Cardiopulmonary resuscitation: how to properly perform heart massage and artificial respiration

Cardiopulmonary resuscitation is a resuscitation measure that involves performing artificial respiration and chest compressions to the affected person.

Cardiopulmonary resuscitation is used when the patient needs urgent medical attention and there is a high risk of death.

This can happen with serious injury, drowning, various spontaneous seizures and other life-threatening conditions.

Moreover, sometimes such resuscitation is used to launch life in newborn babies.

It should be understood that the more people know the basics of first aid in clinical death of a person, the lower the risk of death of the victim as a result of an attack or accident.

All resuscitation actions are divided into two main groups:

• The main measures for the stabilization of cardiac and respiratory functions.
• Extended actions.

Basic or primary resuscitation should be started as soon as possible after respiratory arrest. They teach this in medical schools, as well as in rescue squads. You can see this procedure more clearly on the video of the rescuers. Children's pediatrician Dr. Komarovsky also talked a lot about this.

As for extended resuscitation procedures (fibrillation, artificial ventilation of the lungs, and others), they performed by doctors in an ambulance when transporting a person to a hospital, as well as already in conditions hospital.

Before proceeding with cardiopulmonary resuscitation, you should clearly understand what kind of condition a person has when the heart and respiration are stopped.

Thus, regardless of the cause of the cardiac arrest and breathing, the person's blood ceases to circulate and supply oxygen to the body. As a result, cells do not receive nutrients and oxygen, which leads to their death.

At the same time, it is important to know that for some time there is still a chance to support a person's breathing and slow down the death of tissues, but this period should not be longer than five minutes. After that, brain tissue and internal organs of the body begin to be damaged.

The following signs of clinical death in humans are distinguished:

• Loss of consciousness observed already twenty seconds after the arrest of blood circulation. You can check whether the victim is conscious or not by asking "what is your name." If there is no answer, then the person is unconscious. If he answers, then there is no need to do further resuscitation actions.
• Lack of breath. This symptom can be identified by placing a hand on the chest. If she moves, then the person is breathing. In this case, you do not need to use the method of applying a mirror to a person's mouth, since in this way you will only waste precious time.
  It is also important to know that sometimes patients in this state have weak contractions of the lungs, resembling wheezing. It is not necessary to regard this as normal breathing, as it will soon stop.
• No pulse in the artery of the neck. At the same time, there is no need to waste time looking for a pulse on the wrist.

To check for yourself if there is a pulse, you need to put your fingers on the lower part of the neck, closer to the ear.

In the presence of the above symptoms, an urgent need to start first aid to the patient. The algorithm of the necessary actions will be discussed later in the article.

Heart massage and artificial respiration: stages of carrying out

Indirect (closed) heart massage and artificial respiration are indicated for a person with clinical death.

All symptoms of this condition are divided into main and additional.

The main signs of clinical death will be loss of consciousness, dilated pupils, lack of breathing, pulse and general signs of life.

Additional symptoms may include seizures, lack of reflexes, a bluish tinge of the skin, and lack of muscle tone.

At the same time, it is important to understand that heart massage and artificial respiration are urgent resuscitation measures, for which a person has no more than three to five minutes. For this reason, there is no more than twenty seconds to make a diagnosis.

Cardiac massage and artificial respiration are aimed at returning the injured person to normal life, and not at delaying death, therefore, all resuscitation procedures are not carried out when more than ten minutes have passed after clinical death and the body has already begun to die off fabrics.

Also, these rescue actions are not carried out when a probable cause of clinical death has become outcome from a long-term serious illness that led to gross changes in the body (oncology, For example).

Another contraindication is the advanced stage of liver or kidney disease, as well as the absence signs of life of the victim and visible signs of death, when there is simply no resuscitation meaning.

Additional contraindications that prohibit emergency cardiac massage and artificial respiration are cases when clinical death occurred after the provision of a full list of intensive medical care or in the presence of refusal of adults to treat the patient child.

There are three main stages of CPR:

1. The first stage is to provide primary care to a person, namely, to ensure normal patency breathing (inhalation, exhalation, blowing air into the mouth) and closed external massage of the myocardium by pressing on the chest cage. The main task of this stage is to reduce the risk of death by combating oxygen starvation of cells. Simply put, this stage of assistance is simply maintaining the vital functions of the body.
2. The second stage of rendering assistance is carried out by already specialized doctors. It provides for the connection of monitors to control the work of the heart, defibrillation, as well as drug treatment. The task of this stage is to normalize blood circulation in the body.
3. The last stage of resuscitation measures is carried out in special resuscitation departments that will support a person's life. It is aimed at restoring all disturbed body functions.

In this state, the patient undergoes full examinations that will identify the root cause of cardiac and respiratory arrest.

How often is chest compressions performed?

Before considering the frequency with which an indirect cardiac massage is performed in a victim, one should understand the general ABC algorithm.

The ABS algorithm is a complex of resuscitation actions that can be used to increase the chance of a person's survival.

Thus, the essence of such a method lies in its name:

1. A (Airway) - ensuring normal airway patency (this is often practiced by rescuers for drowned patients, as well as during resuscitation of newborn children).
2. B (Breathing) - carrying out artificial respiration to maintain oxygen access to the cells.
3. C (Circulation) - carrying out a heart massage by rhythmic pressure on the sternum of an adult or a child.

At the very beginning of CPR, it is necessary to determine whether the affected person is conscious. It cannot be moved, since after the impact, his spine may be broken and other complications may be present.

The pulse should be felt by placing fingers on the carotid artery in the neck.

If the diagnosis of clinical death is confirmed and all the supporting signs are present, you can proceed to CPR.

The airway should be cleared first. The technique is as follows:

1. Place the victim on a flat surface and open his mouth.
2. Raise your head and throw it back.
3. Press your palm on the forehead and slightly tilt the person's head to the side to open the airways.
4. Clasp the victim's mouth tightly with your lips, and pinch your nose with your hands, thus making it tight.
5. Inhale air from mouth to mouth.
6. After the person's chest rises, take a second breath.
7. Start myocardial massage.

Not everyone knows how often chest compressions are performed. So, the frequency of chest compressions is 120 compressions per minute.

To better understand the frequency with which chest compressions are performed, we present the general technique of this resuscitation procedure:

• Put your hand on the patient's chest. Put the other palm on top. Straighten your back and arms at the elbows.
• Use your own weight to press on the patient's chest.
• After thirty compressions, throw the person's head back and inhale mouth to mouth.
• Then repeat the resuscitation in the same order until the person breathes, a pulse appears, or a lethal outcome is not diagnosed.

The use of an automatic external defibrillator should only be performed by emergency physicians. Also, this event is done in a hospital, when heart massage was not effective.

The frequency of chest compressions in children aged one to seven years is practically no different from this activity in adults.

The differences are as follows:

• If you carry out resuscitation yourself, then before the arrival of the doctors, you need to give the baby five taps on the chest and five breaths into the mouth.
• A child needs a breath of air weaker than an adult.
• Pressing on the chest of the child needs to be more careful so as not to cause a fracture of the ribs and compression of the lungs.
• The frequency of indirect massage for children is more frequent than for adults.
• Massage for children is done with one hand, and for newborns with two fingers.
• It is necessary to continue to massage the heart until the ambulance doctors arrive or the child starts to move.

Cardiovascular resuscitation: features and mistakes

Cardiovascular resuscitation ceases to be carried out if breathing and pulse appear in the victim, if the appearance of acute physiological signs of death, as well as half an hour after the start of the resuscitation.

It is possible to understand that cardiovascular resuscitation is effective when the patient's pupils react to light, their constriction, the appearance of a pulse (albeit weak), as well as when a person breathes on their own.

It is very important for this type of resuscitation measures to constantly monitor vital signs. At the same time, good signs of resuscitation will be the appearance of pink lips, pulse on the vessels, as well as stabilization of blood pressure.

More extended resuscitation actions are carried out by doctors in a hospital setting using auxiliary medicines and devices.

One of the most effective extended action techniques is defibrillation. It should not be done for epilepsy and other conditions that disrupt a person's consciousness. Also, this type of resuscitation is not practiced in crowded places.

After defibrillation is performed, the doctor must perform tracheal intubation so that the person can breathe. This should be done by a specialist, since improper intubation can only worsen the patient's situation, and he will simply suffocate.

Adrenaline, lidocaine, and magnesium are commonly used as medications for cardiovascular resuscitation. They should be selected by the attending doctor for each patient individually, depending on the patient's condition.

The following are the most common mistakes in emergency CPR:

• Detention of resuscitation measures and the conduct of minor diagnostic and therapeutic procedures, because of which time is wasted.
• Participation in the resuscitation process of several people who make different orders. CPR is also often interfered with by unauthorized persons and the absence of a single supervisor physician who would give clear instructions.
• Lack of vital signs control when performing cardiac massage and pulmonary resuscitation. This also includes the loss of time control for the permissible conduct of resuscitation actions.
• The introduction of some medications unnecessarily.
• Resuscitation in poor conditions (for example, when the victim lies on a soft springy mattress, heart massage will not be effective).
• Too early termination of resuscitation procedures.
• Incorrect technique of myocardial massage and too long a break between pressing on the heart and blowing air.
• Injection of air in the absence of airway patency. This is a gross mistake made by inexperienced health workers.

The lethal outcome of the victim is established in such cases:

• If the person has not regained consciousness, and his breathing has not been restored.
• If the pulse does not appear and the heart does not work.
• If the pupils have been dilated after cardiac arrest.