The rules of the cardio-pulmonary resuscitation
Sudden illness, exacerbation of chronic diseases, massive blood loss, injuries, and other causes may lead to respiratory arrest, cardiac and clinical death.
Immediately after that to start CPR.
later manifest other signs of clinical death - cyanosis, dilated pupils, lack of reflexes, muscle atonia, but wait for them to not be offensive.It is considered that the duration of clinical death in normothermia is 5-6 minutes, after which the restoration of central nervous system becomes impossible, and there comes a biological death.
Main responsibilities nurses monitor post:
• strict compliance with safety regulations;
• ensuring continuous high quality of recorded curves;
• systematic registration of monitored parameters and their record.
The first step is to hold a closed heart massage and artificial respiration.
For this patient should be laid on a hard surface (if he is in bed - to move quickly on the floor).Then apply precordial punch from a height of about 30 cm in the middle third of the ster
In infants and young children should be lightly press on the middle part of the sternum with one hand, with the thumb and index and middle fingers with a frequency of 80-100 strokes per minute.
At the same time should be carried out artificial respiration.For this
providing assistance kneels at the head of the victim, putting one hand under the neck, the other on the forehead and throws his head back.At the same time the patient opens the horn, the airways become passable.If the patient's mouth are dentures, other foreign bodies or vomit, they should be removed.The head of the patient in this case must be rotated in the direction of the danger of aspiration.
If you suspect an injury of the cervical spine is not recommended to throw back his head.It is the most push forward the lower jaw.For this purpose, it captures both sides of the base (two-handed), and is displaced so that the mandibular teeth are ahead of the upper jaw line.
to prevent retraction of the tongue of the patient unconscious, enter the duct.Its size is determined by the distance from the tip of the patient's ear to the corner of the mouth.Duct take so that its bend looking down to the language, and the opening up to the palate;it is introduced into the mouth and promote deeper, touching the end of the palate.1/2 entering the duct length, it is rotated by 180 ° and is advanced further until the outer end of the flange abuts the lip.
Taking a deep breath, assisting with patient pinches his nose between thumb and forefinger, firmly presses his mouth to his mouth and makes a sharp breath as long as the patient's rib cage starts to rise.This is followed to step back, holding the patient's head in the upturned state, and to materialize passive exhalation.Thorax with drops.This cycle should be repeated 12 times per minute.
the presence of air exhalation is done in it.If it is impossible to open for any reason the victim's mouth breath should be held to the nose.But this is less desirable as the nasal passages are narrow and can often be clogged with mucus or blood.
diagnose clinical death can be based on the following features.
1. Lack of consciousness.
2. Absence of breathing.
3. The lack of cardiac activity.
Young children CPR is performed through the mouth and nose at the same time.The use of mechanical ventilation devices much easier and improves the efficiency of artificial respiration.In the absence of hygienic and aesthetic considerations of the patient's mouth must be covered with a cloth or handkerchief.
When helping a single person after 15 compressions sternum should take two breaths.When assistance is provided by two, after every five compressions followed by one breath.It is necessary to coordinate their actions to prevent simultaneous air injection and compression of the chest.To do this, one providing care (usually the one who carries out heart massage) thinks out loud loud pressure on the sternum, "One!Two!Three!Four!! Five, "then commanded:" Breathe "holds second air injection, and then the cycle repeats.For
cardiac stimulation start epinephrine administered 1% - 1 mL intravenously.If it is impossible to get into the vein is injected into the base of the tongue (sublingually through ro g), there is a rich capillary network.In the presence of air it can vsprysnut (i.e. intratracheally introduce) a mixture of 1% epinephrine 2 ml - sodium chloride and 0.9 ml of 5.7% solution.In the absence of adrenaline effect can enter at the same dosage again after 2-5 minutes (total 5-6 ml).
Utility of intracardiac injections is currently controversial, as it is believed that this causes significant mechanical damage to the heart.
Signs effectiveness of cardiopulmonary resuscitation are: pupillary constriction, the appearance of their reaction to light, skin pinkness, the appearance of the pulse in the peripheral arteries, the restoration of spontaneous breathing and consciousness.
case of failure of resuscitation for 30 minutes, it stopped.
patient in a state of clinical death, resuscitation should be started immediately.In the course of intensive care it turns out the presence or absence of indications for its conduct.If the resuscitation is not shown, it is stopped.
Cardiopulmonary resuscitation is not indicated:
• chronic patients in the terminal stages of chronic diseases (must have medical documents confirming the existence of these diseases);
• if well established, it's been more than 30 minutes after cardiac arrest.
biological death is possible to ascertain on the basis of reliable features and a set of attributes.
Credible signs of biological death.
1. Cadaverous spots (there are 2-4 hours at normothermia).
2. Rigor mortis (at normothermia occurs within 2-4 hours, reaches a maximum at the end of the first day, spontaneously takes place on 3-4 th day).
In the absence of these signs of biological death diagnosis is put on the basis of the totality of the following features:
• no pulse on main arteries, there is no heart rate, spontaneous breathing for more than 30 minutes;
• pupils are wide, do not react to light;
• no corneal reflex (no reaction to touching the cornea, for example, a piece of cotton wool);
• presence of blood stains hypostasis (pale skin, and sloping lower located parts of the body are blue-purple spots can disappear when pressed).
should be transported to the nearest hospital, which has an intensive care unit after the appearance of signs of recovery of basic vital functions of the patient or injured during the ongoing resuscitation.