How artificial respiration and heart massage are performed. Indirect heart massage and artificial respiration - rules and techniques for its implementation

Each of us is not immune from the situation when a loved one or just a passerby receives an electric shock, heat stroke, which leads to respiratory arrest, and often to the cessation of the heart. In such a situation, a person's life will depend only on the instant reaction and assistance provided. Schoolchildren should already know what artificial heart massage is and with which you can bring the victim back to life. Let's figure out what these tricks are and how to properly apply them.

Reasons for stopping breathing

Before dealing with first aid, it is necessary to find out in what situations breathing can stop. The main reasons for this condition include:

suffocation, which is the result of inhaling carbon monoxide or attempting suicide by hanging;
drowning;
electric shock;
severe cases of poisoning.

These reasons are the most common in medical practice. But you can name others - in life, what just does not happen!

Why is it necessary

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

If first aid, artificial respiration and heart massage are not provided in a timely manner, then a person who has returned to life can no longer be called a full-fledged person. The death of brain cells will subsequently lead to the fact that this organ will no longer be able to work 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 do artificial respiration and heart massage is taught at a secondary school in biology lessons. Only most people are sure that they will never get into such a situation, so they don’t really delve into the intricacies of such manipulations.

Finding themselves in such a situation, many are lost, unable to orient themselves, and precious time is running out. Resuscitation of adults and children has its own differences. And they are worth knowing. Here are some features of resuscitation in adults:

When all these factors are taken into account, you can proceed to resuscitation, if necessary.

Actions before artificial respiration

Quite often, a person loses consciousness, but breathing is preserved. In such a situation, it must be taken 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, which will lead to suffocation.

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

After that, it is necessary to check whether spontaneous breathing has resumed. Almost all of the films or biology lessons know that for this it is enough to bring a mirror to your mouth or nose - if it is fogged up, then the person is breathing. In the absence of a mirror, you can use the phone screen.

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

If the victim is not breathing due to drowning, suffocation with a rope or a foreign body, an urgent need to remove a foreign object and clean the oral cavity if necessary.

If all the procedures are carried out, and breathing has not recovered, it is necessary to immediately perform artificial respiration, heart massage, if it has stopped working.

Rules for performing artificial respiration

If all the causes that caused the respiratory arrest are eliminated, but it has not recovered, then it is urgently necessary to start resuscitation. Artificial respiration can be carried out by different methods:

inhalation of air into the mouth of the victim;
blowing into the nose.

The first method is most often used. Unfortunately, not everyone knows how to do artificial respiration and heart 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 you will have to urgently do a closed heart massage and artificial respiration at the same time.

Artificial respiration technique " mouth in nose»

This method of resuscitation is considered the most effective, as it reduces the risk of air entering the stomach. The procedure for this 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 heart muscle massage

Most often, artificial heart massage and artificial respiration are combined in first aid. Almost everyone imagines 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, while supplying 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 expand and venous blood enters the atria.

Thus, blood flows through the body, which carries everything the brain needs.

Algorithm for conducting cardiac resuscitation

In order for cardiac resuscitation to be 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 trousers for men must also be removed.

the point is located at the intersection of the inter-nipple line and the middle of the sternum;
it is necessary to retreat from the chest by the thickness of two fingers to the head - this will be the desired point.

After determining the desired pressure point, you can proceed to resuscitation.

Technique of heart massage and artificial respiration

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

It must be taken into account that artificial respiration and chest compressions require considerable effort, so it is advisable that there is someone else nearby who can take over and provide assistance.

Features of helping children

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

Signs of Effective Help

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

there is a pupillary reaction to light;
the skin becomes pinkish;
a pulse is felt on the peripheral arteries;
the victim begins to breathe on his own and regains consciousness.

If artificial heart massage and artificial respiration do not give a result 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 for resuscitation

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

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

We figured out how to do artificial respiration and heart 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 life:

If something does not work out with artificial respiration, then you can and should continue to do heart massage.
In most adults, breathing stops due to the cessation of the myocardium, 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.

Everyone can find themselves in a situation where a person walking nearby loses consciousness. We immediately have a panic that needs to 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.

In the absence of a pulse and breathing, it is necessary to take immediate action, provide air access and rest of the patient, and also call an ambulance team. We will tell you how and when to perform chest compressions and artificial respiration.

Chest compressions 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, gases are exchanged: 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 into the tissues. And the tissues “give away” 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:

Asystole of the ventricles.
Paroxysmal tachycardia.
ventricular fibrillation, etc.

Predisposing factors include:

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 blocked airways 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.
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.
Pupils constrict.

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. In the cells there is an accumulation of metabolic products, and in the blood - carbon dioxide. This leads to a stoppage 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 circulatory arrest. For example, for brain cells, this is 3-4 minutes. Cases of revival after 15 minutes refer to situations when, before cardiac arrest, the person was in a state of cooling.

An indirect heart massage involves squeezing the chest, which must be done to compress the chambers of the heart. At this time, blood through the valves enters the ventricles from the atria, then it is sent to the vessels. Due 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 to restore the independent work of the organ. First aid can bring results in the first 30 minutes after the onset of clinical death. The main thing is to correctly follow the algorithm of actions, follow the approved first aid technique.

Massage in the heart area must be combined with mechanical ventilation. Each punching of the chest of the victim, 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 squeezing / releasing the chest, an active inhalation is performed, then a passive exhalation.

What is direct and indirect heart massage

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

open (direct).
closed (indirect) method.

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

Indirect cardiac massage is much easier and more affordable 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, squeeze the heart and force the blood out of its cavities into the vessels.

When the pressure on the sternum ceases, the cavities of the heart expand, and blood is sucked into them from the veins. By indirect heart massage, it is possible to maintain pressure in the systemic circulation at the level of 60-80 mm Hg. Art.

The method of indirect heart massage is as follows: the assisting person puts 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. On the sternum produce 50-60 pressures per minute in the form of quick shocks.

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

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

When and why is heart massage done?

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

Situations where cardiac arrest is possible:

Drowning,
traffic accident,
electric shock,
fire damage,
The result of various diseases,
Finally, no one is immune from cardiac arrest for unknown reasons.

Cardiac arrest symptoms:

Loss of consciousness.
Absence of a pulse (usually it can be felt on the radial or carotid artery, that is, at the wrist and on the neck).
Absence of breath. The most reliable way to determine this is to hold a mirror up 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 eyes a little and shine a flashlight, it will immediately be clear whether they react to light or not. If a person's heart is working, then the pupils will immediately narrow.
Gray or blue complexion.

Chest compression (CCM) is a resuscitation procedure that saves many lives every day around the world. The sooner you start doing NMS to the victim, the more chances he has to survive.

NMS includes two methods:

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

If a person has a pulse but is not breathing, they need artificial respiration but not chest compressions (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 circulation.

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

External cardiac massage is represented by rhythmic squeezing of the heart through compressions performed between the sternum and spine. It is not difficult for victims who are in a state of clinical death to perform chest compressions. This is due to 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 assisting, following the technique, easily displaces the victim's chest by 3-5 cm. Each contraction of the heart provokes a decrease in its volume, an increase in intracardiac pressure.

Due to the implementation of rhythmic pressures on the chest area, a difference in pressure arises inside the heart cavities that extend from the heart muscle of the blood vessels. Blood from the left ventricle travels down the aorta to the brain, while blood from the right ventricle travels to the lungs, where it is oxygenated.

After the cessation of pressure on the chest, the heart muscle expands, intracardiac pressure decreases, and the heart chambers fill with blood. External heart massage helps to recreate artificial circulation.

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

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 puts the palm of one hand on the other hand. After that, the specialist begins to perform uniform shocks until signs of restoration of blood circulation 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 caregiver must determine the location of the xiphoid process.
Determination of the compression point, which is located in the center of the axis, of the finger 2 above the xiphoid process.
Place the base of the palm on the calculated compression point.
Perform compression along the vertical axis, without sudden movements. Compression of the chest should be performed to a depth of 3 - 4 cm, the number of compressions per chest area - 100 / minute.
For children under one year old, resuscitation is performed with two fingers (second, third).
When performing resuscitation to young children under one year old, the frequency of pressing on the sternum should be 80 - 100 per minute
Adolescent children are helped with the palm of one hand.
Adults are resuscitated in such a way that the fingers are raised and do not touch the chest area.
It is necessary to perform an alternation of two breaths of mechanical ventilation and 15 compressions on the chest area.
During resuscitation, it is necessary to monitor the pulse on the carotid artery.

Signs of the effectiveness of resuscitation are the reaction of the pupils, the appearance of a pulse in the carotid artery. The method of conducting an indirect heart massage:

put the victim on a hard surface, the resuscitator is 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 the palms rhythmically, in jerks, using the weight of one's own body and the efforts of both hands;
if during an indirect heart massage a fracture of the ribs occurs, it is necessary to continue the massage by placing the base of the palms on the sternum;
the pace of massage is 50-60 strokes per minute; in an adult, the amplitude of chest oscillations should be 4-5 cm.

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

For children, massage is performed carefully, with the brush of 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 do heart massage in an adult

Stages of implementation:

Get ready. Gently shake the casualty by the shoulders and ask, "Is everything all right?" This way you make sure that you are not going to do NMS to a person who is conscious.
Quickly check if he has any serious injuries. Focus on the head and neck as you will be manipulating them.
Call an ambulance if possible.
Lay the victim on their 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 release 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 up. Keep your mouth open so your teeth are almost touching. Do not place your fingers on the soft tissues under the chin - you may inadvertently block the airway you are trying to clear.

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

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

Keep the victim's airway open.

Bend over to his mouth and nose, looking towards his legs. 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.

Begin 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 your mouth tightly with your lips.

Take two full breaths. After each exhalation, inhale deeply as the victim's chest collapses. It will also prevent swelling of the abdomen. 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 make pushes in 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 breath. 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 circulation.

Keep one hand on the victim's forehead to keep the airway open. With the other hand, check the pulse in the neck by feeling for 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 the pulse.

If there is a pulse, do not squeeze your chest. Continue artificial respiration at a rate of 10-12 breaths 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 safe time. Then with the hand that is closer to the victim's legs, feel for the lower edge of the ribs. Move your fingers along the edge to feel where the ribs meet the sternum. Put your middle finger in this place, next to it forefinger.

It should be above the lowest point of the sternum. Place the base of your other hand 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 hands lie correctly, all the effort should be concentrated on the sternum.

This reduces the risk of rib fracture, lung puncture, liver rupture. Elbows tense, arms straight, shoulders directly over the arms - you are ready. Using body weight, press the victim's sternum 4-5 centimeters. You need to press with the bases of the palms.

After each press, 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 the hands when pressing. Do 15 clicks at the rate of 80-100 clicks per minute. Count "one-two-three ..." to 15. Click on the count, release for a break.

Alternate compression and artificial respiration. Now take two breaths. Then again find the correct position for the hands and do another 15 clicks. After four complete cycles of 15 compressions and two breaths, check the carotid pulse again. If it's still not there, continue with NMS cycles of 15 compressions and two breaths, starting with a breath.

Watch for reactions. Check your pulse and breathing every 5 minutes. If a pulse is felt but no breathing is heard, take 10-12 breaths 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

The movement of the chest should be no more than 1.5-2 cm. The frequency of pressing 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 chest compressions 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 a small face, an adult can carry out artificial respiration covering both the mouth and nose of the child at once. 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 heart massage is carried out 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 an accident. An infant's heart may stop due to congenital diseases or sudden death syndrome. In preschool children, the base of only one palm is involved in the process of cardiac resuscitation.

There are contraindications for indirect heart massage:

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

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

External baby massage

Conducting indirect massage for babies is as follows:

Gently shake the baby and say something out loud.

His reaction will allow you to make sure that you are not going to do NMS on 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, ask someone to do it. If you are alone, do NMS for one minute, and only then call the professionals.

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

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

Try to get your breath back.

If the infant is unconscious, open his airway by placing one hand on his forehead and gently lift his chin with the other to allow air to enter. Do not apply pressure to the soft tissues under the chin as this may block the airway.

The mouth must be open. Take two mouth-to-mouth breaths. To do this, inhale, tightly close your mouth and nose of the baby with your mouth. Gently exhale some air (the lungs of an infant are smaller than those of an adult). If the chest rises and falls, then the amount of air seems to be appropriate.

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

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

Restore circulation.

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

If the pulse is not felt, begin to squeeze the chest. To determine the position of the 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 two fingers are one finger below the imaginary line. Press them on the sternum so that it drops 1-2.5 cm.

Alternate pressing and artificial respiration. After five presses, take one breath. Thus, you can do about 100 clicks and 20 breathing movements. Do not stop NMS until the following happens:
- the baby will begin to breathe on its own;
- he will have a pulse;
- doctors will arrive;
- You will get tired.

Having laid the patient on his back and throwing his head as far 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. The roller can be made independently from clothes or towels.

You can do 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 tightly grab your nose and blow in air not abruptly, but vigorously.

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 snugly 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 of 2-3 cm. And this means that air will enter the stomach.

The person conducting resuscitation of the lungs and heart should take a deep long breath, hold the exhalation and bend over to the victim. Place your mouth tightly against the patient's mouth and exhale. If the mouth is loosely pressed or the nose is not closed, then these actions will not have any effect.

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

After that, you need to free the mouth of the victim. 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, then the victim's chest will rise when inhaling. You should also pay attention to the stomach, it should not swell. When air enters the stomach, it is necessary to press under the spoon so that it comes out, as this makes the whole process of revitalization difficult.

Pericardial beat

If clinical death has occurred, a pericardial blow can be applied. It is such a blow that can start the heart, as there will be a sharp and strong effect 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 region of the heart. You can focus on the xiphoid cartilage, the blow should fall 2-3 cm above it. The elbow of the arm that will strike should be directed along the body.

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

Signs of effectiveness, subject to the rules for performing artificial respiration, are as follows:

When artificial respiration is performed correctly, you can notice the movement of the chest 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 to the nose, a shallow breath, a foreign body that prevents air from reaching the lungs.
If, when inhaling 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 heart massage should also be checked every minute:

If, when performing an indirect heart massage, a push appears on the carotid artery, similar to a pulse, then the pressing force is sufficient so that blood can flow to the brain.
With the correct implementation of resuscitation measures, the victim will soon have heart contractions, pressure will rise, spontaneous breathing will appear, the skin will become less pale, the pupils will narrow.

You need to perform all the steps for at least 10 minutes, and preferably before the ambulance arrives. With a persistent heartbeat, artificial respiration should 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's" pupil (when pressing on the eyeball, the pupil becomes vertical, like a cat's) or the first signs of rigor mortis - 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 bring back to 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 an indirect heart massage, namely the resumption of normal blood circulation and the process of air exchange, and bringing a person to life by tactile acupressure on the heart through the chest, you must 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 CPR?

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 carotid artery in the neck;
breathing is not performed;
pupil dilation;
skin is pale or bluish.

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

Call an ambulance before attempting to revive the victim.

If there is no certainty that the patient is breathing on his own, he should immediately do artificial respiration, without wasting precious time on “experiments” with a mirror: will it fog up if it is brought to the patient’s mouth or not.

ABC of ABC revival -

- an algorithm of science-based and alphabetically simple resuscitation techniques available to every person in a domestic environment.
The revival of a person according to the ABC program is carried out in three steps, which are performed in strict sequence.

A - restoration of airway patency.

1. Lay the patient on his back.

2. Tilt his head as far back as possible.

3. Push the lower jaw of the patient as far forward as possible (the teeth of the lower jaw are located in front of the upper teeth).

4. Wrap the finger of your hand with a handkerchief (bandage).
With quick circular movements, carefully free the patient's oral cavity from objects that prevent him from breathing (sand, food, dentures, vomit, sunken tongue, etc.).
Make sure the airways are clear. Proceed to step B.

B - artificial respiration by the method "mouth to mouth" (or "mouth to nose").

Breathing "mouth to nose" is done with injuries to the lower part of the face. In this case, the victim's mouth is clamped, a tissue is placed on the nose with a hole and air is blown into the patient's nostrils.

1. Bite through the middle of a handkerchief (any thin piece of fabric, bandage) hole and tear it with your fingers up to 2-4 cm.

2. Place the tissue with a hole on the patient's mouth.

3. Pinch the patient's nose.
Take a deep breath. Hermetically press your lips to his face through the tissue and on a long (≈1 sec) exhalation, avoiding air leakage through the nose or corners of the mouth, blow air into the victim's mouth through the tissue hole.

4. The fidelity of the rescuer's actions is determined by the fact that the patient's chest rises, but not his stomach.

5. The time of "exhalation" of the patient lasts twice as long as his "inhalation". During this pause, the rescuer takes two or three deep breaths "for himself."

When breathing stops, circulatory disorders and cardiac arrest quickly develop. Therefore, when artificial respiration is performed, as a rule, an external heart massage is performed at the same time.

C - external cardiac massage.

1. Place the crossed palms of the hands strictly in the middle of the sternum, in its lower third.

2. Rhythmically, vigorously press on the sternum with all the weight of your body. In order not to break the patient's ribs, the pressure force must be applied strictly in the center of the sternum, but not on its lateral surfaces.

When the heart is compressed between the sternum and the spine, blood is expelled from it. During the pause, the chest expands and the heart fills with blood again. External heart massage can satisfactorily maintain the patient's blood circulation for about an hour.

How to effectively carry out the resuscitation of the patient alone?

B:S=2:15

It is difficult to do artificial respiration and chest compressions alone. Therefore, it is recommended to do 15 chest compressions every 2 quick blows of air into the lungs of the victim with an interval of 1 second.

How rationally to revive the patient to two rescuers?

B:C=1:5

One person performs artificial respiration, the second - an indirect heart massage.
The first person makes one breath of air into the lungs of the patient. Then the second - makes five pressures on his sternum.

The actions of both rescuers must be coordinated. It is impossible to compress the chest while blowing air into the lungs - there will be no benefit from such a “breath”, but there is a high risk of rupture of the lung.

If the patient does not show signs of life, perform resuscitation until the ambulance arrives.

The expression "breathe life" came to us from ancient times. Humanity has been using the technique of resuscitating a patient with the help of artificial respiration for more than five thousand years.

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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 the technique of which is described in this publication. Having studied some methods of its application, you can save a human life.

Performing chest compressions

First of all, they determine the sudden absence 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 place where the victim was found, 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.

Sequencing

To begin with, the place of compression in the lower third of the sternum is determined.
They have one hand with a protrusion of the palmar surface (“fifth hand”) almost on the lowest part of the sternum. The other hand is placed on top of it in the same way. It is possible to place the palms according to the principle of the castle.
Squeezing movements are performed with arms straightened at the elbows, while transferring the weight of your body when pressed. When performing compression, the hands are not torn off the chest.
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 performed, then for 30 compressions there should be two respiratory movements.

It is highly desirable that the periods of pressure on the sternum and the absence of compression are the same in time.

Nuances

An indirect heart 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 8-10 breaths per minute are performed.

Compression of the sternum in children under ten to twelve years of age is performed with one hand, and the ratio of the number of compressions should be 15:2.

Since rescuer fatigue can lead to reduced compression quality and patient death, 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 an indirect heart massage require to ensure the patency of the respiratory system.

In individuals with a lack of consciousness, muscular atony and obstruction of the airways by the epiglottis and the root of the tongue develop. 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 actions are preceded by an indirect heart massage:

"Triple take" and tracheal intubation are the gold standard in the course of respiratory recovery.

"Triple Take"

Safar has developed three sequential actions that improve the effectiveness of resuscitation:

Tilt your head back.
Open the patient's mouth.
Push the patient's lower jaw forward.

When such a heart massage and artificial respiration are performed, the anterior muscles of the neck are stretched, after which the trachea opens.

Caution

We must be careful and careful, because it is possible to damage the spine in the neck when performing actions on the airways.

Spinal injuries are most likely to occur in two groups of patients:

victims of road accidents;
in the event of a fall from a height.

Such patients can not bend the neck, turn the head to the 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 oral cavity, its revision

The patency of the airways after tilting the head is not always fully restored, because in some unconscious patients with atony of the muscles, 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, false teeth)
Therefore, at first, in such patients, the oral cavity is examined and freed from foreign objects.

To open the mouth, use the "reception of crossed fingers." The doctor stands near the patient's head, 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 pharynx.

An attempt is made with air ducts (no more than 30 seconds). If the goal is not achieved, stop trying and continue to carry out mechanical ventilation with a face mask or The mouth-to-mouth, mouth-to-nose techniques are also used. Heart 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), since it can cause complications in the form of reflux from the stomach and ingestion or entry into the lungs of its contents. In addition, excessive ventilation increases pressure in the chest cavity, which in turn reduces venous return to the heart and survival from sudden cardiac arrest.

Often the life and health of an injured person depends on how correctly first aid is provided to him.

According to statistics, in case of cardiac arrest and respiratory functions, it is first aid that increases the chance of survival by 10 times. After all, oxygen starvation of the brain for 5-6 minutes. leads to irreversible death of brain cells.

Not everyone knows how resuscitation is carried out if the heart stops and there is no breathing. And in life, this knowledge can save a person's life.

Causes and signs of cardiac and respiratory arrest

The reasons that led to cardiac arrest and breathing can be:

Before starting resuscitation measures, it is necessary to assess the risks for the victim and voluntary assistants - is there a threat of collapse of the building, explosion, fire, electric shock, gas contamination of the room. If there is no threat, then you can save the victim.

First of all, it is necessary to assess the patient's condition:

The person should be hailed, asked questions. If he is conscious, then it is worth asking about his condition, well-being. In a situation where the victim is unconscious, fainting, it is necessary to conduct an external examination and assess his condition.

The main sign of the absence of a heartbeat is the absence of pupillary reaction to light rays. In the normal state, the pupil constricts under the influence of light and expands when the light intensity decreases. Extended indicates dysfunction of the nervous system and myocardium. However, the violation of the reactions of the pupil occurs gradually. The complete absence of the reflex occurs 30-60 seconds after a complete cardiac arrest. Some medications, narcotic substances, and toxins can also affect the latitude of the pupils.

The work of the heart can be checked by the presence of tremors of blood in large arteries. It is not always possible to feel the pulse of the victim. The easiest way to do this is on the carotid artery, located on the side of the neck.

The presence of breathing is judged by the noise coming out of the lungs. If breathing is weak or absent, then characteristic sounds may not be heard. It is not always at hand to have a fogging mirror, through which it is determined whether there is breathing. Chest movement may also be imperceptible. Leaning towards the mouth of the victim, note the change in sensations on the skin.

A change in the shade of the skin and mucous membrane from natural pink to gray or bluish indicates circulatory disorders. However, in case of poisoning with certain toxic substances, the pink color of the skin is preserved.

The appearance of cadaveric spots, waxy pallor indicates the inappropriateness of resuscitation. This is also evidenced by injuries and injuries incompatible with life. It is impossible to carry out resuscitation measures with a penetrating wound of the chest or broken ribs, so as not to pierce the lungs or heart with bone fragments.

After the condition of the victim has been assessed, resuscitation should immediately begin, since after the cessation of breathing and heartbeat, only 4-5 minutes are allotted for the restoration of vital functions. If it is possible to revive after 7-10 minutes, then the death of part of the brain cells leads to mental and neurological disorders.

Insufficiently prompt assistance can lead to permanent disability or death of the victim.

Resuscitation algorithm

Before starting resuscitation pre-medical measures, it is recommended to call an ambulance team.

If the patient has a pulse, but he is in a deep fainting state, he will need to be laid on a flat, hard surface, the collar and belt should be relaxed, turning his head to one side to exclude aspiration in case of vomiting, if necessary, it is necessary to clear the airways and oral cavity from accumulated mucus, and vomiting.

It should be noted that after cardiac arrest, breathing can continue for another 5-10 minutes. This is the so-called "agonal" breathing, which is characterized by visible movements of the neck and chest, but low productivity. Agony is reversible, and with properly performed resuscitation, the patient can be brought back to life.

If the victim does not show any signs of life, then the rescuing person must perform a series of the following steps in stages:

Resuscitating the patient, periodically check the patient's condition - the appearance and frequency of the pulse, the light response of the pupil, breathing. If the pulse is palpable, but there is no spontaneous breathing, the procedure must be continued.

Only when breathing appears can resuscitation be stopped. In the absence of a change in state, resuscitation is continued until the arrival of the ambulance. Only a doctor can give permission to end the resuscitation.

The technique of carrying out respiratory resuscitation

Restoration of respiratory function is carried out by two methods:

Both methods do not differ in technique. Before starting resuscitation, the patient's airway is restored. For this purpose, the mouth and nasal cavity are cleaned of foreign objects, mucus, and vomit.

If there are dentures, they are removed. The tongue is pulled out and held to avoid blocking the airways. Then proceed to the actual resuscitation.

The mouth-to-mouth method

The victim is held by the head, placing 1 hand on the forehead of the patient, the other - pressing the chin.

The patient's nose is squeezed with fingers, the resuscitator takes the deepest possible breath, presses his mouth tightly against the patient's mouth and exhales air into his lungs. If the manipulation is carried out correctly, then the chest rise will be noticeable.

The method of respiratory resuscitation by the method of "mouth to mouth"

If the movement is noted only in the abdomen, then the air has entered the wrong way - into the trachea, but into the esophagus. In this situation, it is important to ensure that air enters the lungs. 1 artificial breath is performed for 1 s, exhaling air strongly and evenly into the respiratory tract of the victim with a frequency of 10 “breaths” per 1 minute.

Mouth to nose technique

The mouth-to-nose resuscitation technique completely coincides with the previous method, except that the resuscitator exhales into the patient's nose, tightly clamping the victim's mouth.

After artificial inhalation, air should be allowed to exit the patient's lungs.

The method of respiratory resuscitation by the method of "mouth to nose"

Respiratory resuscitation is carried out using a special mask from the first aid kit or by covering the mouth or nose with a piece of gauze or fabric, a scarf, but if they are not there, then there is no need to waste time looking for these items - rescue measures should be carried out immediately.

Method of cardiac resuscitation

To begin with, it is recommended to free the chest area from clothing. The caregiver is located to the left of the resuscitated. Perform mechanical defibrillation or pericardial shock. Sometimes this measure triggers a stopped heart.

If there is no reaction, then an indirect heart massage is performed. To do this, you need to find the place where the costal arch ends and place the lower part of the palm of the left hand on the lower third of the sternum, and put the right one on top, straightening the fingers and lifting them up (the "butterfly" position). The push is carried out with arms straightened in the elbow joint, pressing with all the weight of the body.

Stages of performing an indirect heart massage

The sternum is pressed to a depth of at least 3-4 cm. Sharp pushes are made with a frequency of 60-70 pressures per 1 minute. - 1 press on the sternum in 2 sec. Movements are performed rhythmically, alternating push and pause. Their duration is the same.

After 3 min. the effectiveness of the activity should be checked. The fact that cardiac activity has recovered is evidenced by probing the pulse in the carotid or femoral artery, as well as a change in complexion.

Carrying out simultaneous cardiac and respiratory resuscitation requires a clear alternation - 2 breaths per 15 pressures on the heart area. It is better if two people provide assistance, but if necessary, the procedure can be performed by one person.

Features of resuscitation in children and the elderly

In children and older patients, the bones are more fragile than in young people, so the force of pressing on the chest should be commensurate with these features. The depth of chest compression in elderly patients should not exceed 3 cm.

How to perform an indirect heart massage for an infant, child, adult?

In children, depending on the age and size of the chest, massage is carried out:

Newborns and infants are placed on the forearm, placing the palm under the back of the child and holding the head above the chest, slightly thrown back. The fingers are placed on the lower third of the sternum.

Also, in infants, you can use another method - the chest is covered with palms, and the thumb is placed in the lower third of the xiphoid process. The frequency of shocks varies in children of different ages:

Age (months/years)	The number of pressures in 1 min.	Depth of deflection (cm)
≤ 5	140	˂ 1.5
6-11	130-135	2-2,5
12/1	120-125	3-4
24/2	110-115	3-4
36/3	100-110	3-4
48/4	100-105	3-4
60/5	100	3-4
72/6	90-95	3-4
84/7	85-90	3-4

When performing resuscitation of breathing in children, it is done with a frequency of 18-24 "breaths" in 1 min. The ratio of resuscitation movements of the heart beat and "inspiration" in children is 30:2, and in newborns - 3:1.

The life and health of the victim depends on the speed of the start of resuscitation measures and the correctness of their implementation.

It is not worth it to stop the return of the victim to life on your own, since even medical workers cannot always determine the moment of death of the patient visually.

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If there is a pulse on the carotid artery, but there is no breathing, immediately begin artificial ventilation. First provide restoration of airway patency. For this the victim is placed on his back, head maximum tip back and, grabbing the corners of the lower jaw with your fingers, push it forward so that the teeth of the lower jaw are located in front of the upper ones. Check and clean the oral cavity from foreign bodies. To comply with security measures you can use a bandage, a napkin, a handkerchief wound around your index finger. With a spasm of the masticatory muscles, you can open your mouth with some flat, blunt object, such as a spatula or a spoon handle. To keep the victim's mouth open, a rolled bandage can be inserted between the jaws.

For artificial lung ventilation "mouth to mouth" it is necessary, while holding the victim's head thrown back, take a deep breath, pinch the victim's nose with your fingers, lean your lips tightly against his mouth and exhale.

During artificial lung ventilation "mouth to nose" air is blown into the nose of the victim, while covering his mouth with the palm of his hand.

After blowing in air, it is necessary to move away from the victim, his exhalation occurs passively.

To comply with safety and hygiene measures blowing should be done through a moistened napkin or a piece of bandage.

The frequency of injections should be 12-18 times per minute, that is, for each cycle you need to spend 4-5 seconds. The effectiveness of the process can be assessed by raising the chest of the victim when filling his lungs with blown air.

In that case, when the victim is both breathing and pulseless, urgent cardiopulmonary resuscitation is performed.

In many cases, restoration of cardiac function can be achieved by precordial beat. To do this, the palm of one hand is placed on the lower third of the chest and a short and sharp blow is applied to it with the fist of the other hand. Then, the presence of a pulse on the carotid artery is re-checked and, if it is absent, they begin to conduct chest compressions and artificial lung ventilation.

For this victim placed on a hard surface The person providing assistance places his palms folded in a cross on the lower part of the victim’s sternum and presses on the chest wall with energetic pushes, using not only his hands, but also his own body weight. The chest wall, shifting to the spine by 4-5 cm, compresses the heart and pushes the blood out of its chambers along the natural channel. In an adult human, such an operation must be carried out with frequency of 60 compressions per minute, that is, one pressure per second. In children up to 10 years massage is performed with one hand with a frequency 80 compressions per minute.

The correctness of the massage is determined by the appearance of a pulse on the carotid artery in time with pressing on the chest.

Every 15 pressures helping blows air into the victim's lungs twice in a row and again performs a heart massage.

If resuscitation is carried out by two people, then one of which carries out heart massage, the other is artificial respiration in mode one breath every five compressions on the chest wall. At the same time, it is periodically checked whether an independent pulse has appeared on the carotid artery. The effectiveness of the ongoing resuscitation is also judged by the narrowing of the pupils and the appearance of a reaction to light.

When restoring breathing and cardiac activity of the victim in an unconscious state, be sure to lay on the side to exclude his suffocation with his own sunken tongue or vomit. The retraction of the tongue is often evidenced by breathing, resembling snoring, and sharply difficult inhalation.

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What kind of poisoning can stop breathing and heartbeat

Death as a result of acute poisoning can happen from anything. The main causes of death in case of poisoning are the cessation of breathing and heartbeat.

Arrhythmias, atrial and ventricular fibrillation, and cardiac arrest can be caused by:

When is artificial respiration necessary? Respiratory arrest occurs due to poisoning:

In the absence of breathing or heartbeat, clinical death occurs. It can last from 3 to 6 minutes, during which there is a chance to save a person if you start doing artificial respiration and chest compressions. After 6 minutes, it is still possible to bring a person back to life, but as a result of severe hypoxia, the brain undergoes irreversible organic changes.

When to start resuscitation

What to do if a person falls unconscious? First you need to determine the signs of life. The heartbeat can be heard by putting your ear to the victim's chest or by feeling the pulse on the carotid arteries. Breathing can be detected by the movement of the chest, bending over to the face and listening for the presence of inhalation and exhalation, bringing the mirror to the nose or mouth of the victim (it will fog up when breathing).

If no breathing or heartbeat is detected, resuscitation should be started immediately.

How to do artificial respiration and chest compressions? What methods exist? The most common, accessible to everyone and effective:

external heart massage;
breathing "from mouth to mouth";
breathing from mouth to nose.

It is advisable to conduct receptions for two people. Heart massage is always performed together with artificial ventilation.

What to do if there are no signs of life

Free the respiratory organs (oral, nasal cavity, pharynx) from possible foreign bodies.
If there is a heartbeat, but the person is not breathing, only artificial respiration is done.
If there is no heartbeat, artificial respiration and chest compressions are performed.

How to do chest compressions

The technique of performing an indirect heart massage is simple, but requires the right actions.

Why is an indirect heart massage impossible if the victim lies on a soft one? In this case, the pressure will not be refused on the heart, but on a pliable surface.

Very often, with an indirect heart massage, ribs are broken. There is no need to be afraid of this, the main thing is to revive a person, and the ribs will grow together. But keep in mind that broken edges are most likely the result of improper execution and the pressing force should be moderated.

Age of the victim	How to press	pressure point	Pressing depth	Click frequency	Inhale/press ratio
Age up to 1 year	2 fingers	1 finger below the nipple line	1.5–2 cm	120 and more	2/15
Age 1-8		2 fingers from the sternum		100–120
Adult	2 hands	2 fingers from the sternum	5-6 cm	60–100	2/30

Artificial respiration from mouth to mouth

If in the mouth of a poisoned person there are secretions dangerous for the resuscitator, such as poison, poisonous gas from the lungs, an infection, then artificial respiration is not necessary! In this case, you need to limit yourself to an indirect heart massage, during which, due to pressure on the sternum, about 500 ml of air is ejected and again sucked in.

How to do mouth-to-mouth artificial respiration?

For your own safety, it is recommended that artificial respiration be best done through a napkin, while controlling the pressing density and preventing air from “leaking”. Exhalation should not be sharp. Only a strong, but smooth (within 1-1.5 seconds) exhalation will ensure the correct movement of the diaphragm and the filling of the lungs with air.

Artificial respiration from mouth to nose

Mouth-to-nose artificial respiration is performed if the patient cannot open his mouth (for example, due to spasm).

Having laid the victim on a straight surface, tilt his head back (if there are no contraindications for this).
Check the patency of the nasal passages.
If possible, the jaw should be extended.
After a maximum breath, you need to blow air into the nose of the injured person, tightly closing his mouth with one hand.
After one breath, count to 4 and take the next.

Features of resuscitation in children

In children, the resuscitation technique is different from that in adults. The chest of babies under one year old is very delicate and fragile, the heart area is smaller than the base of the palm of an adult, so pressure during indirect heart 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 pressing 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 chest compressions 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 a small face, an adult can carry out artificial respiration covering both the mouth and nose of the child at once. 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.

How to determine if resuscitation is performed correctly

Signs of effectiveness, subject to the rules for performing artificial respiration, are as follows.

When artificial respiration is performed correctly, you can notice the movement of the chest 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 to the nose, a shallow breath, a foreign body that prevents air from reaching the lungs.
If, when inhaling 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 heart massage should also be checked every minute.

If, when performing an indirect heart massage, a push appears on the carotid artery, similar to a pulse, then the pressing force is sufficient so that blood can flow to the brain.
With the correct implementation of resuscitation measures, the victim will soon have heart contractions, pressure will rise, spontaneous breathing will appear, the skin will become less pale, the pupils will narrow.

If resuscitation measures are ineffective within 25 minutes, the victim has cadaveric spots, a symptom of a "cat's" pupil (when pressing on the eyeball, the pupil becomes vertical, like a cat's) or the first signs of rigor mortis - all actions can be stopped, since biological death has occurred.

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Artificial respiration (Artificial lung ventilation)

If there is a pulse, but no breathing: exercise artificial lung ventilation.

Artificial ventilation of the lungs. Step one

Provides restoration of airway patency. To do this, the victim is laid on his back, his head is thrown back as much as possible and, grabbing the corners of the lower jaw with his fingers, push it forward so that the teeth of the lower jaw are located in front of the upper ones. Check and clean the oral cavity from foreign bodies. To comply with security measures, you can use a bandage, a napkin, a handkerchief wound around your index finger. To keep the victim's mouth open, a rolled bandage can be inserted between the jaws.

Artificial ventilation of the lungs. step two

To carry out artificial ventilation of the lungs using the "mouth to mouth" method, it is necessary, while holding the victim's head thrown back, take a deep breath, pinch the victim's nose with your fingers, press your lips tightly to his mouth and exhale.

When carrying out artificial ventilation of the lungs using the “mouth-to-nose” method, air is blown into the nose of the victim, while covering his mouth with the palm of his hand.

Artificial ventilation of the lungs. Step Three

After blowing in air, it is necessary to move away from the victim, his exhalation occurs passively.
To comply with safety and hygiene measures, blowing should be done through a moistened napkin or a piece of bandage.

The frequency of injections should be 12-18 times per minute, that is, 4-5 seconds should be spent on each cycle. The effectiveness of the process can be assessed by raising the chest of the victim when filling his lungs with blown air.

Indirect cardiac massage

If there is no pulse or breathing: time for chest compressions!

The sequence is as follows: first, indirect heart massage, and only then inhalation of artificial respiration. But! If the discharge from the mouth of a dying person poses a threat (infection or poisoning with poisonous gases), only chest compressions (this is called non-ventilated resuscitation) should be performed.

With each pushing of the chest by 3-5 cm during an indirect heart massage, up to 300-500 ml of air is ejected from the lungs. After the compression stops, the chest returns to its original position, and the same volume of air is sucked into the lungs. There is active exhalation and passive inhalation.
With an indirect heart massage, the rescuer's hands are not only the heart, but also the lungs of the victim.

You need to act in the following order:

Indirect cardiac massage. Step one

If the victim is lying on the ground, be sure to kneel in front of him. It doesn't matter which way you approach it.

Indirect cardiac massage. step two

For indirect heart massage to be effective, it must be performed on a flat, hard surface.

Indirect cardiac massage. Step Three

Place the base of the right palm above the xiphoid process so that the thumb is directed to the chin or abdomen of the victim. Place the left palm over the palm of the right hand.

Indirect cardiac massage. Step Four

Move the center of gravity to the victim's sternum, keeping your arms straight at the elbows. This will allow you to save strength for the longest possible time. Bending your elbows during an indirect heart massage is the same as doing push-ups from the floor (example: resuscitate the victim with pressure in the rhythm of 60-100 times per minute, for at least 30 minutes, even if resuscitation is ineffective. Because only after this time has elapsed signs of biological death are clearly manifested.Total: 60 x 30 \u003d 1800 push-ups).

For adults, indirect heart massage is performed with two hands, for children - with one hand, for newborns - with two fingers.

Indirect cardiac massage. Step Five

Push the chest at least 3-5 cm at a frequency of 60-100 times per minute, depending on the elasticity of the chest. In this case, the palms should not come off the victim's sternum.

Indirect cardiac massage. Step Six

You can start another pressure on the chest only after it has completely returned to its original position. If you do not wait until the sternum returns to its original position, and press, then the next push will turn into a monstrous blow. The implementation of an indirect heart massage is fraught with a fracture of the ribs of the victim. In this case, indirect heart massage is not stopped, but the frequency of pressing is reduced to allow the chest to return to its original position. At the same time, be sure to maintain the same depth of pressing.

Indirect cardiac massage. step seven

The optimal ratio of chest compressions and mechanical ventilation breaths is 30/2 or 15/2, regardless of the number of participants. With each pressure on the chest, an active exhalation occurs, and when it returns to its original position, a passive breath occurs. Thus, new portions of air enter the lungs, sufficient to saturate the blood with oxygen.

Chest compressions should be continued, even in the absence of signs of its effectiveness, until the following signs of biological death appear: clouding and drying of the cornea of the eye, "cat's eye" syndrome when squeezing the eye from the sides, lack of pupillary response to light, decrease in body temperature, lack of breathing and pulse more than 25 min.

Source: www.spas01.ru