The theme of our today's conversation is " Cardiopulmonary resuscitation in adults and children: the algorithm for correct respiration" mouth to mouth "and indirect heart massage .Proper execution of the sequence of actions at home - artificial ventilation and external heart massage can save an adult and a child, leading him out of the state of clinical death.
In a number of accidents, human death does not occur immediately - it is preceded by a time interval( transition state), called the terminal state. In one case, the terminal state lasts a second, in the other - hours, days. Everything depends on the severity of damage to vital organs and systems of the human body.
In addition, changes that occur in the body when dying, do not immediately become irreversible and can sometimes be eliminated by properly and timely provided first aid urgent first aid.
CONTENTS
Human death: clinical, biological.
There are two types of death - clinical and biological.
Clinical death of .In the period of clinical death there are no external signs of vital activity - cardiac activity and respiration. Functions of the central nervous system fade. But in tissues metabolic processes are still preserved, although their intensity is reduced. Energy resources of the brain usually exhaust after 5-6 minutes( under normal conditions, when drowning in ice water a little longer).
After five to six minutes, comes on the biological death of .After that, a full restoration of the vital functions of the human body is no longer possible due to the development of irreversible processes in organs and tissues, primarily in the cells of the brain and nervous system. Thus, clinical death turns into biological death.
Resuscitation measures: first aid
All resuscitation measures are usually performed in a short time between clinical and biological death, when the patient is in a terminal state. Therefore, several minutes that separate clinical death from biological death should be used completely.
There should be no room for conversation, panic and confusion, because even the minimal but correct, timely provided first emergency first aid can be much more effective than all medical activities that will be provided later. Therefore, knowledge of the basic methods of resuscitation for each of us is simply necessary.
Indications for resuscitation can be:
- all types of severe injuries,
- sudden cardiac arrest,
- respiratory failure,
- anaphylactic shock,
- electric shock,
- drowning,
- suffocation,
- poisoning.
Signs of sudden cardiac arrest are:
- loss of consciousness,
- respiratory arrest,
- threadlike, barely palpable pulse,
- low( or undetectable) blood pressure,
- pallor of skin and visible mucous membranes.
In cases of acute respiratory failure, there is an increase in the number of heartbeats, faster and slower breathing, sweating.
When to perform artificial lung ventilation and indirect heart massage
In each individual case, first aid is determined by the cause that caused these phenomena, but always with artificial circulation and respiratory arrest should do artificial respiration and closed heart massage. These events are held before the arrival of emergency specialist care and they can not be stopped within 15-20 minutes. If during this time the breathing does not recover and the heart does not start working again, then further measures can be considered useless, since irreversible changes occur in the brain tissue, which is very sensitive to lack of oxygen. The goal of all resuscitation measures is to keep the brain alive alive .
Before beginning the resuscitation of the patient, must be laid on the floor of the or on any firm surface of the :
- A hard roller made of clothes or blankets is placed under the head.
- The head of the patient should hang back, reaching the level of the shoulders.
- Clothing on it should be unbuttoned, especially in the neck and chest.
One of the first conditions that must be met during resuscitation is the airway cleaning .For this, the patient needs to open his mouth and clean the airways. The opening of the victim's mouth and the extension of the lower jaw goes in several stages:
- , the first fingers of both hands are located in the hollow of the lower lip, while the index and middle ones are in the region of the angle of the lower jaw;
- with index and middle fingers push the lower jaw forward until the bottom row of teeth is in front of the upper row;
- lifts the lower jaw and supports it during the entire period of resuscitation.
It is imperative that you look into the patient or injured in the mouth to make sure that nothing interferes with normal breathing.
Breathing difficulties can:
- wrapped tongue "sticking" to the back wall of the pharynx,
- particles of vomit,
- small object or food,
- dentures,
- mucus, saliva.
All foreign bodies( and dentures) are removed from the oral cavity by the index finger of the right hand, wrapped in a piece of gauze or bandage. At the same time, it is necessary to act carefully, so as not to push the foreign bodies further into the pharynx and trachea.
Then it is necessary to check the nasal passages of the victim. This is especially true for young children , because they basically breathe through the nose, and if the nose is clogged, it will significantly worsen the breathing and resuscitation capabilities.
Once the airways have been checked and cleaned, must be verified that the victim is breathing .Pay attention to the chest( it should go up and down), listen to the breath and try to feel it on your face. To make sure there is a nasal breathing to the nostrils of the patient, you can attach a small piece of fleece, which will move when breathing. Breathing can be superficial and difficult to perceive, so when you define it, you must be very careful. If you do not catch any signs of breathing using the above methods, you can try to test its presence with the of a small mirror brought to your lips. If the mirror is misted, then the patient is breathing.
How to do artificial respiration
If there is no natural breathing, then, without losing a second, proceed to holding artificial respiration .
Before this, you need to tilt the patient's head and raise his chin to open the natural airway.
If a sick or injured person is a child under the age of four , then when carrying out artificial respiration, you should close your mouth and nose with your mouth. If the patient old age , then, making artificial respiration "mouth to mouth", be sure to clamp his nostrils with his thumb and index finger, so as not to exhaust the air.
There are many methods of artificial respiration, but the best are two: "mouth to mouth" and "mouth to nose".These methods are very simple, they do not require any special equipment or special knowledge, so they are accessible to everyone.
Breathing technique "mouth to mouth"
Toss the victim's head as far back as possible, using a roll placed under his neck.
Press your lips to the victim's mouth and inhale air into his lungs five times. The inhalation should be so strong that the victim's chest rises, as happens with a deep breath. After each breath, take your mouth off his lips. You need to constantly monitor the chest of the person you are helping. If it rises, it means that the air you inhale gets into the airways of the victim.
The injection of air must be rapid and abrupt. In this case, the rescuing person kneels in front of the victim. With one hand he clamps the nostrils of the patient, and the other supports the lower jaw. Exhalation is passive.
Initially, the frequency of breathing should be large( up to 20 breaths per minute).After 1-2 minutes, the frequency of breathing should be reduced to 15-16 times per minute. Evidence of the effectiveness of ventilation is the appearance of exhaled from the lungs sick air.
Remember that the of affected children should be injected into the lungs half the volume of their lungs. Otherwise, you can stretch the lung tissue and even tear it.
How to make external indirect heart massage
Simultaneously with artificial respiration, external heart massage should be performed. The compression rate of the chest is about 60 times per minute. With external massage of the heart, with both hands, rhythmically press the lower part of the sternum( in the recess at the center just below the level of the horizontal line connecting the nipples) so that each squeezing brings it closer to the spine for 4-5 cm. The force of pressing the chest depends onage of the victim.
When assisting an adult, this force should be 30-50 kg, while providing to the child - much less. Closed heart massage to the nursing child is generally done with two fingers - the index and the middle finger.
If one person resuscitates, then after every 15 compressions, stop the chest massage to make two exhalations "mouth to mouth".It is much more convenient if two people help the victim. One makes artificial mouth-to-mouth breathing, the other - an indirect heart massage.
The effectiveness of resuscitation is determined by the appearance of a pulse on:
- of the radial artery( passes on the wrist in the direction from the thumb to the elbow bend on the outside),
- of the carotid artery( passes in the neck area on both sides of the trachea and can be palpated by slightly pressing in this placetwo fingers),
- of the femoral artery( passes through the inner surface of the thigh),
- disappearance of the cyanosis and pallor of the skin.
If the victim begins to breathe on his own, his face gradually turns pink, the pupils narrow, the movements of the eyeballs appear.
Note : The strongest pulse is in the region of the carotid artery. In infants, the carotid artery is short, so the pulse is more difficult to find. If you have not been able to feel the pulse on the carotid artery, try to find a humeral pulse( on the inside of the upper limb in the middle between the elbow and shoulder).Usually the pulse is felt with two fingers. If you do not have the skills to find him, you need to practice in advance on the child and the adult. It always comes in handy.
Features of heart and respiratory massage in children
When providing intensive care to a child, indirect heart massage is done at a rate of 100 per minute( three push in two seconds).Then give the child one breath( mouth-to-mouth), and for the baby "mouth to mouth and nose."Then repeat all the elements of animation. Press the baby on his chest five times, then draw one breath.
Remember that the baby's lungs are smaller in volume than yours, do half the inspiration - look at the chest - it should gently pumped up and rise up, expanding in volume.
When resuscitation of an infant is necessary to remember its fragility and that the child's heart is the size with his fist. With external massage, the heart is pressed with two fingers at a point below the nipple line at the thickness of one finger. Press down five times and inhale.
You should always remember that the earlier you started resuscitation, the more chances you have to save a person.
Resuscitation measures should be continued until the arrival of a specialized ambulance!
Related videos
How to conduct cardiopulmonary resuscitation, heart massage
Kremenchug Telegraph is a video channel.
First aid: how to make artificial respiration for an adult and a baby
God forbid you happen to be near a person whose heart is stopped. How to give him first aid? What if it happened to the baby? See the master class from the employees of the Ministry of Emergency Situations.
Video about indirect heart massage
Oleksandr Romanyuk will demonstrate on the video indirect heart massage to an adult man according to the algorithm: 30 compressions to the middle of the chest, then 2 breaths, after checking the oral cavity and tilting the head.
Resuscitation in the child: emergency care - Doctor of Komarovsky's school
Today we will really talk about a very serious situation, which in medicine is called critical: the victim does not show signs of life.
What actions need to be taken? How to do heart massage and artificial respiration? What are the characteristics of the resuscitation of infants?
The most common mistakes. Actions after resuscitation. Everyone must know and know this!
The main signs of a critical situation:
- No response to the environment;
- Lack of breath;
- No pulse.
Source: NGNogov. Official and traditional medicine. The most detailed encyclopedia.- Moscow: Izd-vo Eksmo, 2012.
