The Kharkov national medical university Faculty of medicine of accidents and military medicine I "Assert" Managing faculty of medicine of accidents аnd military medicine The colonel m/s S. G. Demjanik "____" ________________________ 20 __ METHODICAL DEVELOPMENT on MEDICINE of EXTREME SITUATIONS With students of medical faculty KhNMU with English-speaking teaching THEME: Extreme situations natural and antropogenic character. The medical - tactical characteristic of extreme situations. It is discussed at session subject-methodical group "___" ___________ 20__. Protocol № _______ Kharkov Introduction. Earthquakes, eruptions of volcano, flooding, hurricanes and other natural calamity, and also wars were constant satellites of a human history. Last decades the tendency of growth of number and scales technogenic accidents is marked. The quantity of human victims, the sizes of a material damage are increased, ecological conditions is worsened. For definition of concept "accident" in the majority of the countries it is accepted to count the general criterion a natural phenomenon or the action of the person representing real threat for life of people. Thus to accidents began to carry incidents when one-stage arose 10 and more injured (recommendations the WHO – World Health Organization). Quantitative criteria in definition of accidents are put in a number of other countries. In USA, for example, any accident, on which dispatcher sends more than 3 automobiles of first aid, count accident and at once actuate a mobilization reserve of service. I. The basic concepts and definitions. The extreme situation is an infringement of normal conditions of ability to live of people in the certain territory, caused by failure, accident, spontaneous or ecological disaster, and also mass infectious diseases which can result in human victims and material losses. In interests of public health services the extreme situation is meant as conditions which has been usual as a result of accident at which the number injured, requiring in emergency medical aid, surpasses opportunities of its duly rendering by forces and means of local public health services, and attraction of them from the outside, and also change of forms and methods of daily work of medical institutions and the personnel is required. Failure is the unforeseen situation arising in modern manufacture which results in failures or a stop of production; to failure of separate machines (units, mechanisms), communications and constructions. Under the certain circumstances failure creates threat of life and to health of people and results in human victims. In such cases the question is accident - the phenomenon having tragically consequences. Accident, catastrophe by definition the WHO, is a natural phenomenon or the action of the person representing threat for life of people of concrete region and demanding help from the outside. Natural disaster is a sudden influence of the powerful and large-scale natural phenomenon which is accompanied by destruction of people, the big number of the victims requiring for rendering emergency medical aid (EMA), infringement of a usual way of life, and also the big economic damage causes. Mass losses among the population - an extreme situation in which the number injured, requiring in medical aid, surpasses opportunities in its duly rendering available in a zone of disaster forces and means of public health services. In due time the help is rendered then when she rescues life and warns development of complications. Emergency medical aid - the help rendered by the victim in the shortest terms at menacing life and health of the population traumas and sudden diseases. The medical-tactical characteristic of accident - the characteristic of losses (size and structure) among the population, a degree of failure of local (territorial) forces and means of public health services, presence or absence of infection of district in area of disaster, the size of the center and so on. Epidemic - mass distribution of infectious diseases among people is higher than a level usually registered in the given territory. All infectious diseases are subdivided into intestinal infections, infections of respiratory ways (aerosol), blood (transmissible) infections and infections of external covers (contact). Epizootic - process of occurrence and distribution of infectious diseases among animals under the certain natural and economic conditions. They share on five groups: alimentary - are transferred through ground, forage, water (murrain, glanders, brucellosis); respiratory - are transferred by an air - drop way (parainfluenza, smallpox); transmissible - are transferred by bloodsucking arthropods (encephalomyelitis, tularemia) or through external covers without participation of carriers (a tetanus, rabies); infections with not revealed ways of infection. Epiphytotic - distribution of infectious diseases of plants in significant territory during certain time. Are classified on age (a phase of development), a place of display, current (sharp, chronic), and the reason of occurrence. Are especially dangerous pandemic and panzootic - such epidemics and epizootic at which infectious diseases cover all country, some countries or the whole continent. For example, in 1918-1920 in time pandemic "Spanish influenza" (a fatal flu) only in Europe has died 20 million person. II. A general characteristic of extreme situations. Amazing factors of extreme situations. Extreme situations derivate the various factors capable at the moment of occurrence ES or subsequently to render harmful or pernicious influence on the person, animal and flora, and also on objects of a national economy. These factors are accepted for naming amazing. On the mechanism of the influence they can be initial or secondary and also have the combined character. The basic amazing factors as natural and technogenic accidents: The dynamic (mechanical) factor The shock wave is one of basic amazing factors ES. She renders dynamic (mechanical) influence. Arises at explosions of an ammunition, at technological explosions (explosions of boilers, gas pipeline, explosive, inflammable substances), and also at influence of seismic waves at earthquakes. The shock wave has two phases - a phase of compression and a phase of underpressure. Depending on in what environment she arises and is distributed (in air, water or a ground), her name air, hydrodynamic or seismic-explosive. Damaging action of a shock wave depends on a degree of pressure of the compressed environment (superfluous pressure), its speed, and time of influence and position of the person or object in relation to front of its distribution. Defeats of people are caused both direct action of a shock wave, and flying fragments of constructions, splinters of glasses, a ground. Dynamic (mechanical) influence on an organism of the person also can occur owing to collapses (landslides), press the falling trees destroyed by designs of buildings, falling from height etc. The thermal factor This influence of the high and low temperatures arising in separate extreme situations. At sharp rise in temperature there are fires, at decrease - are frozen thermal and water-networks. Work of the separate enterprises and transport stops. Under influence of high temperatures there comes overheating (hyperthermia) an organism, there are thermal damages and, on the contrary, at low temperatures there is an overcooling an organism (hypothermia) down to frostbite. The radiating factor Occurrence of this amazing factor probably at failures on the atomic power station and others radiation - dangerous objects (RDO), at explosions of a nuclear ammunition, infringement of technological processes on manufacture and the safety precautions at work with sources ionizing radiations, in a number of other cases. Thus the irradiation of people is possible at the moment of occurrence ES and at infection with radioactive substances of an environment. The person is capable to influence ionizing radiations at a presence directly at a source of radiation or the district infected with radioactive substances (RS). In the first case influence ionizing radiations will be characterized by an external irradiation. At a presence on the district infected with radioactive substances, except for the external irradiation, known danger represent RS, getting in an organism with inhaled air, water and food, and also through a skin. In a basis of radiating involvement lying influence ionizing radiations on organism. The degree of influence is determined by size of the doze received by the person. Radiating defeats can be characterized by local manifestations, sharp or chronic radiation sickness. At dozes of an irradiation in 1 Gr and above sharp radiation sickness of a various degree of severity of injury develops. The chemical factor The strong working poisonous substances (SWPS) widely used now in a national economy and having high toxicity, are capable to amaze the population and to infect the big territories at failures on manufacture, in an agriculture, in a life. From SWPS a wide circulation have received chlorine, ammonia, carbon bisulphide, hydrogen sulphide, weed and pest-killer chemicals and others. Now in industrial production it is used 500 names of the chemical substances, capable to render dangerous influence on an organism of the person. Tens thousand tons SWPS are daily transported by rail. Practically in each city there are stations for disinfecting water on which constantly there are stocks of liquid chlorine. Besides in a life now in quality insecticide are widely used in the form of aerosols neurotropic and other substances which in the certain conditions can be amazing factor for the person. Thus, the risk of occurrence ES with distribution SWPS is great enough. The biological factor Environment infection bacterial agents probably at rough infringements of sanitary-and-hygienic service regulations of objects of water supply and the sewerage, a routine of operation of separate establishments, infringement of technology in work of the enterprises of the food-processing industry and in a number of other cases. Action of this amazing factor is based on hit in an organism of the person (animal) of pathogenic microbes and toxic products of their ability to live which are capable to cause heavy infectious diseases. Damaging action of them is shown not at once, and after the incubatory period which lasts from 2 up to 5 days. Infectious diseases are contagious and are capable to be transferred healthy people directly through air, stings of blood-sucking insect etc. The aerohydrodynamical factor This amazing factor arises at such natural calamity as flooding, typhoons and hurricanes, tornados, have sat landslips, storm, squalls etc. On occasion (destruction of dams, failures on hydroelectric power stations) this factor can have technogenic an origin. In a basis of his occurrence lie the forces of a nature which are for the present not giving in to management by the person though already there are technical opportunities for their forecasting. Presence of secondary amazing factors, and also their combined influence is characteristic. So, at flooding probably flooding of the big territories, agricultural land, and washout of buildings, constructions, bridges, and also failures at the enterprises. Consequence of storms and hurricanes, except for destructions, can be fires, failures with infection of district SWPS, BS etc. Psychoemotional influence On people, taking place in an extreme situation, alongside with others operates and psychotraumatic factors that can be shown by decrease of serviceability, infringement of mental activity, and on occasion to serious mental frustration. Estimating influence of the various adverse factors arising in ES, on mental activity of the person, it is necessary to distinguish not pathological psychoemotional reactions and pathological conditions - psychogeny. For the first the psychological motivation of reaction, its direct dependence on a situation and, as a rule, small duration are characteristic. Thus the serviceability, adequate perception environmental and the critical analysis of the behavior are usually kept. For the person who has appeared in such situation, feelings of fear, alarms, depression, anxiety, and aspiration to find out the true sizes of the arisen danger are typical. Such condition is estimated as a condition of mental intensity, stress. Can arise and the psychopathological psychogenic frustration being painful conditions, deducing the person out of operation, depriving his opportunity of productive dialogue with people and purposeful actions. CLASSIFICATION of EXTREME SITUATIONS Degree of suddenness. ES are: sudden (not predicted) and predicted. It is easier to predict social, political, economic situations, it is more difficult - anthropogenic. While natural calamity though for them factors of accumulation and harbingers also are characteristic authentically difficultly give in to the forecast. Duly forecasting of an extreme situation and correct actions allow to avoid significant losses and on occasion to prevent ES. Speed of distribution. ES can carry explosive, prompt, quickly extending or moderate, smooth character. To prompt and explosive situations it is necessary to attribute the majority of military conflicts, technogenic failures and accidents, natural calamity. Rather moderately and smoothly situations with environmental contamination, and also flooding and high waters develop. Scale of distribution. On scale ES can carry object (local), topical, regional and nation-wide level. • Nation-wide level: ES develops in territory of two and more province, or threatens with distribution on the next states; • Regional level: ES develops in territory of two and more administrative district or cities of regional value, or threatens with distribution on territory of adjacent province; • Topical level: ES oversteps the bounds of potential - dangerous object, threatens with expansion on the next settlements, and also ES which arise on objects of housing-and-municipal sphere. • Object (local) level: ES not oversteps the bounds of potential - dangerous object, not threatens with expansion on the next settlements. Duration of action. On duration of action ES can have short-term character (the first type) or to have long current (the second type). To ES the first type it is possible to relate the majority of natural calamity, line technogenic accidents. All ES as a result of which there is environment pollution, concern to the second type. So, for example, extremely heavy position has developed with a state of health of tens thousands people (especially children) in the areas, undergone to radioactive infection at failure on the Chernobyl atomic power station. Life expectancy is reduced, the number of people, suffering is increased by oncological diseases. Character of extreme situations. ES can carry deliberate (deliberate) or inadvertent (unintentional) character. To deliberate ES it is necessary to relate the majority of national, social and military conflicts, acts of terrorism etc. Natural calamity on character of the origin are inadvertent situations. The majority concerns to this group of situations technogenic failures and accidents also. The World organization of public health services (WHO) offers classification of accidents by origin: • Meteorological - storms (typhoons, hurricanes, tornados, cyclones, burans), frosts, extraordinary heat, a drought; • Topological - flooding, snow avalanche, landslips, mud flow; • Tectonic and tellurian - earthquakes, eruptions of volcanos; • Anthropogenic - failure of technical constructions (dams, tunnels, buildings, mining’s camps (shafts mining’s), fires, ship-wrecks, wrecks of trains, poisonings of water in systems of water supply etc. On Ukraine the following classification of extreme situations by origin is accepted: 1. Spontaneous (natural) accidents: • The meteorological dangerous phenomena: tempests, storm (9-11 points), hurricanes (12-15 points), tornado, squalls, cyclones, a large hailstones, a strong rain (downpour), a strong snowfall, a strong fog, frosts, a strong frost, strong heat, a drought; • Natural fires: extreme fire danger, forest fires, peat fires, fires of grain files, underground fires of combustible minerals; • Tectonic and tellurian the dangerous phenomena: earthquakes (seaquake), eruptions of volcanos; • The topological dangerous phenomena: hydrological (a high water, rain high waters, wind onset, flooding, a tsunami); underflooding, mud flow, landslides, taluses, avalanches, subsidence of a terrestrial surface; • The space dangerous phenomena: falling of meteorites, the rests of comets; other space accidents. 2. Technological (man-made) accidents: • With liberation of mechanical energy: explosions, damage or destruction of mechanisms, aggregate, communications, landslides on mining’s caps (shafts mining’s), fall of buildings; hydrodynamic influence (breaks of dams with formation of waves of break and catastrophic flooding; breaks of dams with formation break a high water; the breaks of the dams which have entailed washout of fertile soils or adjournment of deposits in extensive territories); • With liberation of thermal energy: fires in buildings on the process equipment; fires on objects of extraction, processing, storage inflammable, combustible, explosives; fires in mining’s camps (shafts mining’s), underground developments (manufactures); fires on transport; fires in buildings of inhabited, social and cultural assignment; • With liberation of radiating energy: failures on the atomic power station, atomic energy device industrial and research assignment with emission (threat of emission) radioactive substances (RS); failures with emission (threat of emission) RS at the enterprises of nuclear-fuel cycle (NFC); failures on transport and space means with nuclear installations or with cargo RS; failures with a nuclear ammunition in places of their operation, storage or installation; loss of radioactive sources; • Outflow of strong poisonous substances: failures with emission (threat of emission) SWPS at their industrial processing or storage (burial place); failures on transport with emission (threat of emission) SWPS; formation and distribution SWPS during course of the chemical reactions which have begun as a result of failure; failures with a chemical ammunition; loss of sources SWPS; • Outflow of bacterial agents: infringement of service regulations of objects of water supply and the water drain; infringement of technology in work of the enterprises of the food-processing industry; infringement of a mode of operation of establishments of a sanitary-and-epidemiologic (microbiological) structure; • Transport large failures by the railway, on water, on highways, on an air transportation, in tunnels. 3. Specific accidents: • Infectious disease of people - epidemic, pandemic; • Infectious disease of animals: - epizootic, panzootic; • Infectious illnesses of plants: - progressing epiphytotic; panphytotic (mass distribution of plant pests). 4. Social disasters: • Military conflicts, terrorism, social excitements, public disorders, famine. Classification ES by number of victims: • Small: the victims 25-100 person requiring for hospitalization 10-50 person; • Average: the victims 101-1000 person requiring for hospitalization 51-250 person; • Large: victims more 1000 the person, requiring for hospitalization more than 250 person. Classification of the centers of defeat by kinds of medical consequences: • Traumatic (mainly mechanical and thermal traumas); • Chemical; • Radiating; • Infectious (epidemic); • Combined. Amazing factors of accidents can influence various bodies and systems instantly or is dragged out in time. Thus the plural and combined defeats are probable combined. Defeats of various anatomic areas (for example, breasts and a stomach), caused by the same injuring agent, carry to combined, and one anatomic area in several places (for example, crises of a femur in two places) - to plural; defeats to two and more injuring agents (for example, mechanical force and ionizing) carry radiations to combined. Losses at accidents are irrevocable (lost and disappeared without a message) and sanitary (injured and the patients lost work capacity and requiring for medical aid). At accident of loss usually arise suddenly and their quantity, as a rule, exceeds opportunities local, and it is frequent also territorial public health services in rendering of medical aid by him in optimum terms for rescue of life and the prevention of dangerous complications. A plenty injured (25-30 %) with real threat for life is marked. On the mass character, complexity of structure and weight of defeat of loss among the population though have much in common with those from the weapon of mass defeat, but with the features caused by character of accident (a natural or technological origin). The size of losses, both irrevocable, and sanitary, at each kind of accidents changes in the big range depending on lines of conditions: scales of accident, intensity of action of amazing factors, population density in a zone of accident, character of building, time of day, a degree of protection of the population, readiness of people for actions in adverse conditions etc. For example, at earthquake from 22,5 % up to 45 % of traumas arises from falling designs of buildings and 55 % - from wrong behavior of people (the panic, inability to be covered and falling from height). In a zone of catastrophic flooding perishes up to 30 % of the population, and in the afternoon - no more than 15 % at night. The analysis of the data on character and localization of damages shows, that in the majority of accidents at a dominant mechanical trauma the craniocereberal trauma and crises of bones prevailed. At road and transport accidents the trauma of a head makes 50,9 %, a trauma of finiteness - 20,4 %. Localization of traumas a peace time (E.A.Vagner) in tab. 1. Traumas of finiteness are less dangerous to life, than a trauma of a head, a breast, a stomach and a basin. At such injured there are more than chances of life. At earthquake by an often trauma of a head is scalping skin of a skull subjects flying from height, designs of the destroyed building. Table 1. Localization of traumas a peace time. Localization Victims according to a hospital Victims on the data court. Honey. Examinations Head 32,5 28,7 Neck 0,7 3,8 Breast 12,5 55,4 Stomach 4,7 5,3 Backbone 5,9 1,1 Basin 2,4 1,6 Finiteness 41,3 4,1 In total 100 100 In structure of losses densities combined and a plural trauma is high also. As is known, these traumas are complicated a shock, a bleeding, a suppuration more often, are mutually burdened and demand longer treatment. Outcomes are less favorable more often. It is necessary to note high frequency of a shock and sharp blood loss at victims, it is especial at earthquakes. So, in Armenia these consequences of traumas were observed at 25 % of victims, and the crush syndrome was marked in 23,8 % of cases. Open traumas have exceeded 87 %. Wounds usually are fragmentary, polluted with sand, the ground, splinters of glasses, on the big depth. It was marked at all injured by a tornado in Ivanovo, at explosion in Arzamas, at all earthquakes. It is marked high lethality among victims: in Ivanovo - 8,6 %, in Arzamas - 8,3 %, in treatment-and- prophylactic establishments of Bashkiria - 20,3 %, and in Chelyabinsk - 44 %. The significant part of victims perishes from inopportuneness of rendering of medical aid though the trauma and is not fatal. It is known, that in 1 hour the shock can be irreversible. The antishocks actions which have been carried out at first 6 o’clock reduce death rate on 25-30 %. Among victims 1/3 dies slowly (in the first 6 hours of them it is possible to rescue). On the data the WHO, 20 % among victims as a result of accidents in a peace time could be rescued, if medical aid by him was rendered on a place of incident. The combined defeats can be at any accident. But it is especial frequently they are observed when the phenomenon conducting to catastrophic consequences, has to two and more amazing factors (explosions, fires, radiating failures etc.). So, among hospitalized victims of explosion near Ufa of 30,4 % had burns of a skin in a combination to burns of respiratory ways, 15,2 % - burns of a skin with mechanical traumas and 16,9 % - burns of a skin with mechanical traumas and burns of respiratory ways. Such defeats are accompanied burn by a shock, infectious complications more often. Lethality at them is much higher, than at isolated defeats. She reached, on the same data, 26 % from the general number treated in a hospital. In structure of losses at accidents the significant share is made by women and children. The structure of losses at children on localization a little than differs from those among adult population. Among them also prevail plural, combined and the combined defeats. The especial attention is deserved by pregnant women for conditions of extreme situations can render essential influence on current and outcome of pregnancy. Such women on the average at a different stage of pregnancy of 2,5-5,0 %. So, at earthquake in Ashkhabad (1984) from 25 lying-in women at two have come premature birth, at 8 were abortion. In. Ivanovo and Sverdlovsk (1988) at 10-25 % of pregnant women within 5 days after accidents there has come spontaneous interruption of pregnancy. To bear the child the women who have transferred stress in Sverdlovsk in the earliest terms of pregnancy, could only 15 of 100. At the majority of them labor appeared premature, and half of children was lost. Premature birth and abortions were observed and during earthquake in Armenia, but, unfortunately, the generalized official data are not present. It is known, that among injured women was 5 % pregnant. Thus, doctors should not forget about opening of branches of obstetric aid in the hospitals accepting victims from areas of accidents of any kind. On the person who is taking place in a zone of accident, alongside with amazing factors, conditions therefore various infringements of mentality can be developed, from easy psychogenic reactions, before proof psychological diseases has strong an effect psychotraumatic. So, at inspection of victims at earthquake in Armenia it is revealed, that psychotraumatic influence has touched all without exception injured, and also more than 90 % living in area of a zone of earthquake and, besides relatives and the relatives living in a distance. In Arzamas and Ivanovo from 10 up to 13 % of victims required treatment in conditions specialized psychoneurological a hospital and up to 64 % in polyclinic treatment. At earthquake in Tashkent (1966) sharp reactive conditions were marked at 14 % by duration within day and at 10 % longer time. The significant number of cases of sharp cardiovascular diseases, hypertonic crisis’s, endocrine infringements (complications and deterioration) is observed also. Damages of buildings, failure of the medical personnel and treatment-and-prophylactic establishments at accident. The tragedy of calamity is usually made heavier for the population by failure local o and even territorial treatment-and-prophylactic establishments of stationary and out-patient - polyclinic type that considerably complicates rendering medical aid and treatment of victims. At earthquake in Armenia (1988), for example, it was completely destroyed 250 medical institutions, from 36 large hospitals it is completely destroyed 24 and in part 8 hospitals, 14 polyclinics and 3 SES (sanitary-epidemiological stations). In an emergency condition were 97 polyclinics. 70 % have made losses of the medical personnel. About the same picture was observed and in Tashkent (1966). In Sverdlovsk October, 11, 1988 the shock wave of explosion at railway station was distributed to 10- 15 kilometers and has put out of action 20 hospitals and polyclinics. Ecological disasters and accidents The special place in the modern world is occupied with ecological disasters and accidents. It as though an intermediate link between technogenic and natural accidents. Activity of the person it is irreversible more often changes natural landscapes, destroys biocoenosis, essentially influences the local and global climatic phenomena. At the same time, representation until recently dominated, that resources of our planet are practically inexhaustible, and self-purification capacity ability of a nature is boundless. However events of last decades completely deny this representation. In opinion of many a scientific world, proceeding intervention of people in a nature without acceptance of the emergency measures directed on liquidation of consequences of this intervention, will result to that in the beginning of XXI century in the natural environment there will be irreversible changes. The understanding of vital importance of maintenance of optimum quality of an environment demands from mankind of development of a new level of technical, political and social thinking, is especial in view of that circumstance, that scientific and technical progress on rates of the development considerably outstrips social. In growing quantity of anthropogenic accidents, deterioration of life the person for this break pays. Classification Extreme Situations (ES) of ecological character ES, the conditions of a land connected to change (ground, subsoil, and landscape): • Catastrophic subsidence, landslips, landslides of a terrestrial surface because of development of subsoil at extraction of minerals and other activity of the person; • Presence of heavy metals, including radioactive, and other harmful substances in ground (soil) over maximum permissible concentration (maximum concentration limit); • Because of erosion, salinization of soil, bogging etc.; • The crisis situations connected to an exhaustion of not renewed natural minerals; • Critical situations, in connection with overflow of storehouses (dumps) of industrial both household waste products and pollution by them; ES, connected to change of properties of an atmosphere (the air environment): • Sharp changes of weather or climate as a result of anthropogenous activity of the person; • Excess of maximum permissible concentration (maximum concentration limit) of harmful impurity in an atmosphere; • Temperature inversions above cities; • Sharp « oxygen famine » in cities; • Significant excess of an allowable level of industrial and city noise; • Formation of an extensive zone of acid deposits; • Destruction of an ozone cloud of an atmosphere; • Significant change of a transparency of an atmosphere; ES, the conditions of hydrosphere connected to change (the water environment): • Sharp shortage of potable water owing to an exhaustion of sources or their pollution; • Exhaustion of the water resources necessary for the organization of household-domestic water supply and maintenance of technological processes; • Infringement of economic activities and ecological equilibrium owing to critical pollution of zones of the internal seas and World ocean; ES, the conditions of biosphere connected to change: • Disappearance of separate kinds of animals and plants as a result of change of conditions of an inhabitancy; • Mass destruction of animals; • Destruction of vegetation in extensive territory; • Sharp change of ability of biosphere for reproduction of renewed resources. Influence of amazing factors ES on quality of an environment is very great, and the problem of ecological safety now becomes one of the most global and actual as its decision cannot be effective only at a national level. III. The characteristic of the most widespread extreme situations. Natural calamity results from the difficult phenomena and the actions of forces of a nature occurring in an earth's crust, a gas and water environment of the Earth. These phenomena still poorly studied, and some of them almost do not give in to the forecast. They annually carry away many thousand human life’s, result in occurrence of hundred thousand victims, destroy settlements, industrial targets, cause failures, cause huge damage to a national economy. According to the World meteorological organization the annual damage from natural calamity makes 30 billion dollars, the number of victims reaches 250 thousand people, and according to the United Nations, for last 20 years as a result of natural calamity was lost about 3 million people, the general number of victims has made about 800 million people. It is counted up, that 40 % of all natural calamities in the world falls to flooding, 20 % - on tropical cyclones, 15 % - on earthquakes, 15 % - on droughts. More than 50 % of destructions at natural calamity fall to flooding. Lately growth of number of natural calamity, for example is observed: frequency of droughts has increased in 8 times, fires and eruptions of volcano - in 3 times, cyclones, flooding and epidemics - in 2 times. Among the most significant natural calamity are allocated: hurricanes, storms, tornados, earthquakes, flooding, fires. Principal cause of occurrence of hurricane, storm and tornado is cyclonic activity of an atmosphere. For definition of force of a wind scale Beaufort is accepted. Hurricane (typhoon) - a wind of the huge destructive force having speed not less 29 m / sec, or 12 points on scale Beaufort. Depending on a place of occurrence of cyclones hurricanes are subdivided on tropical and outsidetropical. The major characteristic of hurricane is speed of a wind. Long-term supervision show, that speed of a wind at hurricanes reached in the majority of areas of the European part of the CIS (Commonwealth of Independent States ) 30 - 50 m / sec. Scale Beaufort for definition of force of a wind Point Speed of a The characteristic Action of a wind wind, m /sec of a wind 0 0 - 0,5 Calm Full absence of a wind. The smoke from pipes rises vertically. 1 0,6 - 1,7 Silent The smoke from pipes rises not absolutely vertically. 2 1,8 - 3,3 Easy Movement of air is felt as the facieses. Leaves rustle. 3 3,4 - 5,2 Weak Leaves and fine bough change. Easy flags flutter. 4 5,3 - 7,4 Moderate Change thin twig trees. The wind kicks up dust also scraps of a paper. 5 7,5 - 9,8 Fresh Change big twig. On water there are waves. 6 9,9 - 12,4 Strong Change big twig. Telephone wires hoot. 7 12,5 - 15,2 Strong Trunks of small trees shake. 8 15,3 - 18,2 Very strong Break twig trees. It is difficult to go against a wind. 9 18,3 - 21,5 Storm Small destructions. Chimney and a tile are broken. 10 21,6 - 25,1 Whole gale Significant destructions. Trees are eradicated. 11 25,2 - 29,0 Storm The big destructions. 12 More than 29 Hurricane Makes devastating action. There are hurricanes at any time year, but overwhelming majority of them passes on territory of Ukraine in August and September. Terms of their occurrence have the certain cyclicity that promotes their more exact forecasting. Hurricanes are accompanied also by such phenomena, as downpours, snowfalls, hailstones. Gale- force winds frequently result in occurrence of dusty and snow storms. Storm (storm) - very strong, with speed over 20 m /sec and the long wind causing the big destructions on land and excitement on the sea (storm). For storms it is characteristic smaller, in comparison with hurricanes, speed of a wind. Duration of their action makes from several hours up to days. Tornado (waterspout) - the atmospheric whirlwind arising in a storm cloud and frequently extending up to surface of the ground (water). It looks like a column, sometimes with the bent axis of rotation, diameter from tens up to hundreds meters with funneled expansions from above and from below. Air in a tornado rotates against a course of an hour hand with speed up to 100 m / sec and simultaneously rises on a spiral, involving various subjects. Average speed of moving of a tornado makes 50 - 150 km / hour. There are tornados not for long, from several minutes till several o'clock, passing for this time a way from hundreds meters up to tens kilometers. The tornado, adjoining with a surface of the ground, frequently puts destructions of the same degree, as strong gale-force winds, but on much smaller area. These destructions are connected to action of promptly rotating air and sharp rise of air weights upwards. Thus some objects (automobiles, easy houses, roofs of buildings, people and animals) can come off and be transferred on hundreds meters. Falling, these objects collapse, and people and animals receive traumatic damages, their destruction is possible. Simultaneously due to involving in air of huge quantity of fine subjects indirect defeats of people can be observed. So, as a result of a tornado in Ivanovo (Russia) in 1984 has suffered 804 persons and was lost 69 people. Hurricanes, storms and tornados are one of the most powerful forces of elements and on the destroying influence frequently are comparable to earthquake. The basic parameter determining destroying action of hurricanes, storms and tornados, the high-speed pressure of air weights causing force of dynamic impact and having throwing action is. They cause significant destructions, cause the big damage to a national economy, result in human victims. The notification about threat of hurricanes, storms and tornados moves through broadcasting stations and TV. With reception of a signal the population starts works on increase of stability of buildings, prevention of fires and creation of necessary stocks for maintenance of ability to live. With windward the sides of buildings are densely closed windows, doors, attics hatches and ventilating apertures. Glasses of windows are pasted over, protected shutters or boards. With the purpose of equalizing internal pressure of a door and a window alee buildings open. At the compelled stay open-air it is necessary to be in a distance from buildings and to occupy for protection ravines, holes, ditches, trench, and ditches of roads. Thus it is necessary to lie on a bottom of shelter and densely to nestle on the ground. Such actions considerably reduce number of damages. Earthquakes are seismic natural calamity which represents underground impacts and the fluctuations of an earth's crust caused by the natural reasons (basically tectonic processes). In some areas of earthquake occur frequently and sometimes reach the big force, breaking integrity of a ground, destroying buildings and causing human victims. The quantity of the earthquakes annually registered on globe, is estimated hundred thousand. However overwhelming majority of them concerns to weak, and their only small share reaches a catastrophic level. Seismic center - area of occurrence of underground impact (push) within the limits of which energy collecting long time is liberated. In geological sense the seismic center is a break or group of breaks on which there is almost instant moving mass. The centers of earthquakes arise on various depths, but usually are within the limits of an earth's crust on depth of 20-40 km. The small amount of the centers proceeds from depths of 300-600 km (the top Earth mantle). Hypocenter - a point conditionally selected in the centre of the focus. Epicenter - the site of a terrestrial surface located above hypocenter. Around of an epicenter the area of the greatest destructions - pleistoseistov area settles down. As a result of earthquake on a surface of the ground are observed different intensity of fluctuation of ground which results in occurrence of cracks, breaches in walls, fall parts of buildings or to their full destruction. On intensity of pushes and, hence, the areas of distribution of fluctuations of earthquake are subdivided into classes, and on display on a surface of the ground - are estimated by points, according to international seismic scale MSK-78. Intensity of earthquake, measures in points, characterizes a degree of concussion on a surface of the Earth that depends on depth bedding a seismic center. As a measure of the general energy of waves serves magnitude earthquakes. The strongest earthquake has magnitude no more than 9. Classification of damages of buildings at earthquakes № Degree Character of damages 1 Easy damages Cracks in plaster and break off small pieces. 2 Moderate damages Small cracks in walls, breaking off of rather big pieces of plaster, falling of a roofing tile. 3 Heavy damages The big and deep cracks in walls, falling of chimneys of buildings. 4 The heaviest damages Destructions, through cracks in walls, fall easy constructions. 5 Full destruction Landslides of buildings of all designs. Classification of intensity of fluctuations of ground at earthquake (extraction from a scale of seismic intensity MSK-78). Point The name of The brief characteristic earthquake 1. Imperceptible It is marked only by seismic devices 2. Very weak It is felt as the separate people who are taking place in a condition of full rest. 3. Weak It is felt as a small part of the population. 4. Moderate It is distinguished on easy jingle and fluctuation of subjects, utensils and window panes, a scratch of doors. 5. Rather strong The general concussion of buildings, fluctuation of furniture. Probably damages of buildings of 1 degree. 6. Strong It is felt as all. Many in a fright run out on street. Pictures fall from walls. Moving furniture is marked. Damages of buildings 1, 2-nd degrees. 7. Very strong Damages of buildings 1, 2, 3, 4-th degrees. In antiseismic buildings of damage of 1-st degree. In well water vanishes. 8. Destructive Cracks on abrupt slopes and on crude ground. Monuments are shifted from a place or overturn. Damages of buildings 1, 2, 3, 4, 5-th degrees. In antiseismic buildings of damage of panels, partitions. 9. Devastating Damages of buildings 3, 4, 5-th degrees. In antiseismic buildings of damage 2, 3-rd degree. In ground of a crack reach 10 sm. 10. Destroying Large cracks in ground (up to 1 m). Landslips and landslides. A curvature of railway rails. Damages of buildings 4, 5-th degrees. In antiseismic buildings of damage 2, 3, 4-th degree. Damages of dams and dams. 11. Accident Numerous landslips and landslides. In antiseismic buildings of damage 4, 5-th degree. Damages of dams, dams, bridges, roads, destruction of underground pipelines. Deformation of ground. 12. Strong accident Changes of a terrestrial surface. Numerous cracks, landslips and landslides. Occurrence of falls, dam on lakes, a deviation of current of the rivers. Any construction does not maintain. In a seismic center which is in settlement, since 5 points on scale MSK-78 where damages of buildings of a various degree are marked, allocate zones of weak, average, strong and continuous destructions. Depending on an arrangement of settlement in these zones there will be appropriate sanitary losses among the population. The number of sanitary losses with each point of intensity of earthquakes from 5 up to 9 points is increased at 6-10 time, and then sanitary losses grow a little bit, and at increase of intensity of earthquakes with 10 up to 12 points the size of sanitary losses decreases. Reduction of sanitary losses occurs on a background of increase of the general and irrevocable losses. At the analysis of sanitary losses in a zone of weak destructions bruises, cuts were observed by glass. The destruction of people occurred more often due to wrong behavior and an aggravation of somatic diseases (basically hypertonic crisis’s, heart attacks of a myocardium, endocrine diseases). In a zone of average destructions among sanitary losses crises of tubular bones, a backbone burns II, III degrees and other traumas prevailed. In zones of strong and continuous destructions there were heavy and heaviest defeats. Earthquakes in 6-7 points and above result in infringement of normal conditions of life of people and are connected to danger to their health. Human losses and a material damage from earthquakes are caused by their intensity and a degree of destructions of buildings and communications. At catastrophic earthquakes mass losses of people arise within minutes and even seconds. During strong earthquake unpredictable conditions can arise. And degrees of training of the population depend on readiness a degree of a possible traumatism and quantity of human victims. Quickly it is necessary for people to abandon buildings (better within the first 15-20 seconds). Thus it is necessary to use not the lift, and a ladder. Go out (of the house) from a building, it is necessary to depart him on an open place, far away from electricity cables, eaves, glasses etc. If conditions does not allow abandoning a building, it is necessary to be covered in beforehand chosen rather safe place. In the multi-storey house it is possible to fling open a door on a ladder and to begin in an aperture. As shelter from falling subjects and fragments places under strong tables and beds can serve. It is necessary to accustom to be hidden children there at occurrence of tremors in absence of adults. In any building it is necessary to keep further from windows, is closer to internal main walls. It is necessary to be afraid of glass partitions. The death-roll and received at earthquake considerably varies damages and can exceed half of inhabitants of settlement. At victims the closed traumas of a skull, finiteness, a chest and a basin, bruises of soft fabrics with extensive hemorrhages, smash, the wounds polluted with the ground prevail. At a significant part of victims the syndrome long pressure is marked. At the earthquakes accompanying with fires, probably big number burnt. The analysis of the reasons of the traumas, carried out on the basis of domestic and foreign experience, testifies that in 10 % of cases of a trauma were received directly from landslides, destructions of walls and roofs of buildings; in 35 % - from falling designs and fragments of constructions; at 55 % of victims the reasons of traumas was their wrong behavior, the not realized actions caused by psychological stress (outleap from windows, bruises at a panic and haste etc.). At the persons who have appeared in a zone of earthquake, psychological reactions are observed, weight and which duration appreciably depends on intensity of earthquake. Approximately in 20 % of cases this condition passes at the first o’clock, per 70 % - from several hours about 2-3 day, and in 10 % the serious mental frustration demanding hospitalization is observed. Persons with jet conditions can provoke among associates, is especial at the persons unstable in the emotional - strong-willed attitude, mass panic reactions. For their preventive maintenance well thought over system of the information adequate to concrete inquiries of a situation, calming and disseminating negative hearings, and also realization in short terms of saving both other urgent works and rendering by the victim of medical aid has the big value. Serious influence of earthquake on occurrence and current of some somatic diseases, and first of all - cardiovascular is revealed. The hypertonic crisis’s proceeding with a coronary-cerebral syndrome become frequent and made heavier, raises lethality among patients with a heart attack of a myocardium, current of diabetes is burdened, and normal current of pregnancy (premature birth, abortions etc.) is broken. In a seismic center the secondary centers of chemical or radioactive infection can arise as a result of destructions of radiationally-dangerous objects or capacities with SWPS. In such situation there can come mass defeats ionize radiation, and also poisonings of people with ammonia, chlorine, and other chemically dangerous substances. Infringement of water supply and the water drain, deterioration of conditions of accommodation and a feed, downturn of the immune reactance, connected with earthquake, can promote occurrence of infectious diseases and create threat of epidemic flashes. At full destruction of buildings and constructions under blockages there can be all people who are taking place in them at the moment of earthquake, and at strong destruction of buildings - about 50 %. Up to 60 % injured with the heavy traumas, appeared under blockages, perish during the first 6 hours, 90 % - in the first day, practically all victims - during first 3 days Injured with traumas of an average and easy degree of weight start to perish under blockages since 4 day and 95 % from them die on 5-6 days Death at injured comes not only owing to a trauma, but also in result dehydratation and supercooling of an organism. The weights of traumas injured on a degree at earthquake by intensity in 9 points are distributed as follows: heavy - 32-34 %; average - 29-30 %; easy - 36-39 %. Proceeding from the analysis of large earthquakes by intensity over 9 points, it is possible to predict, that the general losses on all zones can make about 36 %, of them sanitary - 64 %. From sanitary losses on the average 35 % will require hospitalization. The number bed for hospitalization should make from 30 up to 40 % from number of prospective sanitary losses. The structure beds should be following: neurosurgical - 13 %, thoracoabdominal- 10 %, traumatological - 26 %, general surgical - 34 %. Offered calculations are necessary for forecasting, at occurrence of the accident, required number of brigades of the first help, BEMH-(brigade extreme medical help), BESMA-(brigade emergency specialized medical aid), quantities beds, unwrapped in the kept medical establishments, and additional input of field mobile medical establishments. Liquidation of consequences of earthquakes has nation-wide character and is organized by the president and the government. For the organization of rendering assistance to the injured population, saving and other urgent works, rescue of the state material assets and personal property of citizens are usually created the extreme commissions with large powers. For realization of saving and other urgent works specialized and not militarized formations Civil Defense, the Ministry of Emergency Measures, armies MD, formations of the Ministry of Internal Affairs, fire service, and also the population which has kept serviceability of the victim from earthquake of settlement are involved. To saving works concern: • Search of victims; • Extraction from under the blockages, the burning buildings, the damaged (injured) vehicles; • Evacuation (export, carrying out, a conclusion) people from a zone of earthquake; • Rendering by the victim of medical aid; • The equipment of points of gathering of victims. To urgent works concern: • Disassembly of blockages, the device passage and passes for formations CD and the Ministry of Emergency Measures with the purpose of evacuation of the population; • Localization and liquidation of failures on the communal-power networks menacing to life of people or capable to put the big material damage; • Destruction or strengthening of designs of buildings and the constructions menacing with a collapse (landslide); • Realization of sanitary processing of the victims, special processing of engineering, transport, roads, constructions, territories etc. Flood - time significant flooding by water of district as a result of rise of a water level in the river, lake or the sea, caused by the various reasons. High waters - fast, but rather short-term rises of a water level in the river (owing to substantial growth of its quantity), caused by strong rains, intensive thawing of snow and glaciers in its pool, break of dams and other hydroconstructions. As against earthquakes, flooding are predicted with a sufficient degree of accuracy. The scales of flooding caused by spring-and-summer-autumnal high waters can be predicted for one month and more. Special danger is represented with the flooding arising owing to sudden break of dams, dams, at destruction of other hydraulic engineering constructions. As a rule, they are accompanied by carry not only waters, but also fragments, friable materials owing to what frequently accept catastrophic character. Tsunami - the sea gravitational waves of very big length arising as a result of shift upwards or downwards of extended sites of a bottom at strong underwater and coastal earthquakes or owing to eruptions of volcanos. If the break of a surface of a bottom of the ocean, given push to weight of water, is parallel to coast, the tsunami will be directed to a coast, and force of them will be the greatest. If the break is perpendicular to coast, the tsunami slide in parallel it and harm it is less. The tsunami on the influence at coast is act of nature. The height of a wave directly above the center of a tsunami at ocean makes from 0,1 up to 5 m. At an output she is increased by shallow water, reaching at coast from 10 up to 50 m. The final height of a wave depends on a relief of a bottom of ocean, a contour and a relief of a coast. At flat wide coasts the height of a tsunami usually happens no more than 5-10 m. Waves in height of 15-30 m are formed on separate rather small sites of coast with narrow bays and valleys. Speed of distribution of a tsunami changes in limits from 50 up to 1000 km /h. Than more depth of ocean, there with the greater speed is distributed a wave. At the approach to a coast speed of a tsunami quickly falls, making at depth of 100 m - about 100 km / h. Scales of consequences of flooding depend on height of dangerous water levels, speed of a water stream, the area and duration of flooding, a season, population density and intensity of economic activities on the flooded district, timeliness and reliability of the forecast of the given flooding, presence of protective hydroconstructions and concrete measures of preparation for flooding, a level of organization and preparation for actions in conditions of flooding. At flooding there is a fast rising of water and flooding (flood) of adjoining district. Submergence - a covering of district a layer of the water which are filling in court yard, streets and ground floors of buildings. Underflooding - penetration of water into cellars of buildings through a sewer network, on various channels and trenches, and also because of significant support subsoil waters. Depending on speed of current of water, heights floods waves and remoteness of settlements allocate 4 zones: 1 zone - catastrophic submergence - directly adjoins to the dangerous natural phenomenon or the destroyed hydroconstructions and reaches 6-12 km. The height of a wave can reach several meters. The wave is characterized by a rough stream of water with speed of current of 30 and more km / h. Time of passage of a wave - 30 minutes. 2 zone - fast current - speed of current of 15-20 km / h. Extent of a zone of 15-25 km. Time of passage of a wave - 50-60 minutes. 3 zone - average current - with speed of current of 10-15 km / h and extent of 30-50 km. Time of passage of a wave 2-3 hours. 4 zone - weak current - speed of current of 6-10 km / h. Its extent will depend on a lay of land and can make 36-70 km from a hydroconstructions or places of the beginning of the dangerous natural phenomenon. Submergence of settlements, constructions, communications, and agricultural lands has significant negative consequences. Initial consequences of flood: • Destruction of people; agricultural and wild animals; • Destruction or damage of buildings, constructions, communications, engineering; • Interruption of economic activities; • Destruction of a crop; • Washout or flooding of fertile soils; • Change of a landscape; Secondary consequences of flooding: • Loss of durability of constructions as a result of their washout and undermining; • Carry by water of the harmful substances poured out from damaged storehouses (including RS, PS, SWPS) and pollution of extensive territories by them; • Deterioration of sanitary - epidemic conditions; • Bogging of district. On a specific material damage of flooding concede only to earthquakes. Losses among the population are estimated by a death-roll, the victims who have disappeared without a message. Inhabitants of zones of regularly repeating flooding should be beforehand informed on approaching threat are trained and prepared for actions during flooding. With reception of the forecast the population is notified on flooding through a network of a radiotelevision announcement. In the message on threat of flooding the hydrometeorological data, expected time of flooding, border flood under the forecast of territory, the order of actions of the population, including and the order of evacuation are specified. Evacuation from zones of possible flooding appears the special order of the commission on ES. She is made in the nearest occupied point outside of a zone of flooding. At sudden flooding as soon as possible it is necessary to take the nearest safe raised place and to be ready to the organized evacuation on water with the help various notational means or on foot on fords. In such conditions it is necessary to arrange, allowing rescuers is duly to find out people cut off by water and requiring for the help. In the daytime hang out on a high place a white or color panel, and at night submit light signals. Before arrival of the help people who have appeared in a zone of flooding, should remain on the top floors and roofs of buildings, trees and other raised places. The knowledge of key rules of behavior at flooding allows essentially to lower a material damage and to keep life of people living in dangerous areas. Salvage operations at flooding are organized by the appropriate local authorities together with formations of the Ministry of Emergency Measures and include: • Search and gathering of people in the flooded territory (reconnaissance groups on high-speed boats and helicopters); • Rendering of the first medical aid by him; • Their loading on swimming means or helicopters and evacuation in safe places. Then start rescue and export of material assets and the equipment. For evacuation of people and material assets in safe places use steam-ships, barges, launches, cutter, boats etc. Special attention give observance of security measures on water. It is strictly forbidden to use faulty swimming means, and also - to overload serviceable. At victims are observed more often: • Mechanical trauma (basically of finiteness’s and trunks); • The overcoolings, connected to long stay in water; • Are possible drowning. Besides suddenness of the act of nature, usual unusual conditions can result in occurrence of stressful reactions, cardiovascular, neuropsychological diseases or weighting of their current, an aggravation of chronic illnesses. A conclusion out of operation power system, a water-pipe, water drains, pollution of territory in areas of accommodation of the evacuated and injured population are preconditions of occurrence of infectious diseases. All these circumstances demand realization of the whole complex medical-evacuation, treatment-and- prophylactic, sanitary-and-hygienic and antiepidemical actions. For performance of saving and other urgent works at flooding forces and means of the Ministry of Emergency Measures, in particular, saving groups, commands and the groups equipped swimming means and other technical equipment are involved. For rendering the first medical aid by the victim in structure of the listed formations include the younger medical personnel. The first medical assistance is rendered with brigades of the first help. Fire - the uncontrollable process of burning accompanying with destruction of material assets both creating health hazard and life’s of people. To the basic phenomena, characteristic for each fire, concern: • Chemical interaction of combustible substance with air (oxygen); • Allocation of a plenty of heat; • Active gas exchange of products of combustion. The reasons of occurrence of fires: • Casual handling of fire; • Non-observance of service regulations of the industrial equipment; • Self-ignition of substances and materials; • Categories of a static electricity, gas categories; • Arsons. Depending on a place of occurrence distinguish: • Forestry and peat fires; • Steppe and field fires; • Underground fires in coal mine (shafts) and pit; • Fires in buildings and constructions; • Fires on vehicles; The basic amazing factors of fires: 1. Fire and the high temperature, causing traumas of people, and also ignition of everything that is in a zone of a fire. 2. The smokescreen of the big territories rendering irritating influence on people and animals, and in some cases - and their poisoning carbon monoxide. 3. Restriction of visibility. 4. Negative psychological influence on people. Mass wood and peat fires, it is especial at dry windy weather, cover the big territories, causing to significant damage to the natural environment, economy, social sphere. They destroy forest resources, destroying flora and fauna, causing damage of an organic layer of ground and its erosion, polluting atmosphere products of combustion. The plantings weakened by fires become sources of illnesses of plants. As a result of a fire useful properties of a wood are reduced, scheduled conducting a forestry and use of wood resources is broken. In most cases originators of occurrence of forest fires are people carelessly using fire during industrial activity and on rest. Inhabitants of area in which there were forest and peat fires are notified on the fact of occurrence of a fire, a direction of his movement, danger of distribution on an inhabited sector and other objects. Successful struggle against forest and peat fires in many respects depends on correct actions of all citizens participating in suppression, and from observance of safety requirements. Forest fires can cause ignition of constructions, resulting to mass fires in settlements and country settlements. Fire destroys establishments of social sphere, apartment houses and storehouses, support and communication lines and electricity transmissions, bridges, pipelines, arable land and production. As a result of such fires economic activities in significant territories are broken. At fires at the enterprises with dangerous manufactures outflow RS, SWPS and other dangerous substances which can be secondary factors of defeat are possible. On explosive, and danger fires are subdivided into categories A, B, C. To the first category (A) concern: • Oil refining factories; • The chemical enterprises; • Pipelines; • Warehouses of mineral oil. To the second category (B) concern: • Workshop preparations and transportations of a coal dust, a forests flour, powdered sugar; • Flour-grinding mills. To the third category (C) concern: • Sawing, woodworking, joiner's, furniture, forest tares manufactures. Objects of other categories are less dangerous. Fires in settlements on scale and intensity share on: • Isolated - when in process of burning separate constructions are involved. • Mass - 25 % of all constructions. • Continuous - 90 % of all constructions. • Firing storm - 100 % of all constructions. At threat of life of the population from fires his evacuation in safe places is organized. The space covered with a fire, conditionally divide on 3 zones: • Active burning (the center of a fire); • Thermal influence; • Cover of smoke. Zone of active burning. External attributes of her are presence of a flame, and also the decaying or heated materials. Oxygen in a zone of burning usually acts from atmospheric air, on occasion - owing to thermal decomposition oxygen-containing combustible substances. Taking place in the center of a fire combustible designs and materials as a result of thermal influence is heated up and ignited, and fireproof - lose durability, are deformed. The basic characteristic of destructive action of a fire is the temperature developing at burning. In apartment houses and public buildings the temperature indoors reaches 800- 900o C. With increase of quantity of combustible substance at unit of the area of a floor (combustible loading), the maximal temperature raises and duration of a fire is increased. As a rule, the highest temperatures arise at external fires and on the average make for combustible gases 1200-13500o С, for liquids 1100-13000o С, for firm substances 1000-12500o С. Warmly, allocated in a zone of burning, it is transferred in an environment. Zone of thermal influence - space around of a zone of burning in which the temperature as a result of heat exchange reaches the values causing destroying influence on environmental subjects and dangerous for person. The temperature of a mix of air and gaseous products of combustion is not less 60-800o С, and the superficial density of a thermal stream exceeds 4 kWt/m2 (60 kcal / min *.m2). During a fire there are significant moving air and products of combustion. The heated up gaseous products of combustion direct upwards, cause inflow of more dense cold air to a zone of burning (convection). At a fire inside buildings intensity of a gas exchange depends on the sizes and an arrangement of apertures in walls and overlapping (blockings), heights of rooms, and also from quantity and properties of burning materials. The direction of movement of the heated up products usually defines also probable ways of distribution of a fire, since. Powerful ascending thermal streams can transfer the sparks burning coal and charred log on significant distance, creating the new centers of burning. The zone of cover of smoke- is formed by products of combustion (smoke) allocated at a fire. The structure of a smoke usually includes nitrogen, oxygen, carbon monoxide, carbonic gas, steam water, ashes etc. substances. Many products of full and incomplete combustion included in a smoke, have the increased toxicity. The products formed at burning of polymers are especially toxic. In some cases products of incomplete combustion, for example, carbon monoxide can form combustible and explosive mixes with oxygen. At concentration CO, a component of 0,2 %, probably fatal poisoning within 30-60 minutes, at concentration of 0,5-0,7 % - in some minutes. Dangerously also inhalation of heated up air at temperature 60°С, which causes a burn of mucous top respiratory ways. Cover of smoke is considered dangerous when visibility does not exceed 10 m. At occurrence of fires people can receive thermal and mechanical traumas of a various degree of severity of injury; poisonings with toxic products of combustion are possible. Fires render on the population psychotraumatic influence. At occurrence of fires paramount value has rescue of victims. Classification of transport accidents by medical and ecological consequences. On a degree of severity of injury (quantity of victims): № Category of transport accident depending on number of Number of victims victims 1 I-M Up to 5 people. 2 II-M 6-15 people. 3 III-M 16-30 people. 4 IV-M 31-50 people. 5 V-M More than 51 people. On sanitary-and-hygienic and ecological consequences: № Category of transport accident depending on radius of a Radius of a zone of infection zone of infection 1 I-С Up to 50 m 2 II-C of 51-300 m 3 III-C of 301-500 m 4 IV-C of 501-1000 m 5 V-С more than 1000 m Calculation of quantity of exit brigades of “the First help“ depending on number of victims: а) At 3 injured - 2 brigades (linear and intensive therapy); b) 4-5 injured - 3 brigades (from them 1 intensive therapy); c) 6-50 victims - on everyone 5 person - 3 brigades (from them 1 intensive therapy); d) More than 50 victims - on everyone 10 person - 5 brigades (from them 2 intensive therapies). If victims до15 the person on medical sorting point 1 sorting brigade works, от16 up to 30 - 2 sorting brigades, is more 30 - than 3 sorting brigades. The conclusion. Scientific and technical progress changes structure and scales of industrial production due to involving in economic activities all new natural elements and new synthetic connections, essentially changes qualitatively and quantitatively character of an environment. At the same time, representation until recently dominated, that resources of our planet are practically inexhaustible, and self-purification ability of a nature is boundless. However events of last decades completely deny this representation. In opinion of many a scientific world, proceeding intervention of people in a nature without acceptance of the emergency measures directed on liquidation of consequences of this intervention, will result to that in the beginning of XXI century in the natural environment there will be irreversible changes. The understanding of vital importance of maintenance of optimum quality of an environment demands from mankind of development (manufacture) of a new level of technical, political and social thinking, is especial in view of that circumstance, that scientific and technical progress on rates of the development considerably outstrips social. In growing quantity of anthropogenesis accidents, deterioration of life the person for this break pays. The teacher of faculty «Medicine of extreme situations» The lieutenant colonel of medical service AKSAKOV A. F.