👁️ 😛 🍎 Algorithm for cardiopulmonary resuscitation. Cardiopulmonary resuscitation basics 😆 🏴 👨🏽‍🏫

Often, saving a human life completely depends on how timely medical assistance was provided to him. Everyone from school should learn basic methods of providing first aid to the victim. Next, we consider the algorithm for cardiopulmonary resuscitation, its features in adults and children.

What is CPR

Cardiopulmonary resuscitation, the basics of it will be discussed later, are urgent measures that are taken during the termination of contractions of the heart muscle and independent breathing. These measures are aimed at maintaining artificially the vital functions of the brain until breathing and normal blood circulation are restored.

The effectiveness of resuscitation is completely dependent on the skills of the resuscitator, the conditions of the meeting and the availability of necessary equipment.

If we talk about ideal conditions, then the basics of cardiopulmonary resuscitation performed by a person without a medical education include the following:

Indoor cardiac muscle massage.
Artificial respiration.
Use of an external defibrillator.

But in practice it often turns out that people simply do not have the knowledge and skills to provide first aid, which leads to the death of a person. All medical workers, including ordinary nurses, are able to carry out resuscitation actions, but each person will have such skills to save their loved ones life at the right time.

Indications for resuscitation

Some are wondering when to begin cardiopulmonary resuscitation of the victim. Immediately after the appearance of certain signs by which clinical death is diagnosed:

lack of consciousness;
no breathing;
palpitations stopped;
pupils do not respond to light.

In addition to these mandatory signs, the accompanying symptoms can be noted:

blue skin tone and pallor;
lack of muscle tone;
no reaction to external stimuli.

It must be remembered that clinical death lasts several minutes, during which it is necessary to have time to do the correct cardiopulmonary resuscitation. Then you can make a person’s heart beat, but the brain will be dead.

Resuscitation Basics

If a person's heart stopped and breathing stopped, but there are no injuries incompatible with life, then everything can be restored. For 5-6 minutes, you can restart the heart muscle. If the performance of cardiopulmonary resuscitation is delayed, then the chances fall significantly:

After 10 minutes, doctors will be able to make the heart beat, but the nervous system will no longer work fully and adequately.
After 15 minutes, a mentally full-fledged person dies, so a return to life is possible, but the person will be like a plant.
30-40 minutes after cardiac arrest and cessation of respiration, biological death occurs, and it is impossible to restore the body's functions.

The primary task of cardiopulmonary resuscitation of the victim is the restoration of the brain and heart. Further assistance in restoring the full capacity of the body will be carried out in the hospital.

Stages of cardiopulmonary resuscitation

If you turned loudly to the victim, and in response to silence, you should try to stir the person over the shoulder. In the absence of reaction, it is necessary to begin resuscitation. The stages of cardiopulmonary resuscitation are as follows:

Airway cleansing. This may be necessary if the person was pulled out of the water or from the rubble. Dentures and all foreign objects should be removed from the oral cavity.
Auxiliary ventilation. It is necessary if there is no independent breathing. You can use different methods or use bags of oxygen.
ZMS. It must be performed if there is no heartbeat or pulse.

Resuscitation Technique

Basic actions involve helping the victim without the use of drugs. The algorithm for cardiopulmonary resuscitation is as follows:

First you need to make sure that the place is safe to provide assistance.
Preparation for cardiopulmonary resuscitation also includes checking for the presence of consciousness in the victim.
If a person at least somehow reacts, then you need to call a team of doctors.
In the absence of consciousness, it is necessary to turn the victim on his back in order to assess the possibility of independent breathing.
If a person does not breathe, it is necessary to do mechanical ventilation with indirect heart massage. The frequency of pressure is 100-120 per minute. The cycle is carried out in a ratio of 30: 2.

The procedure for cardiopulmonary resuscitation by one rescuer is as follows:

30 compressions;
2 breaths through the mouth or nose.

It is more convenient when resuscitation is carried out together with someone, then one performs compression of the chest, and the second - artificial respiration, and then you can change.

Indirect massage of the heart muscle

Using this technique, it is possible to restore blood supply to the brain and heart at the most minimal, but vital level. During the massage, the volume of the lungs changes, which provokes gas exchange in them without artificial respiration.

The brain is most sensitive to oxygen deficiency; in a few minutes irreversible changes begin. The heart muscle is in second place in sensitivity to oxygen deficiency, so the success of resuscitation largely depends on correctly performed actions.

The execution technique is as follows:

The victim must be placed on a hard surface on his back.
Located on the side of it.
Place the palm of your right hand (if you're right-handed) on the chest so that the base of the palm rests on the sternum. This will increase the compression force, but reduce the likelihood of fracture of the ribs.
Put the palm of the second hand on top.
For the most effective massage, the shoulders of the first aid resuscitator should be located above the victim’s chest. The arms are straightened at the elbows.
When pressed, the sternum should shift in adult patients by 5-6 cm.
After pressing, it is necessary to allow the chest to restore its shape and again to compress. Long pauses reduce the effectiveness of resuscitation.

If resuscitation is carried out by two people, it is recommended to change every 2 minutes of the ZMS so that the quality does not decrease.

Airway release and artificial respiration

When clinical death occurs, the muscles relax, and if the victim lies on his back, his tongue may shift and block the entrance to the larynx. To release you need:

Put a palm on a person’s forehead.
Raise your head back under the chin, but if you suspect a spinal fracture in the cervical spine, it is strictly forbidden to do this.
With the fingers of the other hand, push the jaw forward.

If there is absolutely no skill in conducting an ID, then it is better not to do it, but to do an indirect heart massage before the arrival of the team of doctors. But with such skills, it is better to combine ZMS with artificial respiration.

The rules are as follows:

open the victim’s mouth;
hold the nostrils with the fingers of your hand;
press against the victim’s mouth and exhale;
after two such exhalations, start a heart massage;
repeat 30 compressions - 2 breaths.

The event should be carried out until the victim recovers independent breathing or the arrival of an ambulance.

Features of resuscitation of children

The algorithm for cardiopulmonary resuscitation in children includes the same actions, but there are some features that must be considered:

Different methods can be used for breast babies to restore breathing, but remember that the tidal volume in babies is only 30 ml.
When performing resuscitation measures, the chest should be pressed so that it does not move more than 3-4 cm.

When should cardiopulmonary resuscitation of the affected child begin? Immediately, as soon as breathing stopped, or the heart stopped. The sequence of actions is as follows:

Start with 5 breaths in the baby’s mouth or nose.
This is followed by indirect heart massage. Infants of pressure on the chest should be done not with the palm of the hand, but with two fingers: middle and index.
The cycle includes 15 compressions and 2 breaths.
Within a minute, carry out resuscitation measures and call a team of doctors.

If a small victim has injured lips or jaw, then artificial respiration is carried out as follows:

fix the forehead of the child;
gently push the lower jaw;
close your mouth and breathe air into the baby's nose;
make a short pause;
repeat a breath;
then begin a heart massage.

Resuscitation automatic defibrillator

This is a small device that allows you to apply an electric discharge through the chest to the heart muscle. These actions allow you to restore blood circulation and start the heart.

Not every cardiac arrest requires defibrillation, but a portable device allows you to evaluate your heart rate and determine the need for electrical discharges.

Modern defibrillators even have the ability, with the help of voice guidance, to prompt a person providing assistance a sequence of actions.

The use of such devices is simple and does not require serious knowledge and skills. They were developed specifically to provide assistance at home in the absence of a medical education.

In prosperous countries, such defibrillators are located in places where there is a large concentration of people, for example, in stadiums, in entertainment centers, airports, and educational institutions.

Using the device involves the following steps:

Connect the portable device to the power circuit and wait for voice instructions.
Release the victim’s chest from clothing.
If the skin is sweating or wet, then you need to wipe it with a napkin.
The device has a diagram showing how to place the electrodes on the human chest: one is fixed above the nipple on the right side of the sternum, and the second is attached on the left side, but below the nipple.
Make sure that the electrodes are firmly attached to the skin and the device is connected to a power source.
Ask everyone to move away from the victim. No one should touch it at the time of operation of the device.
Click the “Analysis” button.
The device will independently perform a heart rate analysis and give the following instructions. If the defibrillator decides on the need for electrical effects on the heart muscle, he will notify about it by voice message.
There are devices that themselves perform defibrillation, and some models require pressing the "Discharge" button.
After discharge, continue resuscitation.

The presence of such a device nearby will make a person’s heart beat even before the ambulance arrives.

Resuscitation according to new requirements

The main task in helping a person is to eliminate oxygen deficiency in order to prevent the onset of biological death. The current standard of cardiopulmonary resuscitation involves several stages.

Primary resuscitation:

Removal of foreign objects from the respiratory tract.
Mechanical ventilation
Heart massage.

The second stage includes:

Drug therapy.
ECG monitoring of heart function.
Defibrillation.

The last stage:

Determining the effects of clinical death on the body.
Measures to restore body functions.
Normalization of the nervous system.

Properly performed resuscitation guarantees a complete restoration of body functions.

Resuscitation with electrical injury

Under the influence of current, thermal and electrolytic effects develop. Symptoms with this lesion are as follows:

Burns are noticeable at current entry points. The stronger the current, the more serious the lesion, up to carbonization.
Hair is not scorched.
Any electric shock affects the heart.
In any case, blood pressure drops, shortness of breath appears, increased heart rate.
In severe cases, cramps and respiratory arrest.

With electrical injury, the basics of cardiopulmonary resuscitation are as follows:

Exclude contact of the victim with the power source.
If the victim does not breathe on his own, then an urgent need to proceed with the ID.
If there is no breathing and when the ambulance arrives, then the trachea is intubated and artificial respiration is continued. The victim is taken to a hospital.

If cardiac arrest is diagnosed, then the algorithm for cardiopulmonary resuscitation is as follows:

inflicting precordial strikes on the lower part of the sternum;
conducting mouth-to-mouth ventilation or mouth-to-nose ventilation;
Indirect cardiac massage.

After successful completion of resuscitation, the patient is taken to the hospital to monitor the functioning of the heart muscle. To do this, a person is given a polarizing mixture, cardiac and vascular drugs:

"Adrenaline" 0.1% solution in an amount of 1 ml.
2 dice "Cordiamine."
Subcutaneously 1 ml of a 10% solution of "Caffeine".
To stimulate breathing, the Lobelin solution is administered intramuscularly or intravenously.

A sterile dressing should be applied to the wound after an electric shock.

Drowning resuscitation

With asphyxia, drowning, the basics of cardiopulmonary resuscitation require urgent resuscitation. Artificial respiration should be done immediately after the victim has been removed from the water or from the rubble or removed from the loop.

When drowning, you can not waste precious time removing all water from the lungs, it is enough to clean the mouth of foreign objects so that mechanical ventilation can be performed.

If you start resuscitating the victim right away, you can almost always manage to restore spontaneous breathing, and the lungs themselves will be cleaned of the accumulated fluid there.

After resuscitation measures, a person must be warmed up, given hot tea to drink and taken to the hospital for safety.

Resuscitation Errors

Resuscitation is not always a positive result, failure is most often associated with a violation of the rules of cardiopulmonary resuscitation:

Help began to render too late.
Ventilation was ineffective.
When performing indirect heart massage, the chest moved less than 5 cm, which did not allow the heart muscle to start working and blood flow to be restored.
Location of the victim during resuscitation on a soft surface.
The resuscitator violates the technique of performing mechanical ventilation and indirect heart massage.

If resuscitation is carried out for more than half an hour, and the injured person cannot be brought back to life, then biological death is ascertained.

If the patient has an attack of heart failure, and resuscitation is carried out with errors, then this is fraught with serious consequences for the patient. With improper heart massage, the following are possible:

fractures of ribs and chest;
lung injury;
injuries of the heart muscle.

When to stop resuscitation

The fact that resuscitation measures should be started as soon as possible is understandable, and when can they be stopped? The instructions are as follows:

An ambulance crew arrived.
The victim showed signs of life and began to breathe on his own.
The resuscitator did not have the physical strength to assist.

The more effective the resuscitation is, the less time it may take.

Contraindications to resuscitation

Given that cardiopulmonary resuscitation aims to re-breathe life into a person, there are some contraindications in which such actions are futile:

Death due to serious illness, such as the last stage of oncology, acute respiratory or heart failure.
Severe injuries incompatible with life.
The presence of symptoms of biological death in the form of cadaveric spots, opacification of the pupil, rigor mortis.

With first aid skills, you can save a person’s life. The main thing is to start actions in a timely manner, and not wait for the ambulance to arrive.

Algorithm for cardiopulmonary resuscitation. Cardiopulmonary resuscitation basics