In medical practice, there are cases in which there is a potential opportunity to restore the most important functions of the human body. This necessitated the development of a specific scheme of actions that can contribute to revival. Next, consider what a complex of resuscitation measures is.
General information
There is a certain branch of medicine that studies resuscitation. Within the framework of this discipline, various aspects of human revitalization are studied, methods for the prevention and treatment of terminal conditions are developed. This section of clinical medicine is called resuscitation, and the direct application of certain methods of restoring life is called resuscitation.
When are animation methods used?
There are various occasions when resuscitation techniques are needed. So, resuscitation measures are used when stoppingheart (against a background of a heart attack, due to electrical trauma, etc.), breathing (when a foreign body blocks the trachea, etc.), poisoning with poisons. A person needs help in case of large blood loss, acute kidney or liver failure, severe injuries, and so on. Very often, the time for resuscitation is very limited. In this regard, the actions of the caregiver must be clear and quick.
Important moment
In some cases, resuscitation is not advisable. In particular, such situations include irreversible damage to vital systems and organs, primarily the brain. Resuscitation measures in case of clinical death are ineffective 8 minutes after its ascertainment. Resuscitation techniques are not used if the available compensatory resources of the body are exhausted (for example, against the background of malignant tumors that occur with general exhaustion). The effectiveness of resuscitation measures is significantly increased when they are carried out in specialized departments that are equipped with the necessary equipment.
Main methods
These include heart massage and artificial respiration. The latter is a procedure to replace the air in the victim's lungs. Artificial ventilation helps to maintain gas exchange in case of insufficiency or impossibility of natural respiration. Heart massage can be direct and closed. The first is carried out by direct compression of the organ. This method is used during operations in the chest area.cells upon opening its cavity. Indirect massage is the squeezing of an organ between the sternum and the spine. Consider these resuscitation measures in detail.
CPR: general information
The need for ventilation of the lungs appears in case of violations of the centers of regulation against the background of edema or circulatory disorders in the brain. The procedure is carried out in case of damage to the nerve fibers and muscles involved in the act of breathing (on the basis of polio, tetanus, poisoning), severe pathologies (extensive pneumonia, asthmatic condition, and others). The provision of resuscitation measures using hardware methods is widely practiced. The use of automatic respirators allows you to maintain gas exchange in the lungs for a long period. Ventilation of the lungs - as a measure of emergency care - is treated against the background of such conditions as drowning, asphyxia (suffocation), stroke (solar or thermal), electrical injury, poisoning. In such cases, artificial respiration is often resorted to using expiratory methods: from mouth to mouth or nose.
Respiratory tract patency
This indicator is the most important condition for effective air ventilation. In this regard, before using expiratory methods, it is necessary to ensure the free passage of air through the respiratory tract. Ignoring this action leads to ineffective ventilation of the lungs by mouth-to-mouth or nose-to-mouth ventilation. Poor traffic can oftenbe due to the retraction of the epiglottis and the root of the tongue. This, in turn, is due to the relaxation of the masticatory muscles and the displacement of the lower jaw in the unconscious state of the patient. To restore patency, the head of the victim is thrown back as much as possible - unbent in the vertebral-occipital joint. In this case, the lower jaw is advanced so that the chin is in a more elevated position. A curved air duct is inserted behind the epiglottis through the pharynx.
Preparatory manipulations
There is a certain sequence of resuscitation measures to restore normal breathing in the victim. The person must first be laid on their back horizontally. The stomach, chest and neck are freed from restrictive clothing: they untie the tie, unfasten the belt, collar. The oral cavity of the victim must be freed from vomit, mucus, saliva. Further, putting one hand on the crown of the head, the other is brought under the neck and the head is thrown back. If the jaws of the victim are strongly clenched, the lower one is pulled out by pressing on its corners with the index fingers.
Procedure progress
If artificial respiration will be carried out from mouth to nose, then the victim's mouth should be closed, raising the lower jaw. The caregiver, taking a deep breath, wraps his lips around the nose of the patient and exhales vigorously. When using the second method, the actions are somewhat different. If artificial respiration is carried out in the mouth, then the nose of the victim is closed. Exhalationthe person assisting carries out into the oral cavity, covered with a handkerchief. After this, a passive exit of air from the patient's lungs should occur. To do this, his mouth and nose are slightly opened. During this time, the caregiver moves his head to the side and takes 1-2 normal breaths. The criterion for the correctness of the implementation of the manipulations are the excursions (movements) of the chest of the victim during artificial inhalation and during passive exhalation. In the absence of movement, the causes should be identified and eliminated. This may be insufficient patency of the paths, a small volume of the blown air flow, as well as poor sealing between the nose / mouth of the victim and the oral cavity of the caregiver.
More information
Within one minute, on average, 12-18 artificial breaths should be taken. In emergency cases, ventilation of the lungs is carried out using "manual respirators". For example, it may be a special bag, which is presented in the form of a rubber self-expanding chamber. It has a special valve that separates the incoming and passively outgoing air flow. When properly used in this way, gas exchange can be maintained for an extended period.
Heart massage
As mentioned above, there is a direct and indirect method of restoring the activity of the body. In the latter case, due to the compression of the heart between the spine and the sternum, blood enters the pulmonary artery from the right ventricle, and from the left- in a big circle. This leads to the restoration of nutrition of the brain and coronary vessels. In many cases, this contributes to the resumption of heart activity. Indirect massage is necessary with a sudden cessation or deterioration of organ contractions. This can be cardiac arrest or ventricular fibrillation in patients with electrical injury, heart attack, and so on. When determining the need for the use of indirect massage, you should focus on a number of signs. In particular, resuscitation measures are carried out with a sudden cessation of breathing, the absence of a pulse on the carotid artery, dilated pupils, loss of consciousness, development of skin pallor.
Important information
As a rule, massage started early after cardiac arrest or deterioration is very effective. Of great importance is the period after which manipulations are started. Thus, resuscitation measures in case of clinical death, carried out immediately after its onset, are more effective than actions after 5-6 minutes. Properly performed manipulations allow you to restore the activity of the organ relatively quickly. As in other cases, there is a certain sequence of resuscitation measures. Knowledge of the technique of chest compressions will allow you to save a person's life in emergency situations.
Procedure progress
Before resuscitation, the victim should be placed on a hard surface on his back. If the patient is in bed, thenin the absence of a rigid couch, it is transferred to the floor. The victim is released from outerwear, remove the belt. An important point is the correct position of the hands of the resuscitator. The palm is placed on the lower third of the chest, the second is placed on top. Both arms should be straight at the elbow joints. The limbs are located perpendicular to the surface of the sternum. Also, the palms should be in the most extended state in the wrist joints - with raised fingers. In this position, pressure on the sternum in its lower third is carried out by the initial section of the palm. Pressings are quick thrusts into the sternum. To straighten it, the hands are taken away from the surface after each pressing. The force necessary to displace the sternum by 4-5 cm is provided not only by the hands, but also by the weight of the resuscitator. In this regard, if the victim lies on a couch or trestle bed, then it is better for the person providing assistance to stand on a stand. If the patient is on the ground, then the resuscitator will be more comfortable on his knees. The frequency of pressure is 60 clicks per minute. With simultaneous cardiac massage and ventilation of the lungs, two people perform 4-5 pushes into the sternum for one breath, 1 person - 2 breaths for 8-10 compressions.
Extra
The effectiveness of manipulations is checked at least once a minute. At the same time, it is necessary to pay attention to the pulse in the region of the carotid arteries, the condition of the pupils and the presence of independent breathing, an increase in blood pressure and a decrease in cyanosis or pallor. If the appropriate equipment is available, resuscitation measures are supplementedintracardiac infusion of 1 ml of 0.1% adrenaline or 5 ml of a ten percent solution of calcium chloride. In some cases, the restoration of the contractility of the organ can be achieved by a sharp blow of the fist to the center of the sternum. When ventricular fibrillation is detected, a defibrillator is used. The termination of resuscitation takes place 20-25 minutes after their start in the absence of the result of manipulations.
Possible Complications
The most common consequence of chest compressions is rib fracture. It is most difficult to avoid this in elderly patients, since their chest is not as supple and elastic as in young patients. Less commonly, damage to the lungs and heart, ruptures of the stomach, spleen, and liver occur. These complications are the result of technically incorrect manipulations and dosing of physical pressure on the sternum.
Clinical death
This period is considered the stage of dying and is reversible. It is accompanied by the disappearance of external manifestations of human activity: breathing, heart contractions. But at the same time, irreversible changes in tissues and organs are not observed. As a rule, the duration of the period is 5-6 minutes. During this time, with the use of resuscitation measures, it is possible to restore vital activity. After this period, irreversible changes begin. They are defined as a state of biological death. In this case, it is not possible to achieve a complete restoration of the activity of organs and systems. The duration of clinical death depends on the duration and type of dying, body temperature, age. For example, when using artificial deep hypothermia (lowering t to 8-12 degrees), the period can be increased to 1-1.5 hours.
