much as are frequently interrupted during CPR.
possible for the vital organs. When the compressions 8 The new recommendations reinforce that the rescuers of-
who performs chest compressions fast enough Apply effective compressions at a frequency (in
and deep. These recommendations also guide the minimum, 100/minute) and depth of 5 cm, minimize-
lifeguards about the need to reduce the number of give the number and duration of interruptions in purchases
interruptions of chest compressions. chest compressions. Other components of high-quality CPR.
The rescuers must let the chest return to the position. quality involves obtaining the total return of the thorax after
normal action after each compression, because during the return each compression and avoid excessive ventilation.
from the thoracic wall, the blood fills the heart again When to use an Automated External Defibrillator
ction. (DEA), apply 1 shock, followed by immediate CPR, start
If the rescuer does not allow the chest to return or rise I am doing chest compressions.
again after each compression, the blood flow will be
reduced during the next compression, as the heart Compression should be performed as follows:
will not have been filled with sufficient quantity of The victim should preferably be kept on the ground.
blood before the next compression. Do not place it on beds, mattresses, or sofas;
During CPR, the blood flow to the lungs The rescuer must be in a position that is firm-
is much smaller than normal, therefore, the victim needs in the movements. The most suitable is with both joes-
less ventilation than usual. The ventilations of worms on the ground;
rescue can be applied safely during 1 se- Position the crossed hands over the outer bone
gun. Including, during CPR cycles, it is important no, at the midpoint between the nipples;
limit the time used to apply the rescue ventilations The force applied should be the weight of your body, or
you, to reduce interruptions in chest compressions. be, do not force your arms, let the weight of your body
The rescue ventilations applied during CPR increase I do most of the work. This saves the help
It increases the thoracic pressure. This pressure reduces the amount of list of fatigue;
blood that fills the heart which, in turn, diminishes the The elbows should not be bent during the
blood flow generated by the next series of compressions massage and the arms should be at a 90º angle
thoracic. in relation to the body.
For all these reasons, hyperventilation (breathing-
excessive actions in number or with a very large volume Casos especiais
large) is not necessary, and can be harmful because, in There are cases that deserve special attention such as
Indeed, this maneuver can reduce blood flow. in babies and children up to 8 years.
generated by chest compressions. In addition, the application- Lay the child on their back and tilt their head.
Long and forced ventilation can cause distension. nothing behind;
gastric and its complications. Lift your chin so that it is projected forward.
fora;
Keep the child in this position so that their
CPR APPLIED BY LAY RESCUERS the tongue does not obstruct the airflow;
In these, the massage must be performed with only one
The main recommendations from the American Heart of the hands, since its bone structure is more fragile than the
Association–AHA (2010) on Cardiac Resuscitation of an adult;
pulmonary and Emergency Cardiovascular Care, In the case of babies, artificial respiration should be performed.
related to guidelines on CPR applied by rescuers mouth-to-mouth-nose and with the air from the cheeks of the rescuer
the laypeople are as follows: rista.

STATE OF SHOCK

The failure of the circulatory system, causing the

interruption or change in blood supply to Signs and Symptoms
brain with pronounced depression of the functions of the organism Intense sweating (perspiration) on the forehead, as well as on the palms.
me. of the hands;
The victim shows signs of dizziness, low tension. Nausea and vomiting;
sweat (sudores) and always faints, entering the picture of Cold, damp, and pale skin;
unconsciousness. It occurs in most cases in the processes Dyspnea (shortness of breath, difficulty breathing, shortness of air);
from severe hemorrhages, polytrauma, that is, blow- Weak and rapid pulse (tachycardia);
the in almost the entire body, emotional state Unconsciousness, or partial consciousness;
unstable, general weakness, insufficient nutrition, advanced age Shivers of cold;
fear, anguish, worry, etc. Regardless of the Dizziness and fainting;
the above states are still found in: heart attack (co- Agitation or depression of the level of consciousness;
ração), queimaduras graves, ferimentos externos, esmaga- Dilated pupils.
mentos, acidentes por choque elétrico, acidentes automobi-
listings, poisonings by chemical products and derivatives How to provide assistance

two, complicated fractures (exposed), poisonings by ali- Initially perform a thorough inspection, ensuring that
mentos, medications, gases, excessive exposure to ca- state of shock. Confirm case:
the cold (in these cases it is often fatal).
9
 Place the victim lying down, always paying attention to the Warm the victim, covering them with blankets;
possibility of the existence of other associated injuries; If he vomits, turn his head to the side;
Keep the victim lying down, with their legs elevated above Keep your breathing normal;
body level, if there are no signs of fractures or Provide pure air, or oxygen, if possible;
hemorrhages in the head; The victim should move as little as possible.
Loosen the clothes, tie, etc., to facilitate circulation;

HEMORRHAGE

Hemorrhage refers to rupture or leakage. elevate the members, do not offer liquids and refer her
of an artery, vein or capillary with partial or total loss urgently to a hospital.
of blood volume, which can occur both externally and
to internally to the victim's body. Help quickly the
Care
victim, stopping the blood (hemostasis). Keep the victim lying down with the head lower than the body.
that the body, except when there is suspicion of fracture of the
External bleeding: keep the victim lying on their back,
raise the members and use gloves (if you don't have them, use a bag)
skull or stroke; in these cases, the head must
to be kept elevated. Apply compresses with well water
plastic in the hands to avoid the risk of infection). It can be
cold if possible icy, and treat it as if it were a victim
resolved by direct or indirect compression. In this, the c
pressure should be applied between the cut and the heart (if it's art-
in a state of shock. If it is a stomach hemorrhage,
Do not give anything to the victim by mouth. Remove it immediately.
royal, since the path of arterial blood is from the center to the
to the hospital.
periphery) or between the cut and the periphery (if it is venous, already
that the blood is of return).
Tourniquet
How to stop (hemostasis):
Its use is questioned because it blocks circulation.
Use a clean compress (gauze, cloth, handkerchief) and
neuromuscular injuries with post-necrosis may occur
dry;
leaving serious sequelae. We must have base-
The pressure must be continuous;
be very careful not to use inappropriate material (wires,
If the dressing becomes full of blood, do not remove it, call...
cords, laces, etc.). Tourniquets are always made
put another on top Put it on top of the wound,
with a wide and very sturdy cloth. Wrap the cloth around.
press firmly yet carefully;
on the upper part of the arm or leg just above the wound
Use clean binding (tie, sheet, diaper, etc.) to
tie a half knot by pressing with a piece of
hold the compress;
wood and then tie the whole knot; twist the piece of
If you are in a place where there is no resource for
wood until stopping the bleeding (halt the blood); sea-
no nature, make compression with your fingers or
with lipstick, charcoal or pencil on the forehead or anywhere
with hands against the bone at the points where the visible place of the victim the letters T.Q. (tourniquet) and the time;
arteries, veins, and capillaries are easy to find.
do not cover the tourniquet and stay alert for complications
Internal Hemorrhage: These are ruptures or leaks of blood vessels. (state of shock or cardiac arrest).
glands that occur in the human body, inside the organ- Important:
the victim, never seen by the rescuer, only identified Wake up and stretch slowly every 10 to 15 minutes and
by signs and symptoms presented by the victim. The cases go check the hemostasis; if this is the case
more common are severe thoracic and abdominal trauma it's happening, go relaxing so that he can be
nice (through a vehicle accident, for example) good reaperted in case of need. While it is with-
how you fall from great heights. They are generally injured to control the hemorrhage proceed as follows:
the liver, stomach, lung and intestine. Symptoms: Skin Keep the victim warm with blankets or
cold, rapid pulse, thin and weak (filiform pulse), sweating, proper clothing avoiding direct contact with the ground
intense paleness (cyanosis), pale mucous membranes, dizziness and cold and damp;
headquarters. The occurrence of vomiting blood of a brownish color Give plenty of liquids to the victim if they are well.
It indicates stomach hemorrhage. The cough with presence conscious and there are no signs of internal bleeding
bright red and foamy blood indicates pulmonary hemorrhage .
monitor. Ensure to keep the victim warm and let her rest,
BURNS

Water is the natural barrier of protection for the body being affected muscles, bones, nerves, and blood vessels and
against the aggression of microorganisms, physical agents and still the eyes and the airways.
chemicals and assist in temperature control and retention Burns can be classified and assessed in
liquid loss. Once damaged by the burn, these its severity according to:
factors are immediately altered. Burns, with The causative agent;
often reach structures beyond the skin. They can The depth (layers of skin it reaches);
The extent (body area affected).
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 Mild Burns: are those of 1st and 2nd degrees, affe-
According to the causative agent, the burn can tando small extensions of the body and that correspond
to be from the absolute majority of accidents of this type;
Burns Sources Moderate Burns: these are 1st degree burns.
Térmica Flames or heat of the fire, second degree average extension SAS;
vapor, hot liquids, obje- Severe Burns: are all third-degree burns and second-degree burns.
heated tanks. gray that involves face, neck, chest, hands, feet, virile-
Chemistry Various acids or bases. the joints, in addition to extensive 2nd degree burns
Electric Alternating currents, conti- gray. Chemical and electrical burns are
clouds or rays. always considered serious.
By the Light (reaching prin- Intense light or ultraviolet light
mainly the eyes (including sunlight). Emergency measures (rescuer):
By Radiation Nuclear radiation, ultraviolet light
ultraviolet or infrared. Thermal burns:
Extinguish the flames using a blanket or rolling on it.
victim on the ground;
According to depth(*):
Burn Characteristics Perform the primary assessment of the victim;
de: Cool the burned area with plenty of running water.
First It only affects the epidermis. It is characterized by 10 to 15 minutes;
Gray due to redness, some swelling, and local pain. Remove the clothes, watches, and bracelets that are not.
grudados;
Second It affects the dermis and epidermis. There is intense pain,
Gray swelling, redness, and blisters. Do not pop bubbles!!!
Cover the entire burned area with wet gauze.
Third Considered serious (**), as it affects everyone
saline solution or clean water, involving this therapy-
Gray the layers of the skin, as well as muscles and even
with crepe bandages also moistened. Keep-
even the bones. The injury shows color-
use the wet dressing with serum bottles or
dark and/or whitish. (*). It is in
water, until arrival at the hospital;
general surrounded by lesions of 1st and 2nd.
If the burn is extensive, be concerned about warming it.
It is important for the rescuer to know that the injury is not
victim
uniform, with varying degrees of depth
Do not offer medications or food to the victim;
in the same injury.
Remove her to the nearest hospital, even though -
(**) It is considered as serious any burn
if the burns are of small extent;
ra (even if it is of first degree) that reaches 15% of
Never apply sprays, butters, creams, oils, paste
body or more.
of teeth, vaselines, ointments, ice etc., on the area
burnt;
Burn Area: the larger the area, the more
The secret is... Water! Lots of water! Only water!
it increases the risks for the victim, as there may be excessive loss
loss of body fluids, temperature loss, and high risk
Chemical burns:
of infections. To calculate in an adult the percentage
Use gloves and act carefully!
approximate burned skin surface area, we take in
Wash the area with plenty of running water for 10 to 15
count the following data, considering the parts in relation
minutes;
action in total, for adults:
Remove clothes, bracelets, and watches contaminated with
the substance, as long as they are not stuck;
Head 9%
Do not pop bubbles!!!
Neck 1% Cover the entire burned area with wet gauzes.
Upper limbs (each one) 9% saline solution or clean water, involving this dressing-
Thorax and abdomen 18% with crepe bandages also moistened;
Coasts 18% If the burn is extensive, worry about warming the
Lower limbs (each one, including buttocks 18% victim;
gas Do not offer medications or food to the victim;
Take her to the nearest hospital, even though
For the children, the percentage is as follows: if the burns are of small extent, due to
Head 18% dealing with chemical agents.
Upper limbs (each one) 9% If possible, try to identify the chemical agent, as
Thorax and abdomen 18% this will help in definitive medical care;
Buttocks and hips 18% The secret is... For powdered or paste substances, first...
Lower limbs (each one, including buttocks) 14% to remove the excess before washing, to prevent that
gas the burning product drains!
Watch out!!! They are especially dangerous both for
Based on this information and the location of the burn, if the victim as well as the one who helps.
you can say that:

11
Chemical burn in the eyes: Seizures (in severe cases);
Immediately wash the victim's eyes with water. Did you know...that electric current causes two
abundance for 10 to 15 minutes. burn areas: one at the entry point and
Quickly initiate the transport of the victim to the hospital and another at the point of exit of the current?
wash throughout the journey, covering both Care!!! Do not touch the victim still connected to the color-
your eyes with moist gazes, even if just electric bill. Ensure your safety by turning it off
one of them has been hit; energy!
If, after this procedure, the victim reports again...
If you have a burning sensation, wash your eyes with water again. How to help
Do not approach if there is live electricity, wires
Electric burn: loose or water on the floor;
Electrical burns are considered very serious, Perform the primary assessment;
as they can cause changes in the functioning of the Use water to relieve the burn process and
body systems, leading even to death due to cardiac arrest make wet dressings;
about Warm up the victim;
Signs and symptoms: Transport it without delay.
Burn signal in 2 points (*);
Tremors or muscle laxity;
Respiratory difficulty;

POISONINGS

Poisonings are very common accidents. Do it How to help

a test: when you're at home, take a look at your The objectives of first aid in these situations are:
medicine cabinet. Go to the service area and count. Support for vital functions (breathing and circulation);
how many cleaning products are there? Imagine happiness- Reduction of contact (acting with general measures
the shock of a child when faced with this huge amount of detoxification);
A quantity of colorful little jars. It will be a joy for her. Heating of the victim;
huge!!! At least in the first minutes. After that, Prevention of new injuries (seizures and status of
after ingesting a good part of them, certainly this child will start- agitation).
it will result in a poisoning condition that could lead to death.
Intoxication is defined as the interaction between the organism Important general information for attendance
the toxic substances, which are responsible for effects Type of substance;
negative or destructive to the individual. The severity of the in- Amount ingested;
toxication depends on factors such as age and susceptibility Time elapsed since the exhibition;
the victim's age, the quantity, the type, and the method of penetration Route of exposure: ingestion, inhalation, or contact with
the toxic substance. Large urban centers have the skin;
information and guidance services called Centers of Medical history returns (drug use, medications,
Intoxication Control (ICI), usually linked to hospitals alcohol and even behavioral disorders).
city's pits. In Salvador, the Information Center Administration of home remedies or ingestion of
Antivenom (CIAVE) is located at the General Hospital Ro- liquids, etc;
Berto Santos operates 24 hours a day, every day of the year. The secret is... Time is your ally! Be quick, ev-
being prepared to assist accident victims with so that the poison is absorbed!!!
poisonings by venomous animals. There you will obtain in- Care!!! If you are called to help al-
trainings, via phone, tips and procedures for someone, always think about your safety. Examine the
cases of poisoning, in addition to indicating the most suitable hospital local, paying attention to the odors - sign of a leak -
to receive the victim. release of gases and toxic waste - liquids on the ground,
empty jars etc., to avoid accidents as well.

12
 FRACTURES

Fracture is the breaking of a bone. It seems simple, but it is not. Make gentle movements with your hands, moving
The bones are part of the musculoskeletal system, which do the affected part only if necessary.
gives shape, support, protection, and movement to the body. Always suspect other injuries, in addition to the most evident.
Therefore, an injury to any part of the skeleton you.
can deeply affect these functions.
In addition to fractures, there are also 2 other types of injuries. The basic principles of immobilizations are:
bones are also considered important. They are immobilize before moving the victim.
they Cut the clothing that is over the affected area, if necessary.
Twists or sprains: caused by movement. the injury cannot be seen.
mention of a circulation beyond its limits (ca- Protect wounds, such as bone tips, with gauzes
physiological capacities. the clean cloth. Always respect the position found,
Dislocations: characterized by the loss of congruence not making any correction or traction, in the attempt
that articulate. This situation can be translated as to leave her "normal".
a bone that comes out of its normal socket Always respect the position in which the victim feels me-
in pain (antalgic position). Apply and secure the splint
Don't think it will be easy to distinguish a fracture from a immobilization always in one joint above and another
sprain or a dislocation, as its signs are many below the affected location.
similar. Suspect immediately the presence of fratu- If possible, elevate the injured part to reduce the
ra, when the victim presents: swelling and pain.
Pain or abnormal sensitivity (the victim may hold the Do not tighten the ties excessively, very me-
affected area, trying to protect itself from the pain. we fix them on the affected area.
Swelling at the site. Cushion the spaces between the splints and the body, using
Deformity at the site. of towels, fabrics, etc. Use fabric ties
Presence of purplish areas. long enough not to constrict and prevent the circulation-
Absence of movement or great difficulty in relationship.
to move. Care!!! Fractures cause a lot of impact on
Presence of bone tips pierced through the skin. lifeguard. Remember that, although these are gra-
Feeling of broken bones under the skin (crepitation). Yes, other types of injuries can lead to death
faster.
Until proven otherwise, always treat as having
fracture the victim with any story of a fall or others How to immobilize different parts of the body:
various accidents and that presents some of the signs and symptoms Shoulder and Clavicle:
Tomas mentioned earlier. There are 2 basic types of Use the victim's own body as a beam. Fix the arm.
fractures: closed and exposed (or open). The closed ones on the trunk with a fabric material, in the form of ti-
those are the ones where cuts or injuries do not happen which leaves the fabrics visible. If you want to intensify
wounds on the skin that may expose pieces of bones; already the the fixation, use a second fabric material, to fi-
open, present skin rupture and bone exposure. tie the arm to the trunk, as in the case of immobilization of
arm.
In the face of a suspected fracture, be aware of the possibility. Ribs and Sternum:
of the compromise of other structures of the body. For example: Severe fractures, as they cause enormous difficulty in breathing
Rib fractures can interfere with breathing due to per- they must be immobilized like the shoulders and collarbone,
lung puncture; open fracture in the leg can cause respecting the affected side.
rupture of blood vessel and consequent bleeding Arm (Humerus):
to, possibly leading to a shock. Respect the position in which the arm was found, if the
the arm should be extended along the victim's body. If
How to Help be folded, use fabric materials, making a
Regardless of the type of injury to the bones, the first arm sling to support the arm and then two more to tie
Basic first aid is immobilization. This procedure... rations, with one above and the other below the lesion.
guarantee, in addition to the reduction of pain, the reduction of the possibility of Forearm and Wrist:
the severity of the aggravation. By reducing pain, we will be re- Place a wooden splint under the forearm, covered with-
reducing stress, which is a serious component of the sin- bracket or even a closed umbrella. The fingers must
tomatology. sticking out or holding something to maintain the curvature
The immobilization should be done with a splint, which can natural. Use a bandage or fabric material to
improvised or commercially available type. The fix and improvise a sling so that the arm doesn't hang
the most common types of improvised splints are pieces lowered, increasing the swelling.
of wood, cardboard, magazines, pillows, blankets and Basin
even the victim's own body. It is a difficult immobilization that depends on the judgment-
During immobilization, always talk to the victim. from other people. You will also need a ma-
The victim should feel comfortable. long, wide, and strong enough to accommodate a
person. If possible, use a long wooden splint.
13
that extends from the armpits to the feet of the victim; in case Foot and Ankle:
River, the body itself will serve for this. For this, a person To immobilize the foot and ankle, one can use a bandage.
will firmly hold the head and another, the feet. A third pes- slings and braces, always remembering to keep the immobilization
the fabric will be used to secure the hips, the knees and the fixed tension above and below the injury and comfortably.
feet, in this order. Then, prepare the long wood The fixation of the foot can be done with a fabric, making the
(maca), placing it near the victim who will be rolled onto it. figure of eight to keep it in a natural position.
this, without much movement. Remember to put Column:
cushioned between the legs and, before lifting the victim Spinal fractures are considered serious and with great
to transport her, secure her on the stretcher so that she does not fall. possibility of causing sequelae. These injuries are originating
Fêmur: narratives of major accidents and traumas such as: falls from
The femur can be immobilized with long splints that height, run-overs, car or motorcycle collisions
extend from the hip to beyond the foot or even utilize fins, diving accidents, and even injuries from weapons of
using the healthy leg as a splint. In this case, before fire. Some signs and symptoms indicative of injury in the co-
tie one leg to the other, cushion it and use bindings moon are:
of very wide fabric so it doesn't constrict. Follow the Paralysis (the victim cannot move).
leg immobilization drawing, to visualize better. Tingling
Knee: Respiratory difficulty.
The knee can be found extended or bent. If Loss of control of bowel movements and urination.
Folded, support it on pillows and use splints to im- These signs and symptoms depend on the intensity and location.
ask to be extended back. If extended, immobilize it. affected by the spine. If the victim is conscious, talk
as in the case of the femur. The main thing is to remember to already- with her, ask her to squeeze your hand and move the
but trying to correct an injury, bringing the limb back feet, so you can have an idea of its limitations. Pro-
is normal, as this is a medical procedure and of high- ceded as in cases of immobilization of the basin, managed to
there is a risk to the victim. do auxílio e uma tábua/maca. O primeiro socorrista segura
Leg: firmly the victim's head, while a second pro-
Utilize firm legs that extend beyond the feet and evidence of improvising a necklace for the neck, utili-
fixed with fabric material. Secure both joints well. First aiders should never use fabric or towels.
(knee and ankle), performing the binding in '8'. to take the victim's head off, to prevent the appearance of
as will be described below in the immobilizations of the foot and other injuries. Then, use bindings as in
braces. In the absence of firm splints, make use of the leg. case of the basin, whereby the arms must also be
sadia to immobilize. tied about o thorax.

Electric shock

The electric current must be turned off and the victim to weigh against her something sufficiently heavy that can
disconnected from the power source - for this to be done with release it from the energized material.
safety, the rescue provider must use a material How to Help
rubbered or dry wood, so as not to take any Call an ambulance immediately.
download. People struck by lightning do not conduct electricity. Check the breathing and heartbeat;
city and can receive help immediately. If the If the victim is not breathing, resuscitation should be started.
the victim was stuck to the energized material and there was mouth-to-mouth resuscitation;
difficulty turning off the power supply it must be moved away from If the heart is stopped, it is necessary to start the co-
anyway, even if this is necessary to do so chest compressions (cardiopulmonary resuscitation).

14
 TRANSPORT OF INJURED

The removal of the victim must be done with the utmost care. The victim's head must be protected.
be careful not to aggravate the injuries. So, do not move one If it is necessary to raise it before knowing what the nature
injured person before the arrival of medical assistance to treating injuries is important to protect all
unless there is a risk of worsening the situation if it parts of the body
permanecer no local. Antes de levantar o ferido, verifique The body must always remain straight, never bent;
the injuries, especially when there is a possibility of In the transportation of an injured person to another
damage to the spine. Each part of the body must be local, use one of the transport methods according to the
supported. If possible, control the bleeding and the breathing. illustrations depending on the type and severity of the accident
Before moving the victim, place splints where there is suspicion. you, of available assistance and of the location (steps, walls,
the fracture. If this is not possible, follow the following etc.);
instructions: The transport done by one or two people is ideal.
for the unconscious victim due to asphyxia or drowning.
How to Safely Pull the Victim: For the conscious victim, transportation should be done by
Depending on the location of the injury, the victim may be 3 people.
pulled by the legs or under the arms. Never
pull to the side.

The maca is the best means of transportation for any aci-

toothed. And it can be improvised as follows:
Take two broomsticks, tree branches or
very resistant material.
Take two shirts or blazers. Put the sleeves in
inside, button up and thread the cables through the sleeves.
Wrap a large blanket or towel around the two.
cables.
Boards or doors can be used to improvise the
maca.

WHERE TO RESEARCH ABOUT HST ON THE INTERNET

Public entities in the Occupational Safety sector in Salvador (BA)

1.1 - FUNDACENTRO (Jorge Duprat Figueire Foundation Endereço: Av. Sete de Setembro, 698 Mercês Salvador-
of Safety and Occupational Medicine. BA, Phones: 3329-8400 and 3329-0833
Address: Rua Alceu Amoroso Lima, 142 (across from the 1.3 - CESAT (Center for the Study of Health at Work)
Iguatemi Medical Center) Phone: 3341-1412 Address: Rua Pedro Lessa, 123–Canela, Phone:
1.2 - Regional Superintendence of Labor and Employment 3336-1627
SRTE (formerly DRT)

2. Internet addresses that provide important information

[Link] [Link]
doras/[Link] - Regulatory Standards of uto_consulta.asp(Research on chemical sheets of pro-
Ministry of Labor dangerous chemical pipes
[Link]

15
[Link] (Technical information- [Link] (Cards of
case and electronic content about health and safety of tra- chemical substances
job [Link] - Environmental Protection)
[Link] Surveillance Agency) Agency - USA
Health Surveillance [Link] - Canadian Centre for
[Link] (Protection Magazine) Occupational Health and Safety
[Link] Prosecutor's Office of [Link] (International Organization-
Work Labour Organization - ILO
[Link] Institute of Security and [Link] American Association of Hygiene
Hygiene in the Workplace - Spain Industrial
[Link] Health Organization [Link] for Disease Control
[Link] Occupational Safety and Health USA
Administration - USA)
[Link] - National Fire
Protection Agency - USA

16