Features of cardiopulmonary resuscitation (CPR, indirect heart massage).
Each employee and service operational staff should know rules of hospital care, methods of artificial respiration and indirect cardiac massage.
Provide first aid to the victim on the spot accident state death may only be a doctor.
The purpose of cardiopulmonary resuscitation (ShD and NMS) - Recovery of respiration and circulation. Progress in cardiac arrest and breathing.
Specifics of artificial respiration and cardiac massage:
1) types of artificial respiration: "mouth-mouth", "mouth-nose";
2) Put the victim on his back, under the neck - shaft, head thrown back;
3) clean the mouth, remove dentures;
4) with "mouth-mouth" - plug your nose, if the court has reduced the jaw, the "mouth-nose";
5) savior breathe in the air and blown into the mouth of the victim; presses on chest 4-5 times (deflection cells by 4-5 cm) with a frequency of 1 every second;
6) Repeat the savior of 10 - 15 times per minute until it recovers breath and will not be wiretapped by heart;
7) criteria for evaluation: the emergence of the pulse, respiration, pupil constriction
8) if for 0.5 hours not resumed breathing and the heart, not there are signs 7), theascertained death.
Methods of artificial respiration are manual and hardware. Manual methods - "with mouth to mouth "(Fig. 1) and" mouth-to-nose "(Fig. 2).
In the mouth or nose of the victim inhales savior of his lungs in lung victim in the amount of air volume 1000-1500 ml of 50% saturated with oxygen (50% used savior, breathing clean air his lungs).
Fig.1. Artificial respiration by "mouth to mouth": a - injection of air, b - exhale victim.
To assist the victim, who is in a state of clinical death, it is desirable to operate two men:
One-performs indirect heart massage;
Second - artificial respiration.
For this hold the victim's head thrown back, lying on his back horizontally open collar and took a deep breath, exhale air into the mouth of the victim (pre clean mouth), lips tightly attaching to enter the mouth of the victim. Nose of the patient clamped with your fingers to create a seal and prevent release of air blowing, outside. You can use a handkerchief, gauze, a special tube. Head maximum throw back to the chin was in line with your neck (resting pre-roller litter of any material). Mouth cavity examined fingers, which pull sterile cotton or gauze: extract blood clots from the mouth, mucus, artificial teeth and dentures. This operation is carried out by turning the head and shoulders aside. Then turn head to its previous position, the most neglected back.
Рис. 2. Штучне дихання методом "з рота в ніс": а - видих потерпілого; б - вдмухування повітря.
Rescuer breathes air into the mouth of the victim, after deep breathing air and throwing the nose of victim, then he release the victim's mouth and nose for passive exhalation. Meanwhile savior again gaining air.
When to open the victim's mouth is not possible due to convulsive clamping of jaw, then doing CPR "mouth-to-nose" while jaw not relax. Artificial respiration "mouth-to-mouth" performing is more efficient. And so rhythmically 1-2 hours. It is preferably to change rescuers every 15 minutes. Breath efficiency is tested by lifting the chest of the victim as a result of filling his lungs with air, which is blowed in. Sigh, as it was said, is passive during termination of airways. Rescuer rears his head and makes himself the next breath, then he leans back on the victim and blowing air into his lungs.
Injection rhythm - 15-20 times per minute, i.e. Every 5-6 seconds. Artificial ventilation continues to restore self-adequate breathing. For each blows in of air it is necessary to make 4-5 pushes to the chest of a victim.
The best airway of victim is provided in the following cases: by the maximum inclination of a head to the back; by opening his mouth; by pushing forward mandible.
The rhythm of artificial breathing is used, when small breath of victim is appeared. Features of the efficient reanimation: appearance of pulse on the large vessels forehead, hips, pink skin color, papillary constriction.
Indirect cardiac massage
When in the victim dilated pupils, lost consciousness not palpable pulse even on the neck, then paralyzed not only breathing but also heart stopped.
Then artificial respiration alternating with cardiac massage (Fig. 3).
Fig. 3. Indirect cardiac massage: a - in the adult; b - in teenager, c - in the child.
Cardiac massage - external (closed) indirect heart massage - a rhythmic click on the anterior wall of the chest of the victim, resulting in heart compressed between the sternum and the spine and pushes the blood from their cavities.
After termination of pressing chest and heart and straighten heart fills with blood that comes from the arteries. After compressing the heart blood enters the hepatic artery and the aorta, with relaxation - with pulmonary and hollow veins to the atrium.
Purpose heart massage - an artificial circulatory support in the body of the victim
and restore normal natural contractions of the heart. Preparing for massage heart is actually preparing to artificial respiration, cardiac massage as necessary held together with artificial respiration.