Artificial respiration and chest compressions. Artificial respiration methods: sequence of actions

Artificial respiration is performed when

The victim is not breathing;

The victim breathes very badly (rarely, convulsively, with a sob):

The victim's breathing keeps getting worse.

The most effective method of artificial respiration is the “mouth to mouth” or “mouth to nose” method, since this ensures that a sufficient volume of air enters the victim’s lungs.

Air is blown through gauze, a clean handkerchief, etc. or "duct".

To perform artificial respiration:

1) Lay the victim on his back, unfasten clothing that restricts breathing.

2) Ensure patency of the upper respiratory tract (clean the oral cavity, pull out the tongue, which may be sunken).

3) The person providing assistance should position himself to the side of the victim’s head.

4) Place one hand under the victim’s neck, and with the palm of the other hand press on his forehead, throwing his head back as much as possible (the root of the tongue rises, the larynx is released, the mouth opens).

5) Lean towards the victim’s face and take a deep breath with your mouth open.

6) Completely tightly cover the victim’s open mouth with your lips and exhale vigorously, blowing air into the victim’s mouth (at the same time cover his nose with his cheek or fingers on his forehead),

7) Observe the victim’s chest:

As soon as she rises, stop blowing air, turn her face towards the person providing assistance; passive exhalation occurs in the victim;

When air enters the stomach, bloating occurs “in the pit of the stomach.” You must carefully press the palm of your hand on the stomach between the sternum and the navel (if vomiting occurs, turn the victim’s head and shoulders to one side and clear the mouth);

If the chest does not expand after the air is blown in, it is necessary to push the victim’s lower jaw forward so that the lower teeth are in front of the upper teeth.

8) Observe the interval between artificial breaths, which should be 5 seconds (12 respiratory cycles per minute).

Stop artificial respiration after the victim has restored deep and rhythmic spontaneous breathing.

At the workplace, artificial respiration can be performed with the victim sitting (for example, in a cradle) or in a vertical position (fastened when descending from a height, etc.).

Resuscitation measures - a combination of artificial respiration with indirect cardiac massage allows you to simulate the functions of breathing and blood circulation.

If the revival is carried out by one person, then 2 breaths of artificial respiration are done after 15 pressures on the sternum. The rate of resuscitation must be high. For 1 minute, you need to do 60 pressures and 12 blows.

If the revival is carried out by two people, then 2 breaths of artificial respiration are done after 5 pressures on the sternum.

During artificial inhalation of the victim, the one who massages the heart does not apply pressure, since the forces developed during pressure are much greater than during insufflation, which leads to the futility of artificial respiration and, consequently, to resuscitation measures.

TICKET No. 5

Safety briefing, types of briefing.

According to the nature and timing of the briefings are divided into:

Introductory– is carried out with all newly hired employees, regardless of their education and work experience. It is carried out by a labor protection engineer or a person assigned these responsibilities by order. An entry about the briefing is made in the registration log with the obligatory signature of the person being instructed and the person instructing;

Initial training at the workplace– carried out before the start of production activities with each employee individually with a practical demonstration of safe techniques and work methods. Possible with a group of people servicing the same type of equipment, and within a common workplace. Conducted by a master or immediate supervisor. An entry about the briefing is made in the registration log with the obligatory signature of the person being instructed and the person instructing;

Re-briefing– all workers, regardless of qualifications, education, or experience, undergo it at least once every six months. An entry about the briefing is made in the registration log with the obligatory signature of the person being instructed and the person instructing;

Unscheduled- carried out individually or with a group of workers of the same profession:

When introducing new standards, rules, instructions, new or revised, on labor protection. ;

When changing the technological process, replacing equipment. Raw materials, materials, and other factors affecting labor safety;

If workers violate labor safety requirements, which can lead or have led to injury, accident or fire;

At the request of supervisory authorities;

During breaks in work - 60 days, and for special work (increased occupational safety requirements) - more than 30 days.

An entry about the briefing is made in the registration log with the obligatory signature of the person being instructed and the person instructing.

Target- carry out:

When performing one-time work that is not related to direct duties in the specialty (cleaning the territory, loading, etc.);

When eliminating the consequences of accidents and natural disasters;

In the performance of work for which a work permit, permit and other documents are issued.

An entry is made in the registration log about the briefing with the obligatory signature of the instructed and instructing

Primary briefing at the workplace, repeated, unscheduled and targeted is carried out by the immediate supervisor of the work.

The previously used artificial respiration (artificial ventilation of the lungs) by means of bending the arms and legs of the victim is no longer used. There is a more effective method of restoring breathing - "mouth to mouth" and "mouth to nose".

Before starting artificial respiration, it is necessary to make sure that the upper respiratory tract of the victim is patent. To do this, the head of the victim is thrown back, since in this position the airways are better opened. To avoid retraction of the tongue, the lower jaw of the victim is pushed forward.

If the jaws are tightly compressed, then they must be carefully pushed apart with some flat (not sharp!) Object and a roller made of any clean cloth should be placed between the teeth, and preferably a bandage (if any). After that, with a finger wrapped in a bandage, gauze, a clean handkerchief or a clean cloth, quickly examine the oral cavity and free it from vomit, mucus, blood, sand, algae, etc.

If the victim has dentures, they need to be removed. After this, the zipper is unfastened, which can impede breathing and circulation. The entire preparatory part must be done very quickly, but carefully and carefully, since the severe, sometimes critical condition of the victim can be worsened even more. After the upper respiratory tract is cleared, the victim should be quickly and carefully laid with his back on a flat, flat surface, and his arms extended along the body. Then the head of the victim is thrown back. With one hand, pull the lower jaw forward and down, and pinch the nose with the fingers of the other hand.

It is necessary to ensure that the victim’s tongue does not fall back and block the airway. If the tongue sinks, you need to pull it out and hold it with your fingers or pin (you can even sew) the tip of the tongue to the clothing. The one who provides assistance stands on either side of the victim. Then he takes a maximum breath and, leaning towards the victim, presses his lips tightly to his open mouth, at this moment exhaling as much as possible, making sure that while air enters the respiratory tract and lungs, the victim’s chest expands as much as possible.

After straightening the chest, you need to take your mouth away from your lips and stop squeezing the victim’s nose. At this moment, the air itself should leave his lungs, simulating an exhalation. Such breaths should be taken every 3-4 seconds. The intervals between breaths and the depth of each breath should be the same.

In case of injury to the tongue, jaw or lips, another method is used - “mouth to nose”. The technique for carrying out this method is the same as in the first case, only the victim’s mouth must be tightly closed. Air is blown from the resuscitator's mouth into both nostrils of the victim.

If you start artificial respiration as quickly as possible after breathing stops, it often leads to success. The first spontaneous inhalation is not always quite clearly expressed and can only be noticeable by a weak rhythmic contraction of the neck muscles, reminiscent of a swallowing movement. After this, respiratory movements become more pronounced and increase, but can occur at large intervals and be convulsive in nature.

Closed heart massage.

Heart massage is an artificial compression of its cavities, which helps push blood into the bloodstream and irritates the nervous apparatus of the heart muscle. As a rule, it is carried out in case of sudden cardiac arrest (in case of shock, lightning, being caught in an avalanche, etc.). When the victim is in a state of death, his chest becomes more mobile as a result of decreased muscle tone.

And since the heart is located between the sternum and the spine, when pressing on the chest, it can be compressed so much that blood from its cavities is squeezed into the vessels, and when the compression stops, the heart straightens out again, and a new portion of blood from the veins enters it. By repeating sharp and strong pressure on the front of the chest, you can artificially maintain blood circulation in the vessels.

The first signs of cardiac arrest.

- Sharp blueness or pallor.
- The pulse is not felt in the radial and carotid arteries.
- When listening with the ear, the work of the heart is not audible.

The technique for performing closed cardiac massage is as follows. The victim is placed on his back on a hard, flat surface. The one who will provide assistance stands on the left and places the palm of one hand on the lower part of the victim’s chest, and places the palm of the other hand on it. Then, with energetic jerking movements of the arms, straightened at the elbow joints, the resuscitator presses on the sternum. After each pressure, the hands must be raised from the chest, giving it the opportunity to straighten so that the cavities of the heart fill with blood. About 60 pressures should be performed per minute.

Signs of cardiac recovery.

- The appearance of an independent pulse in the carotid or radial arteries.
— Reduction of pallor or bluishness of the skin.

Resuscitation and timing of its implementation in emergency situations.

The success of resuscitation depends on the time it began after the accident, the correctness and quality of artificial respiration and closed cardiac massage, or a combination thereof. But the combination of these two techniques when returning the victim to life is only possible if at least two people provide assistance. Although this is possible alone, it is very difficult and ineffective.

When providing assistance together, one of them performs cardiac massage, and the other at the same time performs artificial respiration. In this case, blowing into the victim’s mouth or nose should be done every four pushes on his sternum. If one person provides assistance, then the sequence of resuscitation techniques and their regime change - after every two quick injections of air into the lungs, 10-12 chest compressions are performed with an interval of 1 second.

As soon as cardiac activity becomes stable (the pulse begins to be felt and the heartbeat is heard), artificial respiration is continued until it is completely independent. In the absence of heartbeats, artificial respiration and cardiac massage are carried out for 60 to 90 minutes, but if neither one nor the other appears during this period, then resuscitation can be stopped.

Clear signs of biological death.

- Clouding of the cornea and drying out.
— When you squeeze the eye with your fingers from the sides, the pupil narrows and resembles a cat's eye.

Based on materials from the book “Encyclopedia of Survival.”
Chernysh I. V.

There are so many situations in life that a person can influence and change the outcome for the better. But sometimes people simply lack basic skills to help victims. Therefore, it never hurts to learn how to act when a random passerby or family member stops breathing. Any person can provide first aid to a patient, observing basic rules and following clear instructions. Disruption of the respiratory process can be caused by a foreign body entering the mouth or trachea or a stuck tongue.

In what cases is ventilation performed?

The procedure for rescuing a person should begin by identifying the source of the problem. Ventilation should be done in the following cases:

If the heartbeat stops. To restore breathing, it is necessary to perform an indirect cardiac massage.
The retraction of the tongue has occurred (man is without creation). While lying down, the muscles of the tongue and pharynx relax, which can cause the root of the tongue to move and close the entrance to the trachea. At the same time, respiratory movements are present, but noises cannot be heard. In this case, it would be appropriate to tilt the head back, which will clear the entrance and allow air to enter the trachea. In order for the mouth to open, there must be a helping hand under the person’s neck and pressure on the forehead with the other hand.
If a foreign body (this can be a particle of water, food, dirt, as well as blood and other objects) has entered the organs that provide air passage. Symptoms of this problem are weak breathing movements, bluish knees and lips, rapid pulse (110 or more beats per minute), noisy convulsive inhalation, exhalation with the sound of hoarseness.

Having determined the cause of stopping (difficulty) breathing, providing first aid to the victim is mandatory. But for this you need to create comfortable conditions for the victim.

Methods of ventilation

The breathing restoration procedure should be carried out until a positive result occurs. First you need to remove the victim’s clothes, which may be compressing the chest area, then you should ensure that your mouth is open and your clenched teeth are unclenched.

There are three ways to perform ventilation:

To apply this method, the victim must lie with his back up, one arm under his head, the other extended along the body, and his face turned to the side. The person performing artificial respiration should position himself so that the patient's thighs are between his knees. The palms are on the victim’s back, and the fingers clasp him from the sides. Leaning forward, the person leans on his outstretched arms and leans back, exhaling and inhaling.
To apply the second method, the victim is placed with his back to the surface and a bundle of clothes is placed in the area of the shoulder blades, this allows the patient’s head to be thrown back. The mouth should be cleaned and the tongue extended. During the procedure, the tongue is slightly pulled down towards the chin. To exhale, you need to take the victim’s hands at the elbows and press them to the side of the chest. To inhale, raise your arms and throw them behind your head.
The mouth-to-mouth method is the most common and effective way to restore a victim’s breathing. Before starting the procedure, the person should be on his back with his head thrown back (chin and neck should be in line). The victim's mouth should be cleared of mucus. Air enters through the mouth of the person providing assistance, while the victim’s nose must be pinched. It is necessary to make 10-12 blows per minute.

Before providing first aid to the victim, you need to call an ambulance. By the time she arrives, you may have saved someone's life.

Each of us is not immune from a situation where a loved one or just a passer-by receives an electric shock or heat stroke, which leads to respiratory arrest, and often to the cessation of heart function. In such a situation, a person’s life will depend only on the instant reaction and assistance provided. Already schoolchildren should know what artificial heart massage is and with the help of which you can bring the victim back to life. Let's figure out what these techniques are and how to perform them correctly.

Causes of respiratory arrest

Before you deal with first aid, you need to find out in what situations breathing may stop. The main reasons for this condition include:

strangulation, which is a consequence of carbon monoxide inhalation or attempted suicide by hanging;
drowning;
electric shock;
severe cases of poisoning.

These reasons are most common in medical practice. But you can name others - everything happens in life!

Why is it necessary?

Of all the organs in the human body, the brain needs oxygen the most. Without it, cell death begins in about 5-6 minutes, which will lead to irreversible consequences.

If first aid, artificial respiration and cardiac massage are not provided in a timely manner, then the person who has returned to life can no longer be called full-fledged. The death of brain cells will subsequently lead to the fact that this organ will no longer be able to function as before. A person can turn into a completely helpless creature that will require constant care. It is for this reason that the quick reaction of others who are ready to provide first aid to the victim is very important.

Features of adult resuscitation

How to perform artificial respiration and cardiac massage is taught in biology classes in secondary schools. Only most people are sure that they will never find themselves in such a situation, so they do not particularly delve into the intricacies of such manipulations.

Finding themselves in such a situation, many get lost, cannot find their way, and precious time is wasted. Resuscitation of adults and children has its differences. And they are worth knowing. Here are some features of resuscitation measures in adults:

When all these factors are taken into account, resuscitation measures can begin, if necessary.

Actions before artificial respiration

Quite often a person loses consciousness, but breathing remains. In such a situation, it is necessary to take into account that in an unconscious state all the muscles of the body relax. This also applies to the tongue, which, under the influence of gravity, slides down and can close the larynx, leading to suffocation.

The first step when you find a person unconscious is to take measures to ensure the free flow of air through the larynx. You can put the person on his side or throw his head back and open his mouth slightly, pressing on the lower jaw. In this position there will be no danger that the tongue will completely block the larynx.

After this, you need to check whether spontaneous breathing has resumed. Almost everyone knows from films or biology lessons that to do this, it is enough to bring a mirror to your mouth or nose - if it fogs up, it means the person is breathing. If you don't have a mirror, you can use your phone screen.

It is important to remember that while all these checks are being carried out, the lower jaw must be supported.

If the victim is unable to breathe due to drowning, strangulation with a rope, or a foreign body, it is necessary to urgently remove the foreign object and clean the oral cavity if necessary.

If all the procedures have been carried out, and breathing has not been restored, it is necessary to immediately perform artificial respiration and cardiac massage if it has stopped working.

Rules for performing artificial respiration

If all the reasons that caused the respiratory arrest have been eliminated, but it has not recovered, then it is urgently necessary to begin resuscitation. Artificial respiration can be performed using different methods:

inhaling air into the victim’s mouth;
blowing into the nose.

The first method is most often used. Unfortunately, not everyone knows how to perform artificial respiration and cardiac massage. The rules are quite simple, you just need to follow them exactly:

If the victim, after all the efforts, does not come to his senses and does not begin to breathe on his own, then he will have to urgently perform a closed heart massage and artificial respiration at the same time.

Artificial respiration technique " mouth V nose»

This method of resuscitation is considered the most effective, as it reduces the risk of air entering the stomach. The procedure is as follows:

Most often, if all manipulations are performed correctly and in a timely manner, it is possible to bring the victim back to life.

The effect of cardiac muscle massage

Most often, artificial heart massage and artificial respiration are combined when providing first aid. Almost everyone can imagine how such manipulations are carried out, but not everyone knows what their meaning is.

The heart in the human body is a pump that vigorously and constantly pumps blood, delivering oxygen and nutrients to cells and tissues. When performing an indirect massage, pressure is applied to the chest, and the heart begins to contract and push blood into the vessels. When the pressure stops, the myocardial chambers straighten and venous blood enters the atria.

In this way, blood flows through the body, which carries everything the brain needs.

Algorithm for cardiac resuscitation

To make cardiac resuscitation more effective, it is necessary to lay the victim on a hard surface. In addition, you will have to unbutton your shirt and other clothes. The belt on men's trousers must also be removed.

the point is located at the intersection of the internipple line and the middle of the sternum;
you need to step back from the chest to the thickness of two fingers to the head - this will be the desired point.

Once the desired pressure point has been determined, resuscitation measures can begin.

Cardiac massage and artificial respiration techniques

The sequence of actions during resuscitation procedures should be as follows:

It is necessary to take into account that performing artificial respiration and chest compressions requires considerable effort, so it is advisable to have someone else nearby who can relieve you and provide assistance.

Features of providing assistance to children

Resuscitation measures for young children have their own differences. The sequence of artificial respiration and cardiac massage in babies is the same, but there are some nuances:

Signs of effective help

When performing it, you need to know the signs by which you can judge its success. If artificial respiration and external cardiac massage are performed correctly, then, most likely, after some time the following signs can be observed:

the pupils react to light;
the skin becomes pinkish in color;
the pulse is felt in the peripheral arteries;
the victim begins to breathe on his own and regains consciousness.

If artificial cardiac massage and artificial respiration do not produce results within half an hour, then resuscitation is ineffective and must be stopped. It should be noted that the earlier cardiopulmonary resuscitation is started, the more effective it will be in the absence of contraindications.

Contraindications to resuscitation

Artificial heart massage and artificial respiration set the goal of returning a person to a full life, and not just delaying the time of death. Therefore, there are situations when such resuscitation is pointless:

The rules of artificial respiration assume that resuscitation is started immediately after cardiac arrest is detected. Only in this case, if there are no contraindications, can we hope that the person will return to a full life.

We figured out how to do artificial respiration and cardiac massage. The rules are quite simple and clear. Don't be afraid that you won't succeed. Here are some tips to help save a person's life:

If things don’t work out with artificial respiration, then you can and should continue doing cardiac massage.
In most adults, breathing stops due to the cessation of myocardial function, so massage is more important than artificial respiration.
Do not be afraid that as a result of excessive pressure, you will break the victim's ribs. Such an injury is not fatal, but a person’s life will be saved.

Each of us may need such skills at the most unexpected moment, and it is very important in such a situation not to get confused and do everything possible, because life often depends on the correctness and timeliness of actions.

Anyone can find themselves in a situation where a person walking nearby loses consciousness. We immediately begin to panic, which must be put aside, because that person needs help.

Every person is obliged to know and apply at least basic resuscitation actions. These include chest compressions and artificial respiration. Most people undoubtedly know what it is, but not everyone will be able to properly help.

If there is no pulse or breathing, it is necessary to take immediate action, ensure air access and rest the patient, and also call an ambulance. We will tell you how and when it is necessary to perform indirect cardiac massage and artificial respiration.

Indirect cardiac massage and artificial respiration

The human heart has four chambers: 2 atria and 2 ventricles. The atria provide blood flow from the vessels to the ventricles. The latter, in turn, carry out the release of blood into the small (from the right ventricle into the vessels of the lungs) and large (from the left - into the aorta and further, to other organs and tissues) circulation circles.

In the pulmonary circulation, an exchange of gases occurs: carbon dioxide leaves the blood into the lungs, and oxygen into it. More precisely, it binds to the hemoglobin of red blood cells.

In the systemic circulation the reverse process occurs. But, besides it, nutrients come from the blood to the tissues. And the tissues “give back” the products of their metabolism, which are excreted by the kidneys, skin and lungs.

Cardiac arrest is considered a sudden and complete cessation of cardiac activity, which in certain cases can occur simultaneously with the bioelectrical activity of the myocardium. The main reasons for stopping are the following:

Ventricular asystole.
Paroxysmal tachycardia.
Ventricular fibrillation, etc.

Among the predisposing factors are:

Smoking.
Age.
Alcohol abuse.
Genetic.
Excessive stress on the heart muscle (for example, playing sports).

Sudden cardiac arrest sometimes occurs due to injury or drowning, possibly due to an obstructed airway as a result of electric shock.

In the latter case, clinical death inevitably occurs. It should be remembered that the following signs can signal a sudden cardiac arrest:

Consciousness is lost.
Rare convulsive sighs appear.
There is a sharp pallor on the face.
In the region of the carotid arteries, the pulse disappears.
Breathing stops.
The pupils dilate.

An indirect heart massage is performed until the restoration of independent cardiac activity occurs, among the signs of which the following can be distinguished:

The person comes to consciousness.
A pulse appears.
Decreases pallor and blueness.
Breathing resumes.
The pupils narrow.

Thus, in order to save the life of the victim, it is necessary to carry out resuscitation, taking into account all the circumstances, and at the same time call an ambulance.

In case of circulatory arrest, tissue metabolism and gas exchange stops. Metabolic products accumulate in the cells, and carbon dioxide accumulates in the blood. This leads to a cessation of metabolism and cell death as a result of "poisoning" by metabolic products and lack of oxygen.

Moreover, the higher the initial metabolism in the cell, the less time is needed for its death due to cessation of blood circulation. For example, for brain cells this is 3-4 minutes. Cases of revival after 15 minutes refer to situations where, before cardiac arrest, the person was in a state of cooling.

Indirect cardiac massage involves compression of the chest, which must be done to compress the chambers of the heart. At this time, blood leaves the atria through the valves into the ventricles, then it is directed into the vessels. Thanks to rhythmic pressure on the chest, the movement of blood through the vessels does not stop.

This method of resuscitation must be done to activate the heart’s own electrical activity, and this helps restore the organ’s independent functioning. Providing first aid can bring results in the first 30 minutes after the onset of clinical death. The main thing is to correctly carry out the algorithm of actions and follow the approved first aid technique.

Massage in the heart area should be combined with mechanical ventilation. Each pressing of the victim’s chest, which must be done by 3–5 cm, provokes the release of about 300–500 ml of air. After the compression stops, the same portion of air is sucked into the lungs. By compressing/releasing the chest, an active inhalation is performed, then a passive exhalation.

What is direct and indirect cardiac massage?

Cardiac massage is indicated for palpitations and cardiac arrest. It can be done:

open (straight).
closed (indirect) method.

Direct cardiac massage is carried out during surgery when the chest or abdominal cavity is opened, and the chest is also specially opened, often even without anesthesia and observing the rules of asepsis. After exposing the heart, it is carefully and gently squeezed with your hands at a rhythm of 60-70 times per minute. Direct cardiac massage is performed only in an operating room.

Indirect cardiac massage is much simpler and more accessible in any conditions. It is done without opening the chest simultaneously with artificial respiration. By pressing on the sternum, you can move it 3-6 cm towards the spine, compress the heart and force blood out of its cavities into the vessels.

When the pressure on the sternum ceases, the cavities of the heart straighten, and blood from the veins is sucked into them. Indirect cardiac massage can maintain pressure in the systemic circulation at a level of 60-80 mmHg. Art.

The technique of indirect cardiac massage is as follows: the person providing assistance places the palm of one hand on the lower third of the sternum, and the other on the back surface of the previously applied hand to increase pressure. 50-60 pressures are applied to the sternum per minute in the form of quick thrusts.

After each pressure, the hands are quickly removed from the chest. The period of pressure should be shorter than the period of chest expansion. For children, massage is performed with one hand, and for newborns and children up to one year old - with the tips of 1 - 2 fingers.

The effectiveness of cardiac massage is assessed by the appearance of pulsation in the carotid, femoral and radial arteries, and an increase in blood pressure to 60-80 mm Hg. Art., constriction of the pupils, the appearance of their reaction to light, restoration of breathing.

When and why is cardiac massage done?

Indirect cardiac massage is necessary in cases where the heart has stopped. In order for a person not to die, he needs outside help, that is, he needs to try to “start” the heart again.

Situations when cardiac arrest is possible:

Drowning,
Transport accident,
Electric shock,
Damage due to fire,
The result of various diseases,
Finally, no one is immune from cardiac arrest for unknown reasons.

Symptoms of cardiac arrest:

Loss of consciousness.
Absence of pulse (usually it can be felt on the radial or carotid artery, that is, at the wrist and neck).
Lack of breathing. The most reliable way to determine this is to hold a mirror to the victim's nose. If it does not fog up, then there is no breathing.
Dilated pupils that do not respond to light. If you open your eye a little and shine a flashlight, you will immediately understand whether they react to light or not. If a person’s heart is beating, the pupils will immediately constrict.
Gray or blue complexion.

Cardiac compression (CCM) is a resuscitation procedure that saves many lives every day around the world. The sooner you start giving the victim NMS, the greater his chances of survival.

NMS includes two steps:

mouth-to-mouth artificial respiration, restoring breathing in the victim;
compression of the chest, which, together with artificial respiration, forces blood to move until the victim’s heart can pump it throughout the body again.

If a person has a pulse but is not breathing, he requires artificial respiration, but not chest compressions (the presence of a pulse means the heart is beating). If there is no pulse or breathing, both artificial respiration and chest compressions are needed to force air into the lungs and maintain blood circulation.

Closed heart massage must be performed when the victim has no reaction of the pupils to light, breathing, cardiac activity, or consciousness. External cardiac massage is considered to be the simplest method used to restore cardiac activity. It does not require any medical equipment to perform it.

External cardiac massage is represented by rhythmic squeezing of the heart through compressions performed between the sternum and the spine. For victims who are in a state of clinical death, it is not difficult to perform chest compressions. This is explained by the fact that in this state muscle tone is lost and the chest becomes more pliable.

When the victim is in a state of clinical death, the person providing assistance, following the technique, easily displaces the victim’s chest by 3–5 cm. Each compression of the heart provokes a decrease in its volume and an increase in intracardiac pressure.

By performing rhythmic pressure on the chest area, a difference in pressure occurs inside the heart cavities, the blood vessels extending from the heart muscle. Blood from the left ventricle is sent through the aorta to the brain, and from the right ventricle blood flows to the lungs, where it is saturated with oxygen.

After the pressure on the chest stops, the heart muscle straightens, intracardiac pressure decreases, and the heart chambers fill with blood. External cardiac massage helps restore artificial circulation.

Closed heart massage is performed only on a hard surface; soft beds are not suitable. When performing resuscitation, you must follow this algorithm of actions. After placing the victim on the floor, it is necessary to perform a precordial punch.

The blow should be directed to the middle third of the chest, the required height for the blow is 30 cm. To perform a closed heart massage, the paramedic first places the palm of one hand on the other hand. After this, the specialist begins to perform uniform pushes until signs of blood circulation restoration appear.

In order for the ongoing resuscitation to bring the desired effect, you need to know, follow the basic rules, which are the following algorithm of actions:

The person providing assistance must determine the location of the xiphoid process.
Determine the compression point, which is located in the center of the axis, 2 fingers above the xiphoid process.
Place the heel of your palm on the calculated compression point.
Perform compression along the vertical axis, without sudden movements. Compression of the chest must be performed to a depth of 3–4 cm, the number of compressions per chest area is 100/minute.
For children under one year of age, resuscitation is performed with two fingers (second, third).
When performing resuscitation on small children under one year old, the frequency of compressions on the sternum should be 80 - 100 per minute
For teenage children, assistance is provided with the palm of one hand.
For adults, resuscitation is performed in such a way that the fingers are raised and do not touch the chest area.
It is necessary to alternate between two breaths of mechanical ventilation and 15 compressions on the chest area.
During resuscitation, it is necessary to monitor the pulse in the carotid artery.

Signs of the effectiveness of resuscitation measures are the reaction of the pupils and the appearance of a pulse in the area of the carotid artery. Method of performing indirect cardiac massage:

put the victim on a hard surface, the resuscitator is located on the side of the victim;
rest the palms (not fingers) of one or both straight arms on the lower third of the sternum;
press your palms in rhythmically, with pushes, using your own body weight and the efforts of both hands;
if a rib fracture occurs during chest compressions, it is necessary to continue the massage by placing the base of the palms on the sternum;
The pace of the massage is 50-60 shocks per minute; in an adult, the amplitude of the chest oscillations should be 4-5 cm.

Simultaneously with cardiac massage (1 push per second), artificial respiration is performed. For 3-4 compressions on the chest, there is 1 deep exhalation into the victim’s mouth or nose, if there are 2 resuscitators. If there is only one resuscitator, then every 15 compressions on the sternum with an interval of 1 second, 2 artificial breaths are required. Inhalation frequency is 12-16 times per minute.

For children, the massage is performed carefully, with one hand, and for newborns - only with the fingertips. The frequency of chest compressions in newborns is 100-120 per minute, and the point of application is the lower end of the sternum.

It is also necessary to carefully perform an indirect heart massage for the elderly, since with rough actions, fractures in the chest area are possible.

How to perform cardiac massage on an adult

Stages of implementation:

Get ready. Gently shake the victim's shoulders and ask, “Is everything okay?” This way you make sure that you are not going to do NMS to a person who is conscious.
Quickly check to see if he has any serious injuries. Focus your attention on the head and neck as you manipulate them.
Call an ambulance if possible.
Lay the victim on his back on a hard, flat surface. But if you suspect a head or neck injury, do not move it. This can increase the risk of paralysis.
Provide air access. Kneel near the casualty's shoulder for easy access to the head and chest. Perhaps the muscles that control the tongue relaxed, and he blocked the airways. To restore breathing, you need to free them.
If there is no neck injury. Open the victim's airway.

Place the fingers of one hand on his forehead, and the other on the lower jaw near the chin. Gently push your forehead back and pull your jaw upward. Keep your mouth slightly open so that your teeth are almost touching. Do not put your fingers on the soft tissues under the chin - you can inadvertently block the airway that you are trying to free.

If there is a neck injury. In this case, movement of the neck can cause paralysis or death. Therefore, you will have to clear the airways in another way. Kneel behind the victim's head with your elbows on the ground.

Curl your index fingers over your jaw near your ears. With a strong movement, lift your jaw up and out. This will open the airway without moving the neck.

Make sure the victim's airway is open.

Bend toward his mouth and nose, looking toward his feet. Listen to see if there is a sound from the movement of air, or try to catch it with your cheek, see if the chest is moving.

Start artificial respiration.

If no breath is caught after opening the airway, use the mouth-to-mouth method. Pinch your nostrils with the index finger and thumb of the hand that is on the victim's forehead. Take a deep breath and close the victim's mouth tightly with your lips.

Take two full breaths. After each exhalation, inhale deeply as the victim's chest collapses. This will also prevent abdominal swelling. Each breath should last one and a half to two seconds.

Check the victim's reaction.

To make sure there is a result, see if the victim's chest rises. If not, move his head and try again. If after that the chest is still motionless, it is possible that a foreign body (for example, dentures) is blocking the airway.

To release them, you need to push the stomach. Place one hand with the base of the palm on the middle of the abdomen, between the navel and chest. Place your other hand on top and interlace your fingers. Lean forward and make a short, sharp push up. Repeat up to five times.

Check your breathing. If he is still not breathing, repeat pushing until the foreign body is pushed out of the airway or help arrives. If the foreign body has come out of the mouth but the person is not breathing, their head and neck may be in the wrong position, causing the tongue to block the airway.

In this case, move the victim's head by placing your hand on the forehead and tilting it back. When pregnant and overweight, use chest thrusts instead of abdominal thrusts.

Restore blood circulation.

Keep one hand on the victim's forehead to keep the airway open. With your other hand, check the pulse in your neck by feeling the carotid artery. To do this, put your index and middle fingers in the hole between the larynx and the muscle following it. Wait 5-10 seconds to feel your pulse.

If there is a pulse, do not compress your chest. Continue artificial respiration at a rate of 10-12 exhalations per minute (one every 5 seconds). Check your pulse every 2-3 minutes.

If there is no pulse, and help has not yet arrived, proceed to squeezing the chest.

Spread your knees for a secure nap. Then, with the hand closest to the victim’s legs, feel the lower edge of the ribs. Run your fingers along the edge to feel where the ribs meet the sternum. Place your middle finger on this place, next to it your index finger.

It should be located above the lowest point of the sternum. Place the heel of your other palm on your sternum next to your index finger. Remove your fingers and place this hand on top of the other. Fingers should not rest on the chest. If the arms are positioned correctly, all effort should be concentrated on the sternum.

This reduces the risk of a rib fracture, lung puncture, or liver rupture. Elbows tight, arms straight, shoulders directly above your hands - you're ready. Using your body weight, press the victim's sternum 4-5 centimeters. You need to press with the heels of your palms.

After each compression, release the pressure so that the chest returns to its normal position. This gives the heart a chance to fill with blood. To avoid injury, do not change the position of your hands when pressing. Make 15 presses at a rate of 80-100 presses per minute. Count “one-two-three...” until 15. Press the count, release for a break.

Alternate compression and artificial respiration. Now take two breathing movements. Then find the correct position for your hands again and do another 15 presses. After four complete cycles of 15 compressions and two breaths, check the carotid pulse again. If it is still not there, continue NMS in cycles of 15 presses and two breathing movements, starting with inhalation.

Watch for reactions. Check your pulse and breathing every 5 minutes. If the pulse is palpable, but breathing is not heard, take 10-12 breathing movements per minute and check the pulse again. If there is both a pulse and breathing, check them more closely. Continue NMS until the following occurs:

the victim’s pulse and breathing will be restored;
doctors will arrive;
You will get tired.

Features of resuscitation in children

In children, resuscitation techniques differ from those in adults. The chest of babies under one year old is very tender and fragile, the heart area is smaller than the base of the palm of an adult, so pressure during indirect cardiac massage is performed not with the palms, but with two fingers.

The movement of the chest should be no more than 1.5–2 cm. The frequency of compressions is at least 100 per minute. At the age of 1 to 8 years, massage is done with one palm. The chest should move 2.5–3.5 cm. Massage should be performed at a frequency of about 100 pressures per minute.

The ratio of inhalation to compression on the chest in children under 8 years old should be 2/15, in children over 8 years old - 1/15. How to do artificial respiration for a child? For children, artificial respiration can be performed using the mouth-to-mouth technique. Since babies have small faces, an adult can perform artificial respiration by immediately covering both the child’s mouth and nose. Then the method is called "from mouth to mouth and nose."

Artificial respiration for children is done at a frequency of 18-24 per minute. In infants, indirect cardiac massage is performed with only two fingers: the middle and ring fingers. The frequency of massage pressure in infants should be increased to 120 per minute.

The causes of cardiac and respiratory arrest can be not only injuries or accidents. A baby's heart may stop due to congenital diseases or sudden death syndrome. In preschool children, only the base of one palm is involved in the process of cardiac resuscitation.

There are contraindications for performing chest compressions:

penetrating wound to the heart;
penetrating injury to the lung;
closed or open traumatic brain injury;
absolute absence of a hard surface;
other visible wounds incompatible with emergency resuscitation.

Without knowing the rules for resuscitation of the heart and lungs, as well as existing contraindications, you can aggravate the situation even further, leaving the victim no chance of salvation.

External massage for a baby

Carrying out indirect massage for babies is as follows:

Shake the baby gently and say something loudly.

His reaction will allow you to make sure that you are not going to give NMS to a conscious baby. Quickly check for injuries. Focus on the head and neck as you will be manipulating these parts of the body. Call an ambulance.

If possible, have someone else do this. If you are alone, do NMS for one minute, and only then call professionals.

Clear your airways. If the baby is choking or has something stuck in the airway, give 5 chest thrusts.

To do this, place two fingers between his nipples and push quickly in an upward direction. If you are concerned about head or neck injury, move your baby as little as possible to reduce the risk of paralysis.

Try to regain your breathing.

If the baby is unconscious, open the baby's airway by placing one hand on the forehead and gently lifting the chin with the other to allow air to flow. Do not press on the soft tissue under the chin, as this may block the airway.

The mouth should be slightly open. Make two mouth-to-mouth breathing movements. To do this, inhale and tightly close the baby's mouth and nose with your mouth. Gently exhale some air (a baby's lungs are smaller than an adult's). If the chest rises and falls, the amount of air appears to be appropriate.

If the baby does not start breathing, move his head slightly and try again. If nothing has changed, repeat the airway opening procedure. After removing objects blocking the airway, check your breathing and pulse.

Continue NMS if necessary. Continue artificial respiration with one breath every 3 seconds (20 breaths per minute) if the infant has a pulse.

Restore blood circulation.

Check the pulse at the brachial artery. To find it, feel the inside of your upper arm, above the elbow. If there is a pulse, continue artificial respiration, but do not compress the chest.

If the pulse cannot be felt, begin to compress the chest. To determine the position of your baby's heart, draw an imaginary horizontal line between the nipples.

Place three fingers below and perpendicular to this line. Raise your index finger so that your two fingers are one finger below the imaginary line. Press them on the sternum so that it drops 1-2.5 cm.

Alternate compressions and artificial respiration. After five presses, make one breathing movement. In this way, you can do about 100 presses and 20 breathing movements. Do not stop NMS until the following occurs:
- the baby will begin to breathe on his own;
- he will have a pulse;
- doctors will arrive;
- You will get tired.

Having laid the patient on his back and throwing his head back as much as possible, you should twist the roller and place it under the shoulders. This is necessary in order to fix the position of the body. You can make a roller yourself from clothes or a towel.

You can perform artificial respiration:

from mouth to mouth;
from mouth to nose.

The second option is used only if it is impossible to open the jaw due to a spasmodic attack. In this case, you need to press the lower and upper jaws so that the air does not escape through the mouth. You also need to clasp your nose tightly and blow in air not sharply, but energetically.

When performing the mouth-to-mouth method, one hand should cover the nose and the other should fix the lower jaw. The mouth should fit tightly against the victim's mouth so that there is no leakage of oxygen.

It is recommended to exhale air through a handkerchief, gauze or napkin with a hole in the middle measuring 2-3 cm. The exhalation should not be sharp, since the esophagus may open under the influence of a strong jet. This means that air will enter the stomach.

The person carrying out resuscitation measures of the lungs and heart must take a deep, long breath, hold the exhalation and lean towards the victim. Place your mouth tightly against the patient's mouth and exhale. If the mouth is not pressed tightly or the nose is not closed, then these actions will not have any effect.

The air supply by the rescuer's exhalation should last for about 1 second, the approximate volume of oxygen being 1 to 1.5 liters. Only with this volume can lung function resume.

After this, you need to free the victim’s mouth. In order for a full exhalation to take place, you need to turn his head to the side and slightly raise the shoulder of the opposite side. This takes about 2 seconds.

If pulmonary measures are carried out effectively, the victim's chest will rise when inhaling. You should also pay attention to the stomach, it should not be swollen. When air enters the stomach, you need to press under the stomach so that it comes out, as this complicates the entire process of revival.

Pericardial stroke

If clinical death occurs, a pericardial stroke can be applied. It is such a blow that can start the heart, as there will be a sharp and strong impact on the sternum.

To do this, you need to clench your hand into a fist and strike with the edge of your hand in the area of the heart. You can focus on the xiphoid cartilage; the blow should fall 2-3 cm above it. The elbow of the hand that will strike should be directed along the body.

Often this blow brings victims back to life, provided that it is delivered correctly and in a timely manner. The heartbeat and consciousness can be restored instantly. But if this method does not restore function, artificial ventilation and chest compressions should be immediately applied.

Signs of effectiveness when following the rules for performing artificial respiration are as follows:

When artificial respiration is performed correctly, you may notice the chest moving up and down during passive inspiration.
If the movement of the chest is weak or delayed, you need to understand the reasons. Probably a loose fit of the mouth to the mouth or nose, a shallow breath, a foreign body preventing the air from reaching the lungs.
If, when you inhale air, it is not the chest that rises, but the stomach, then this means that the air did not go through the airways, but through the esophagus. In this case, you need to put pressure on the stomach and turn the patient's head to one side, as vomiting is possible.

The effectiveness of cardiac massage also needs to be checked every minute:

If, when performing an indirect cardiac massage, a push appears on the carotid artery, similar to a pulse, then the pressing force is sufficient for blood to flow to the brain.
If resuscitation measures are performed correctly, the victim will soon experience heart contractions, blood pressure will rise, spontaneous breathing will appear, the skin will become less pale, and the pupils will narrow.

All actions must be completed for at least 10 minutes, or better yet, before the ambulance arrives. If the heartbeat persists, artificial respiration must be performed for a long time, up to 1.5 hours.

If resuscitation measures are ineffective within 25 minutes, the victim has cadaveric spots, a symptom of a “cat” pupil (when pressure is applied to the eyeball, the pupil becomes vertical, like a cat’s) or the first signs of rigor - all actions can be stopped, since biological death has occurred.

The sooner resuscitation is started, the greater the likelihood of a person returning to life. Their correct implementation will help not only restore life, but also provide oxygen to vital organs, prevent their death and disability of the victim.

How to do a massage correctly To achieve the exceptional effectiveness of indirect cardiac massage, namely the resumption of normal blood circulation and the air exchange process, and bringing a person to life through tactile acupressure on the heart through the chest, you need to follow some simple recommendations:

Act confidently and calmly, do not fuss.
In view of self-doubt, do not leave the victim in danger, namely, it is imperative to carry out resuscitation measures.
Quickly and carefully carry out preparatory procedures, in particular, freeing the oral cavity from foreign objects, tilting the head back to the position necessary for artificial respiration, freeing the chest from clothing, and a preliminary examination for the detection of penetrating wounds.
Do not tilt the victim's head back excessively, as this can lead to obstruction of the free flow of air into the lungs.
Continue resuscitation of the victim's heart and lungs until the arrival of doctors or rescuers.

In addition to the rules for conducting an indirect heart massage and the specifics of behavior in an emergency, do not forget about personal hygiene measures: you should use disposable napkins or gauze during artificial respiration (if any).

The phrase “saving lives is in our hands” in cases of need to immediately perform an indirect heart massage on an injured person who is on the verge of life and death takes on a direct meaning.

When carrying out this procedure, everything is important: the position of the victim and, in particular, his individual parts of the body, the position of the person performing indirect heart massage, clarity, regularity, the timeliness of his actions and absolute confidence in a positive outcome.

When to stop resuscitation?

It should be noted that cardiopulmonary resuscitation should be continued until the arrival of the medical team. But if the heartbeat and lung function have not recovered within 15 minutes of resuscitation, then they can be stopped. Namely:

when there is no pulse in the area of the carotid artery in the neck;
breathing is not performed;
pupil dilation;
the skin is pale or bluish.

And of course, cardiopulmonary resuscitation is not performed if a person has an incurable disease, for example, oncology.