How to perform artificial respiration correctly and when to do it. Artificial respiration and cardiac massage - rules and techniques for performing cardiac massage, how many presses and breaths

There are so many situations in life that a person can influence and change the outcome in better side. 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 the organs that provide the passage of air get into foreign body(this can be a particle of water, food, dirt, as well as blood and other objects). 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 procedure for restoring breathing should be carried out until positive result. 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. Doing 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.

Early signs of circulatory arrest that appear first are: disappearance of the pulse on carotid artery, lack of consciousness, convulsions. Late signs circulatory arrests that appear first are: dilation of the pupils in the absence of their reaction to light, disappearance of breathing or convulsive breathing (2-6 inhalations and exhalations per minute), the appearance of an earthy-gray color of the skin (primarily the nasolabial triangle).

This condition is reversible, with it it is possible full recovery all functions of the body, if the brain cells do not occur irreversible changes. The patient's body remains viable for 4-6 minutes. Timely resuscitation measures can remove the patient from this condition or prevent it.

Immediately after symptoms appear clinical death, it is necessary to turn the victim on his back and apply a precordial blow. The purpose of such a blow is to shake the chest as hard as possible, which should serve as an impetus to start the stopped heart.

The blow is applied with the edge of the hand clenched into a fist to a point located on the lower middle third of the sternum, 2-3 cm above the xiphoid process, which ends the sternum. Do this with a short, sharp movement. In this case, the elbow of the striking hand should be directed along the victim’s body.

A correctly and timely blow can bring a person back to life in a matter of seconds: his heartbeat is restored, his consciousness returns. However, if this does not happen, then begin chest compressions and artificial respiration, which are carried out until signs of revival of the victim appear: a good pulsation is felt on the carotid artery, the pupils gradually narrow, the skin upper lip turns pink.

Indirect cardiac massage and its implementation

Indirect cardiac massage is performed in the following sequence (Fig. 1):

1. The victim is placed on his back on a hard base (ground, floor, etc., since massage on a soft base can damage the liver), the waist belt and the top button on the chest are unfastened. It is also helpful to raise the victim's legs about half a meter above chest level.

2. The rescuer stands on the side of the victim, places one hand, palm down (after sharp extension of the arm at the wrist joint), on the lower half of the victim’s sternum so that the axis wrist joint coincided with the long axis of the sternum (the midpoint of the sternum corresponds to the second or third button on a shirt or blouse). To increase pressure on the sternum, the rescuer places the second hand on the back surface of the first. In this case, the fingers of both hands should be raised so that they do not touch the chest during massage, and the hands should be strictly perpendicular to the surface of the victim’s chest in order to ensure a strictly vertical push of the sternum, leading to its compression. Any other position of the rescuer’s hands is unacceptable and dangerous for the victim.

3. The rescuer becomes as stable as possible and so that it is possible to press on the sternum with his arms straightened elbow joints, then quickly leans forward, transferring the weight of the body to the arms, and thereby bends the sternum by about 4-5 cm. In this case, it is necessary to ensure that the pressure is applied not to the heart area, but to the sternum. The average force of pressure on the sternum is about 50 kg, so the massage should be carried out not only using the strength of the arms, but also the mass of the torso.

Rice. 1. Artificial respiration and indirect cardiac massage: a - inhale; b - exhale

4. After short pressure on the sternum, you need to quickly release it so that the artificial compression of the heart is replaced by its relaxation. While the heart is relaxing, you should not touch the victim’s chest with your hands.

5. The optimal rate of chest compressions for an adult is pressure per minute. Children under 8 years old are massaged with one hand, and infants - with two fingers (index and middle) with a frequency of additional pressure per minute.

In table 1. The requirements for performing indirect cardiac massage are given depending on the age of the victim.

Table 1. Indirect cardiac massage

Depth per click

1 finger below the nipple line

2 fingers from the sternum

1/5 - 2 rescuers 2/15 - 1 rescuer

A possible complication in the form of a rib fracture during chest compressions, which is determined by a characteristic crunch during compression of the sternum, should not stop the massage process.

Artificial respiration and its implementation

Artificial respiration using the mouth-to-mouth method is carried out in the following sequence (see Fig. 1):

1. Quickly clean the victim’s mouth with two fingers or a finger wrapped in a cloth (handkerchief, gauze), and tilt his head back at the occipital joint.

2. The rescuer stands on the side of the victim, puts one hand on his forehead, and the other under the back of the head and turns the victim’s head (at the same time, the mouth, as a rule, opens).

3. The rescuer does deep breath, slightly holds the exhalation and, bending over the victim, completely seals the area of his mouth with his lips. In this case, the victim’s nostrils must be pinched with the thumb and forefinger of the hand lying on the forehead, or covered with one’s cheek (air leakage through the nose or corners of the victim’s mouth negates all the efforts of the rescuer).

4. After sealing, the rescuer exhales quickly, blowing air into Airways and the victim's lungs. In this case, the victim’s inhalation should last about a second and reach 1 - 1.5 liters in volume in order to cause sufficient stimulation of the respiratory center.

5. After the end of exhalation, the rescuer unbends and releases the victim’s mouth. To do this, turn the victim’s head to the side without straightening it and raise the opposite shoulder so that the mouth is lower than the chest. The victim’s exhalation should last about two seconds, or at least twice as long as the inhalation.

6. In the pause before the next breath, the rescuer needs to take 1-2 small regular inhalations and exhalations for himself. After this, the cycle repeats from the beginning. The frequency of such cycles is in min.

When hit large quantity air in the stomach causes it to swell, making it difficult to revive. Therefore, it is advisable to periodically empty the stomach of air by pressing on the victim’s epigastric region.

Artificial respiration “mouth to nose” is almost no different from what has been described. To seal with your fingers, you need to press lower lip the victim to the top.

When reviving children, insufflation is performed simultaneously through the nose and mouth.

If two people provide assistance, then one of them does indirect cardiac massage, and the other does artificial respiration. At the same time, their actions must be coordinated. Do not press on the chest while inhaling air. These measures are carried out alternately: 4-5 compressions on the chest (as you exhale), then one blow of air into the lungs (inhalation). If assistance is provided by one person, which is extremely tiring, then the sequence of manipulations changes slightly - after every two quick injections of air into the lungs, 15 pressures are applied to the chest. In any case, it is necessary that artificial respiration and chest compressions are carried out continuously for the required time.

Carrying out artificial respiration and chest compressions

How to do it correctly: indirect cardiac massage and mechanical ventilation

When restoring breathing and cardiac activity of a victim who is in unconscious, be sure to lay him on his side to prevent him from suffocating with his own sunken tongue or vomit.

The retraction of the tongue is often indicated by breathing that resembles snoring and severe difficulty in inhaling.

Rules and techniques for performing artificial respiration and chest compressions

If resuscitation is carried out by two people, then one of them performs cardiac massage, the other performs artificial respiration in the mode of one insufflation every five presses on the chest wall.

external cardiac massage;
mouth-to-mouth breathing;
breathing "from mouth to nose".

1. The person is laid on a hard surface, top part the torso is freed from clothing.

2. To carry out closed massage heart resuscitator kneels on the side of the victim.

3. The palm, with its base extended as far as possible, is placed in the middle of the chest, two to three centimeters above the sternal end (where the ribs meet).

4. Where is pressure applied to the chest during closed cardiac massage? The point of maximum pressure should be in the center, not on the left, because the heart, contrary to popular belief, is located in the middle.

5. Thumb hands should be facing the person's chin or stomach. The second palm is placed crosswise on top. The fingers should not touch the patient; the palm should be placed with the base and be extended as much as possible.

6. Pressure on the heart area is done with straight arms, the elbows do not bend. Pressure should be applied with your entire weight, not just your hands. The shocks must be so strong that rib cage for an adult, it dropped by 5 centimeters.

7. With what frequency of pressure is indirect cardiac massage performed? Press on the sternum at least 60 times per minute. You need to focus on the elasticity of the sternum of a particular person, precisely on how it returns to its opposite position. For example, in an elderly person the frequency of clicks may be no more than 40–50, and in children it can reach 120 or higher.

8. How many breaths and presses should you make during artificial respiration?

Every 15 pressures, the person providing assistance blows air into the victim’s lungs twice in a row and again performs a cardiac massage.

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

How to do artificial respiration and chest compressions

Poisoning with certain substances can cause respiratory and cardiac arrest. In such a situation, the victim needs help immediately. But there may not be doctors nearby, and ambulance won't arrive in 5 minutes. Every person should know and be able to apply in practice at least basic resuscitation measures. These include artificial respiration and external cardiac massage. Most people probably know what it is, but do not always know how to correctly perform these actions in practice.

Let's find out in this article what kind of poisoning can cause clinical death, what kind of human resuscitation techniques exist, and how to properly perform artificial respiration and chest compressions.

What kind of poisoning can cause breathing and heartbeat to stop?

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

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

drugs from the group of cardiac glycosides;
“Obzidan”, “Isoptin”;
barium and potassium salts;
some antidepressants;
organophosphorus compounds;
quinine;
hellebore water;
adrenergic blockers;
calcium antagonists;
fluorine.

In what cases is artificial respiration necessary? Respiratory arrest occurs due to poisoning:

drugs, sleeping pills, inert gases (nitrogen, helium);
intoxication with substances based on organophosphorus compounds used to control insects;
curare-like drugs;
strychnine, carbon monoxide, ethylene glycol;
benzene;
hydrogen sulfide;
nitrites;
potassium cyanide, hydrocyanic acid;
"Diphenhydramine";
alcohol.

In the absence of breathing or heartbeat, clinical death occurs. It can last from 3 to 6 minutes, during which there is a chance of saving the person if you start 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 measures

What to do if a person falls unconscious? First you need to identify signs of life. The heartbeat can be heard by placing your ear to the victim's chest or by feeling the pulse in the carotid arteries. Breathing can be detected by the movement of the chest, leaning towards the face and listening for inhalation and exhalation by holding a mirror to the victim’s nose or mouth (it will fog up when breathing).

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

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

external cardiac massage;
mouth-to-mouth breathing;
breathing "from mouth to nose".

It is advisable to conduct receptions for two people. Cardiac massage is always carried out together with artificial ventilation.

Procedure in the absence of signs of life

Release 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 performed.
If there is no heartbeat, artificial respiration and chest compressions are performed.

How to do indirect cardiac massage

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

The person is laid on a hard surface, the upper body is freed from clothing.
To perform closed cardiac massage, the resuscitator kneels on the side of the victim.
The palm, with its base extended as far as possible, is placed in the middle of the chest, two to three centimeters above the sternal end (where the ribs meet).
Where is pressure applied to the chest during closed cardiac massage? The point of maximum pressure should be in the center, not on the left, because the heart, contrary to popular belief, is located in the middle.
The thumb should be facing the person's chin or stomach. The second palm is placed crosswise on top. The fingers should not touch the patient; the palm should be placed with the base and be extended as much as possible.
Pressure on the heart area is done with straight arms, the elbows do not bend. Pressure should be applied with your entire weight, not just your hands. The shocks should be so strong that the chest of an adult falls by 5 centimeters.
With what frequency of pressure is indirect cardiac massage performed? Press on the sternum at least 60 times per minute. You need to focus on the elasticity of the sternum of a particular person, precisely on how it returns to its opposite position. For example, in an elderly person the frequency of clicks may be no more than 40–50, and in children it can reach 120 or higher.
How many breaths and presses should you take during artificial respiration? When alternating chest compressions with artificial ventilation, 2 breaths are taken for 30 pushes.

Why is indirect cardiac massage impossible if the victim is lying on something soft? In this case, the pressure will be released not on the heart, but on the pliable surface.

Very often, ribs are broken during chest compressions. There is no need to be afraid of this, the main thing is to revive the person, and the ribs will grow together. But you need to take into account that broken ribs are most likely the result of incorrect execution and you should moderate the pressing force.

Age up to 1 year

2 fingers from the sternum

Artificial respiration from mouth to mouth

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

How to do mouth-to-mouth artificial respiration?

The victim must be given horizontal position with his head thrown back. You can put a cushion or your hand under your neck. If there is a suspicion of a fracture cervical spine spine, then you can’t throw your head back.
The lower jaw needs to be pushed forward and downward. Free your mouth from saliva and vomit.
Holding the injured person’s open jaw with one hand, with the other you need to tightly pinch his nose, inhale deeply and exhale as much as possible into his mouth.
The frequency of air injections per minute during artificial respiration is 10–12.

For your own safety, it is recommended that artificial respiration is best done through a napkin, while controlling the tightness of the pressure and preventing air “leakage”. Exhalation should not be sharp. Only strong but smooth (for 1–1.5 seconds) exhalation will ensure proper movement of the diaphragm and filling of the lungs with air.

Artificial respiration from mouth to nose

Artificial respiration “mouth to nose” is performed if the patient is unable to open his mouth (for example, due to a 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 inhalation, you need to blow air into the injured person’s nose, tightly covering his mouth with one hand.
After one breath, count to 4 and take the next one.

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. From 1 to 8 years of age, 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 perform artificial respiration for a child? For children, artificial respiration can be performed using the mouth-to-mouth technique. Since kids small face, an adult can perform artificial respiration by immediately covering both the mouth and nose of the child. The method is then called “mouth to mouth and nose.” Artificial respiration is given to children at a frequency of 18–24 per minute.

How to determine if resuscitation is being performed correctly

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.

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 develops cadaveric spots, a symptom of a “cat” pupil (when pressing on 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 bring you back to life, but also provide vital oxygen. important organs, prevent their death and disability of the victim.

Before performing artificial respiration, it is necessary to restore the patency of the airways (cleanse the oral cavity of foreign substances), insert a tongue depressor or use a pin, and place a cushion under the neck. Otherwise, all your efforts are in vain and instead of providing help, you can not only harm, but also kill the victim.

Indirect cardiac massage and artificial respiration - rules and techniques for its implementation

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.

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.

Physiological basis of blood circulation

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, release 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) circulatory 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 big circle blood circulation, the reverse process occurs. But besides this, they come from the blood into the tissues. nutrients. And the tissues “give back” the products of their metabolism, which are excreted by the kidneys, skin and lungs.

Main signs of cardiac arrest

Cardiac arrest is considered a sudden and complete cessation of cardiac activity, which in certain cases may occur simultaneously with bioelectric activity 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 sudden stop cardiac activity:

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

Indirect cardiac massage is performed until independent cardiac activity is restored, among the signs of which are the following:

The man regains consciousness.
A pulse appears.
Pallor and cyanosis decrease.
Breathing resumes.
The pupils narrow.

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

Consequences of circulatory arrest

In case of circulatory arrest, tissue exchange and gas exchange stops. Metabolic products accumulate in the cells, and carbon dioxide accumulates in the blood. This leads to a stop in metabolism and cell death as a result of “poisoning” with 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.

Restoration of blood circulation

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 promotes recovery independent work organ. 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:

Direct cardiac massage is performed during surgery with an open chest or abdominal cavity, and also specially open the chest, 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 once 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 the level of mercury. 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. Pressure is applied to the sternum per minute in the form of quick pushes.

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, the massage is performed with one hand, and for newborns and children up to one year old - with the fingertips.

The effectiveness of cardiac massage is assessed by the appearance of pulsation in the carotid, femoral and radial arteries, increased blood pressure domm rt. 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 colour faces.

The essence and algorithm of performing indirect cardiac massage

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 most simple 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 cardiac cavities extending from the heart muscle blood vessels. 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 resuscitation measure to be performed to bring the required effect, you need to know and follow the basic rules, which consist in 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 by 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 children adolescence 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 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 pushes 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. The inhalation rate is once every 1 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 per minute, and the point of application is the lower end of the sternum.

Indirect cardiac massage should also be performed with caution on the elderly, since rough actions may result in fractures in the chest area.

How to perform cardiac massage on an adult

Get ready. Gently shake the victim's shoulders and ask, “Is everything okay?” This way you will make sure that you are not going to perform NMS on a conscious person.
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 victim's shoulder for easy access to the head and chest. Perhaps the muscles that control the tongue have relaxed, causing it to block the airway. 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 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. Don't put your fingers on soft fabrics under the chin - you may inadvertently block the airway you are trying to clear.

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 for sound from air movement, or try to catch it with your cheek, see if your chest moves.

Start artificial respiration.

If breathing is not caught after opening the airways, use the mouth-to-mouth method. Pinch your nostrils with your index finger and thumb 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 until 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 your chest still doesn't move after this, a foreign body (such as dentures) may be blocking your airway.

To release them, you need to push the stomach. Place one hand with the heel 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 thrusting until the foreign body is expelled from the airway or help arrives. If a foreign body is expelled from the mouth but the person is not breathing, the head and neck may be in an abnormal 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. If you are pregnant and overweight, use chest thrusts instead of abdominal thrusts.

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, place your index and middle fingers in the hole between the larynx and the muscle next to 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 exhalations per minute (one per 5 seconds). Check your pulse every 2-3 minutes.

If there is no pulse and help has not yet arrived, begin chest compressions.

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. Put it in this place middle finger, next to it is the index.

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. Do 15 presses based on 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 again correct position for hands 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 the reaction. Check your pulse and breathing every 5 minutes. If the pulse is palpable, but breathing is not heard, make 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

The movement of the chest should be no more than 1.5–2 cm. The frequency of compressions is at least 100 per minute. From 1 to 8 years of age, 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 perform 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. The method is then called “mouth to mouth and nose.”

Artificial respiration is given to children 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 due to the syndrome sudden death. 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, ask someone else to 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.

Check the pulse at the brachial artery. To find it, feel inner side 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. Lift up forefinger so that two fingers are located 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.

Artificial respiration

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:

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 bottom and upper jaw so that 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 functions, you must immediately apply artificial ventilation lungs and indirect cardiac massage.

How to determine if resuscitation is being performed correctly

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 press on the stomach and turn the patient's head to the 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.

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.

What is unacceptable during external cardiac massage

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.
Due to lack of self-confidence, do not leave the victim in danger, but be sure to carry out resuscitation measures.
Carry out preparatory procedures quickly and thoroughly, in particular the release oral cavity from foreign objects, tilting the head to the position necessary for artificial respiration, freeing the chest from clothing, preliminary examination to detect penetrating wounds.
Do not tilt the victim’s head back excessively, as this may create obstacles to the free flow of air into the lungs.
Continue to resuscitate the victim’s heart and lungs until doctors or rescuers arrive.

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

The phrase “saving a life is in our hands”, in cases where it is necessary to immediately perform chest compressions 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 especially his individual parts body, the position of the person performing indirect cardiac massage, clarity, measuredness, timeliness of his actions and absolute confidence in a positive outcome.

When to stop resuscitation?

It should be noted that pulmonary-cardiac resuscitation should be continued until the medical team arrives. But if the heartbeat and lung function are not restored 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;
dilated pupils;
the skin is pale or bluish.

And of course, cardiopulmonary resuscitation measures are not carried out if a person has an incurable disease, for example, oncology.

Artificial respiration is performed in cases where

The victim is not breathing;

The victim breathes very poorly (rarely, spasmodically, with sobbing):

The victim's breathing is constantly getting worse.

Most effective way artificial respiration is a “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 scarf, etc. or "duct".

To perform artificial respiration you should:

1) Lay the victim on his back, unbutton any clothing that is restricting 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 straighten after blowing air, it is necessary to push the victim’s lower jaw forward so that lower teeth stood in front of the top ones.

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 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 given after 15 compressions on the sternum. The rate of resuscitation must be high. In 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 given after 5 compressions 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

Occupational safety briefing, types of instruction.

Based on the nature and timing of the briefings, they 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 not related to direct responsibilities in the specialty (cleaning the area, loading, etc.);

When eliminating the consequences of accidents and natural disasters;

When performing work for which a work permit, permit and other documents are issued.

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

Poisoning with certain substances can cause respiratory and cardiac arrest. In such a situation, the victim needs help immediately. But there may be no doctors nearby, and an ambulance may not arrive in 5 minutes. Every person should know and be able to apply in practice at least basic resuscitation measures. These include artificial respiration and external cardiac massage. Most people probably know what it is, but do not always know how to correctly perform these actions in practice.

What kind of poisoning can cause breathing and heartbeat to stop?

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

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

In what cases is artificial respiration necessary? Respiratory arrest occurs due to poisoning:

When to start resuscitation measures

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

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

external cardiac massage;
mouth-to-mouth breathing;
breathing "from mouth to nose".

It is advisable to conduct receptions for two people. Cardiac massage is always carried out together with artificial ventilation.

Procedure in the absence of 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 performed.
If there is no heartbeat, artificial respiration and chest compressions are performed.

How to do indirect cardiac massage

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

Why is indirect cardiac massage impossible if the victim is lying on something soft? In this case, the pressure will be released not on the heart, but on the pliable surface.

Age of the victim	How to press	Pressing point	Depth of pressing	Velocity	Inhalation/pressure ratio
Age up to 1 year	2 fingers	1 finger below the nipple line	1.5–2 cm	120 and more	2/15
Ages 1–8 years		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 a poisoned person has secretions in the mouth that are dangerous for the resuscitator, such as poison, poisonous gas from the lungs, or an infection, then artificial respiration is not necessary! In this case, you need to limit yourself to performing an indirect cardiac massage, during which, due to pressure on the sternum, about 500 ml of air is expelled and again absorbed.

How to do mouth-to-mouth artificial respiration?

Artificial respiration from mouth to nose

Artificial respiration “mouth to nose” is performed if the patient is unable to open his mouth (for example, due to a 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 inhalation, you need to blow air into the injured person’s nose, tightly covering his mouth with one hand.
After one breath, count to 4 and take the next one.

Features of resuscitation in children

How to perform 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. The method is then called “mouth to mouth and nose.” Artificial respiration is given to children at a frequency of 18–24 per minute.

How to determine if resuscitation is being performed correctly

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

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.

First aid techniques.

Artificial respiration – is to ensure gas exchange in the body, i.e. saturating the victim’s blood with oxygen and removing carbon dioxide from the blood. In addition, artificial respiration acts reflexively on the respiratory center of the brain, thereby helping to restore spontaneous breathing in the victim. The effect on the respiratory center of the brain is carried out due to mechanical irritation of the nerve endings located in the lungs by incoming air. The resulting nerve impulses enter the center of the brain, stimulating its normal activity, that is, causing the ability to send impulses to the muscles of the lungs, as is the case in a healthy body.

There are many methods of artificial respiration. All of them are divided into hardware and manual.

Hardware methods require the use of special devices that allow air to be blown in and out of the lungs through a rubber tube inserted into the respiratory tract or through a mask placed on the victim’s face. The simplest of the devices is a hand-held, portable device designed for artificial respiration and aspiration (suction) of fluid and mucus from the respiratory tract.

The device allows you to introduce into the lungs under pressure air in a volume of 0.25 to 1.5 liters or air enriched with oxygen. It can be used in field conditions.

Manual methods less efficient and more labor intensive. Their value lies in the fact that they allow you to perform techniques without any devices or instruments, that is, immediately.

The most effective method is “mouth to mouth”. It has been established that the air exhaled from the lungs contains a sufficient amount of oxygen for breathing.

Before starting artificial respiration, you must quickly perform the following operations:

Free the victim from restrictive clothing - unbutton the collar, untie the tie, unbutton the trousers;

Lay the victim on his back on a horizontal surface - a table or floor;

Tilt your head back as much as possible, placing the palm of one hand under the back of your head, and with the other hand press on your forehead until your chin is in line with your neck. This ensures free passage of air into the lungs. At the same time, the mouth opens. To maintain this position of the head, a cushion of folded clothing should be placed under the shoulder blades;

Use your fingers to examine the oral cavity; if foreign content is detected (blood, mucus), it must be removed. To remove it, you need to turn the victim’s head and shoulders to the side, bring your knee under the victim’s shoulders, and then use a scarf or sleeve wrapped around your finger to clean the contents of the mouth. After this, you need to give the head its original position.

Performing artificial respiration. At the end of the preparatory operations, the person providing assistance takes a deep breath and then forcefully inhales air into the victim’s mouth. At the same time, he must cover the victim’s entire mouth with his mouth and close his nose with his fingers.

Then the person providing assistance leans back, frees the victim’s mouth and nose and takes a new breath. At this moment, the chest drops and passive exhalation occurs.

Control of the flow of air into the victim’s lungs is carried out by eye by expanding the chest with each inflation.

Sometimes it is impossible to open the victim’s mouth due to convulsive clenching of the jaws. In this case, artificial respiration should be carried out “from mouth to nose”, closing the victim’s mouth while blowing air into the nose.

In one minute, 10-15 blows should be given to an adult (i.e. every 5-6 seconds). When the victim takes his first weak breaths, artificial inhalation should be timed to coincide with the beginning of spontaneous inhalation.

Artificial respiration must be carried out until deep rhythmic breathing.

Heart massage.

Heart massage is performed by the so-called indirect, or external, heart massage - rhythmic pressure on the chest, i.e. the front wall of the victim’s chest. As a result of this, the heart is compressed between the sternum and the spine and pushes blood out of its cavities. After the pressure stops, the chest and heart straighten, and the heart fills with blood coming from the veins. In a person who is clinically dead, the chest due to the loss muscle tension easily moves when pressed on it, providing compression of the heart. Blood circulation is necessary for the blood to deliver oxygen to all organs and tissues of the body. Therefore, the blood must be enriched with oxygen, this is achieved by artificial respiration. Thus, artificial respiration should be performed simultaneously with cardiac massage.

Preparing for cardiac massage is at the same time a preparation for artificial respiration, since massage must be performed in conjunction with artificial respiration.

To perform a massage, it is necessary to lay the victim on his back on a hard surface, the floor, or place a board under his back, cover his chest, and unfasten clothing that is restricting breathing.

To perform cardiac massage it is necessary to stand on either side of the victim in a position in which a more or less significant bend over him is possible. Then, by listening, determine the place of pressure (it should be two fingers above the soft end of the sternum) and place the lower part of the palm of one hand on it, and then place the second hand at a right angle on top of the first hand and press on the victim’s chest, slightly helping by tilting the entire body.

Forearm and humerus The hands of the person providing assistance should be fully extended. The fingers of both hands should be brought together and should not touch the victim's chest. The pressure should be applied with a quick push so as to move the lower part of the sternum down by 3-4 cm, and fat people by 5-6cm.

Pressing on the sternum should be repeated approximately 1 time per second. After a quick push, the hands remain in the achieved position for approximately 0.5 seconds. After this, you should straighten up slightly and relax your arms, without removing them from the sternum.

If 2 people provide assistance, then one of them should perform artificial respiration, and the other should perform cardiac massage.

It is advisable for each of them to perform artificial respiration and cardiac massage alternately, replacing each other every 5-10 minutes. In this case, the order of assistance should be as follows: after one deep insufflation, 5 pressures are applied to the chest.

If it turns out that after inflation the chest remains motionless, it is necessary to provide assistance in a different order: after 2 inflations, do 15 pressures.

If one person provides assistance, then assistance should be provided in the following order: after two deep blows into the mouth or nose - 15 pressures to massage the heart.

The effectiveness of external cardiac massage is manifested primarily in the fact that with each pressure on the sternum, the pulse is clearly palpable on the carotid artery. Other signs effective massage is a constriction of the pupils, the appearance of breathing in the victim, a decrease in the cyanosis of the skin and visible mucous membranes. To increase the effectiveness of the massage, it is recommended to raise the victim’s legs by 0.5 meters during external cardiac massage, which promotes blood flow to the heart from the veins of the lower body.

The restoration of heart activity is judged by the appearance of a regular pulse, for which it is necessary to interrupt the massage for 2-3 seconds every 2 minutes.

It is necessary to continue to provide care until he is transferred to medical personnel.