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 action, which can contribute to revitalization. Next, consider what a complex of resuscitation measures is.
General information
There is a certain section of medicine that studies resuscitation. In 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 various methods of restoration of vital activity is called resuscitation.
When are revitalization methods used?
There are various cases when recovery techniques are needed. So, resuscitation measures are used for cardiac arrest (against a heart attack, due to electrical injury, etc.), breathing (when a foreign body blocks the trachea, etc.), poisoning by poisons. Helping a person is necessary in case of heavy blood loss, acute kidney or liver failure, severe injuries and more. Very often, the time of resuscitation is very limited. In this regard, the actions of the carer should be clear and quick.
Important point
In some cases, resuscitation is impractical. In particular, these situations include irreversible damage to vital systems and organs, especially the brain. Resuscitation measures for clinical death are ineffective 8 minutes after its establishment. Methods of revitalization 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 lungs of the affected person. Artificial ventilation helps maintain gas exchange in case of insufficiency or impossibility of natural breathing. 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 when opening its cavity. Indirect massage is the compression of the organ between the sternum and the spine. Consider these resuscitation measures in detail.
Artificial respiration: general information
The need for ventilation of the lungs appears in case of violations of the regulation centers 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 (due to poliomyelitis, tetanus, poisoning by poisons), severe pathologies (extensive pneumonia, asthma, and others). It is widely practiced the provision of resuscitation using hardware methods. 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 addressed against the background of conditions such as drowning, asphyxiation (suffocation), shock (solar or thermal), electrical injury, poisoning. In such cases, they often resort to artificial respiration using expiratory methods: from mouth to mouth or nose.
Respiratory tract
This indicator is the most important condition for the implementation of effective ventilation. In this regard, before applying the 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 from the mouth to the mouth or nose. Poor patency can often be due to the lowering of the epiglottis and the root of the tongue. This, in turn, is due to relaxation of the masticatory muscles and displacement of the lower jaw in the patient's unconscious state. To restore patency, the victim’s head is thrown back as far as possible - they are unbent in the vertebral-occipital joint. In this case, the lower jaw is extended so that the chin is in a more elevated position. For the epiglottis, a curved duct is inserted into the victim 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 his back horizontally. The abdomen, chest and neck are freed from tight clothing: they untie the tie, unfasten the belt, collar. The oral cavity of the victim must be freed from vomit, mucus, and saliva. Then, putting one hand on the crown of the head, the second is brought under the neck and the head is thrown back. In case the jaws of the victim are tightly squeezed, the lower one is put forward by pressing on its corners with index fingers.
Procedure
If artificial respiration will be carried out from mouth to nose, then the victim’s mouth should be closed by lifting the lower jaw. He who helps, taking a deep breath, wraps his lips around the patient’s nose and exhales vigorously. When using the second method, the actions are somewhat different. If artificial respiration is carried out in the mouth, then the victim’s nose closes. The exhale that provides assistance takes place in the oral cavity, covered with a scarf. After this, a passive exit of air from the patient's lungs should occur. To do this, his mouth and nose are ajar. During this time, the caretaker takes his head to the side and takes 1-2 normal breaths. The criterion for the correctness of the manipulation are excursions (movements) of the chest of the victim in the process of artificial respiration and passive exhalation. In the absence of movements, the causes should be identified and eliminated. This may be insufficient patency of the paths, a small amount of inflated air flow, as well as poor sealing between the nose / mouth of the victim and the oral cavity that provides assistance.
additional information
Within one minute, an average of 12-18 artificial breaths should be taken. In emergency cases, ventilation is carried out using "manual respirators." For example, it can be a special bag, which is presented in the form of a rubber self-expanding chamber. It has a special valve that provides separation of the incoming and passively outgoing air flow. With proper use in this way, gas exchange can be maintained over an extended period.
Heart massage
As mentioned above, there is a direct and indirect method of restoring the activity of an organ. In the latter case, due to compression of the heart between the spine and sternum, blood enters the pulmonary artery from the right ventricle, and from the left into the large circle. This leads to restoration of nutrition of the brain and coronary vessels. In many cases, this contributes to the resumption of heart activity. Indirect massage is necessary in case of sudden cessation or worsening of organ contractions. This may be cardiac arrest or ventricular fibrillation in patients with electrical trauma, heart attack and others. When determining the need for the use of indirect massage, one 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 pallor of the skin.
Important information
As a rule, a massage started in the early stages after a cardiac arrest or deterioration is very effective. Of great importance is the period after which manipulations have begun. So, resuscitation measures for 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 body relatively quickly. As in other cases, there is a certain sequence of resuscitation measures. Knowledge of the technique of performing indirect heart massage will save a person’s life in emergency situations.
Procedure
Before resuscitation, the victim should be placed on a hard surface on his back. If the patient is in bed, then in the absence of a hard couch, he is transferred to the floor. The victim is freed from outer clothing, the belt is removed. 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 straightened at the elbow joints. The limbs are 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 portion of the palm. Pressure is a quick push to the sternum. To spread it, the hands are taken from the surface after each press. 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 is lying on a couch or trestle bed, then it is better for a person assisting to stand on a stand. If the patient is on the ground, then the resuscitator will be more comfortable on his knees. Pressure frequency - 60 clicks per minute. With parallel massage of the heart and ventilation of the lungs by two people for one breath, 4-5 tremors are performed in the sternum, 1 person - 2 breaths for 8-10 squeezes.
Additionally
The effectiveness of manipulations is checked at least 1 time per minute. 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 appropriate equipment is available, resuscitation measures are supplemented by intracardiac infusion of 1 ml of 0.1% adrenaline or 5 ml of a 10% calcium chloride solution. 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. If ventricular fibrillation is detected, a defibrillator is used. The termination of resuscitation measures occurs 20-25 minutes after their start in the absence of the result of manipulations.
Possible complications
The most common consequence of indirect heart massage is a fracture of the ribs. 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. 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: respiration, heart contractions. But at the same time, irreversible changes in tissues and organs are not noted. As a rule, the duration of the period is 5-6 minutes. During this time, using resuscitation measures, you can restore life. 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.