In emergency situations, when you can save a person's life, you just need to know the basics of first aid. One of these fundamental skills is indirect heart massage, the technique of which is described in this publication. By learning some tricks to use it, you can save a human life.
Performing chest compressions
First of all, a sudden cardiac arrest is determined: lack of breathing, consciousness, and then proceed to resuscitation, in parallel calling an ambulance. First, place the patient on a hard surface. Resuscitation should be carried out immediately at the site of the victim, if this is not dangerous for the resuscitator.
If assistance is provided by a non-professional resuscitator, then only pressure on the sternum is allowed. An indirect heart massage, the technique of which is described below, includes the following points.
Sequence of actions
- First, determine the place of compression in the lower third of the sternum.
- One hand is positioned with a protrusion of the palmar surface ("fifth hand") almost on the very bottom of the sternum. The other hand is placed on top of it in the same way. It is possible to place the palms on the principle of the castle.
- Squeezing movements are performed with arms straightened at the elbows, while transferring the weight of one's body when pressed. Do not take your hands off your chest while doing chest compressions.
- The frequency of pressure on the sternum should be no less than 100 times per minute, or approximately 2 compressions per second. The displacement of the chest in depth is at least five centimeters.
- If artificial respiration is given, there should be two breaths per 30 compressions.
It is highly desirable that the periods of pressure on the sternum and no compression in time be the same.
Nuances
Indirect cardiac massage, the technique of which is familiar to every doctor, requires, if tracheal intubation is performed, that movements be performed at a frequency of up to 100 times per minute without a break for respiratory resuscitation. It is carried out in parallel, while performing 8-10 breaths per minute.
Next, take a break for five seconds to determine the recovery of the heart (the presence of a pulse in the peripheral vessels).
Compression of the sternum in children under ten or twelve years of age is performed with one hand, and the ratio of the number of compressions shouldbe 15:2.
Because rescuer fatigue can lead to reduced compression quality and death of the patient, if there are two or more caregivers, it is advisable to change the chest pressurer every two minutes to prevent degradation of chest compressions. Resuscitator replacement should last no longer than five seconds.
It must be remembered that the rules for conducting chest compressions require the patency of the respiratory system.
In unconscious persons, muscular atony develops and obstruction of the airways by the epiglottis and the root of the tongue. Obturation occurs in any position of the patient, even lying on his stomach. And if the head is tilted with the chin to the chest, then this condition occurs in 100% of cases.
The following initial steps precede the chest compressions:
- The first thing to do is to establish the absence of consciousness - call (ask to open your eyes, ask - what happened?).
- Next, beat on the cheeks, gently shake the shoulders.
- When the absence of consciousness is established, it is necessary to normalize the movement of air in the respiratory tract.
Triple take and endotracheal intubation are the gold standard in breath recovery.
Triple Take
Safar has developed three sequential actions that improve the efficiency of resuscitation:
- Tilt your head back.
- Open the patient's mouth.
- Lower jawpush the patient forward.
When this heart massage and artificial respiration is performed, the front muscles of the neck are tightened, after which the trachea opens.
Caution
You need to be careful and careful, because it is possible to damage the spine in the neck when performing actions on the airways.
Most likely spinal injuries can occur in two groups of patients:
- traffic accident victims;
- in the event of a fall from a height.
Such patients should not bend their neck, turn their heads to one side. You need to moderately pull your head towards you, and then keep your head, neck, torso in the same plane with a minimum tilting of the head back, as indicated in the Safar technique. An indirect heart massage, the technique of which in such cases requires special care, is performed only if these recommendations are observed.
Opening the mouth, its revision
The patency of the airways after tilting the head is not always fully restored, because in some unconscious patients with muscle atony, the nasal passages are closed by the soft palate during breathing.
It may also be necessary to remove foreign objects from the oral cavity (blood clot, fragments of teeth, vomit, dentures)Therefore, in such patients, the oral cavity is first examined and freed from foreign objects.
To open the mouth, apply the "reception of crossed fingers". The doctor stands near the head of the patient,opens and examines the oral cavity. If there are foreign objects, they must be removed. With the right index finger, the corner of the mouth is taken down from the right, this helps to free the oral cavity from liquid contents on its own. Fingers wrapped in a napkin, clean the mouth and throat.
An attempt is made to intubate the trachea with air ducts (no more than 30 seconds). If the goal is not achieved, stop trying and continue to conduct mechanical ventilation with a face mask or Ambu bag. The mouth-to-mouth and mouth-to-nose techniques are also used. Cardiac massage and artificial respiration in such cases are carried out depending on the result.
After 2 minutes of resuscitation, it is necessary to repeat the attempt of tracheal intubation.
When an indirect heart massage is performed, the technique of which is described here, then when breathing "mouth to mouth" the duration of each breath should be 1 second. This method is considered effective if there are movements of the victim's chest during artificial respiration. It is important to avoid excessive ventilation of the lungs (no more than 500 milliliters), as it can cause complications in the form of reflux from the stomach and ingestion or entry into the lungs of its contents. In addition, overventilation increases pressure in the chest cavity, which in turn reduces venous return to the heart and survival from sudden cardiac arrest.
