Artificial respiration and chest compressions for children. The technique of artificial lung ventilation and closed heart massage

It is used in cardiac and respiratory arrest. Cardiac arrest is checked through the pulse. Don't panic.

Adults

1. Kneel next to the casualty and place your hand on their chest. The base of the palm should be at the lower end of his sternum. Raise your fingers so that they do not press on the ribs.

2. Place another over one palm. Press down on the sternum so as to depress it 4-5 cm. Do not overdo it so as not to cause injury and break the ribs. The fingers should remain elevated. Make 15 pressures with a pulse rate (about 80 beats per minute), then blow air into the lungs of the victim twice, while closing his nose. Repeat these steps 4 times per minute. Check your pulse every minute. Watch for signs of cardiac recovery (pink lips and earlobes).

Children up to a year

1. Lay your baby down on a flat, hard surface. Place your index finger on his sternum at the level of the nipples and move it a finger's width down. Massage is done in this area.

2. Press with only two fingers: index and middle. Remember that this is a child. Therefore, the depth of pressure should not exceed 2 cm, and the frequency should not exceed 100 per minute. After every 5 pressures, do one mouth-to-mouth blow, remembering to close your nose.

Reviews

Doctor 04.04.2009 11:02
Thank you, everything is detailed.

j 29.09.2009 19:08
Thanks, I got 12 for the abstract

Andre 03.12.2009 09:45
I heard that if you do a heart massage alone and artificial respiration at the same time, then when you stop the massage for breathing, a reverse outflow of blood occurs and everything loses its meaning.

Roman 28.08.2011 11:56
If it were so, then it would be written in first aid books.

yulya 19.05.2011 20:29
Thank you, I received the abstract 😉

Anton 14.09.2011 23:10
I saw in the cinema how a man was given 5 pushes and 2 breaths according to the scheme.

Ed 04/27/2017 02:11
That's how sailors are taught

nastya 04/05/2012 18:21
thanks! I didn't know at all. on Tuesday there will be a control on obzh with a mannequin!

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.

The purpose of artificial respiration, as well as normal natural respiration, is to ensure gas exchange in the body, that is, oxygen saturation of the victim's blood and removal of carbon dioxide from the blood.In addition, artificial respiration, acting reflexively on the respiratory center of the brain, thereby contributes to the restoration of independent breathing of the victim.

Gas exchange occurs in the lungs, the air entering them fills many pulmonary vesicles, the so-called alveoli, to the walls of which blood saturated with carbon dioxide flows. The walls of the alveoli are very thin, and their total area in humans reaches an average of 90 m2. Gas exchange is carried out through these walls, i.e. oxygen passes from the air into the blood, and carbon dioxide passes from the blood into the air.

Blood saturated with oxygen is sent by the heart to all organs, tissues and cells, in which, due to this, normal oxidative processes continue, i.e., normal life activity.

The impact on the respiratory center of the brain is carried out as a result of mechanical irritation of the nerve endings located in the lungs by the incoming air. The resulting nerve impulses enter the center of the brain, which controls the respiratory movements of the lungs, stimulating its normal activity, that is, the ability to send impulses to the muscles of the lungs, as happens in a healthy body.

There are many different ways to perform artificial respiration. All of them are divided into two groups hardware and manual. Manual methods are much less efficient and incomparably more time-consuming than hardware ones. They have, however, the important advantage that they can be performed without any adaptations and instruments, that is, immediately upon the occurrence of respiratory disorders in the victim.

Among the large number of existing manual methods, the most effective is mouth-to-mouth artificial respiration. It consists in the fact that the caregiver blows air from his lungs into the lungs of the victim through his mouth or nose.

The advantages of the mouth-to-mouth method are as follows, as practice has shown, it is more effective than other manual methods. The volume of air blown into the lungs of an adult reaches 1000 - 1500 ml, i.e., several times more than with other manual methods, and is quite sufficient for the purposes of artificial respiration. This method is very simple, and every person, including those who do not have a medical education, can master it in a short time. With this method, the risk of damage to the organs of the victim is excluded. This method of artificial respiration allows you to simply control the flow of air into the lungs of the victim - by expanding the chest. It is much less tiring.

The disadvantage of the “mouth-to-mouth” method is that it can cause mutual infection (infection) and a feeling of disgust in the caregiver. In this regard, air is blown through gauze, a handkerchief and other loose fabric, as well as through a special tube:

Preparation for artificial respiration

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

a) release the victim from clothing restricting breathing - unbutton the collar, untie the tie, unbutton the belt of the trousers, etc.,

b) lay the victim on his back on a horizontal surface - a table or floor,

c) tilt the head of the victim as far as possible, placing the palm of one hand under the back of the head, and pressing the other on the forehead until the chin of the victim is in line with the neck. In this position of the head, the tongue moves away from the entrance to the larynx, thereby providing free passage of air to the lungs, the mouth usually opens. To maintain the achieved position of the head, a roll of folded clothes should be placed under the shoulder blades,

d) examine the oral cavity with your fingers, and if foreign content (blood, mucus, etc.) is found in it, remove it by removing dentures at the same time, if any. To remove mucus and blood, it is necessary to turn the head and shoulders of the victim to the side (you can bring your knee under the shoulders of the victim), and then, using a handkerchief or the edge of a shirt wound around the index finger, clean the mouth and throat. After that, you should give the head its original position and tilt it as much as possible, as indicated above.

At the end of the preparatory operations, the assisting person takes a deep breath and then exhales the air with force into the victim's mouth. At the same time, he should cover the entire mouth of the victim with his mouth, and pinch his nose with his cheek or fingers. Then the caregiver leans back, freeing the mouth and nose of the victim, and takes a new breath. During this period, the victim's chest descends and passive exhalation occurs.

For small children, air can be blown into the mouth and nose at the same time, while the caregiver must cover the mouth and nose of the victim with his mouth.

Control over the flow of air into the lungs of the victim is carried out by expanding the chest with each blow. If, after blowing in air, the chest of the victim does not straighten out, this indicates an obstruction of the respiratory tract. In this case, it is necessary to push the victim's lower jaw forward, for which the assisting person must put four fingers of each hand behind the corners of the lower jaw and, resting his thumbs on its edge, push the lower jaw forward so that the lower teeth are in front of the upper ones.

The best airway patency of the victim is ensured under three conditions: the maximum bending of the head back, opening the mouth, pushing the lower jaw forward.

Sometimes it is impossible to open the victim's mouth due to convulsive clenching of the jaws. In this case, artificial respiration should be performed according to the "mouth-to-nose" method, closing the victim's mouth while blowing air into the nose.

With artificial respiration, an adult should be blown sharply 10-12 times per minute (i.e., after 5-6 s), and for a child - 15-18 times (i.e., after 3-4 s). At the same time, since the child's lung capacity is less, the blowing should be incomplete and less abrupt.

When the first weak breaths appear in the victim, an artificial breath should be timed to the beginning of an independent breath. Artificial respiration should be carried out until deep rhythmic spontaneous breathing is restored.

When assisting the affected current, the so-called indirect or external heart massage - rhythmic pressure on the chest, i.e. on the front wall of the chest of the victim. As a result of this, the heart contracts between the sternum and the spine and pushes blood out of its cavities. After the pressure is released, the chest and heart expand and the heart fills with blood coming from the veins. In a person who is in a state of clinical death, the chest, due to the loss of muscle tension, is easily displaced (compressed) when it is pressed, providing the necessary compression of the heart.

The purpose of heart massage is to artificially maintain blood circulation in the body of the victim and restore normal natural heart contractions.

Blood circulation, i.e., the movement of blood through the system of blood vessels, is necessary for the blood to deliver oxygen to all organs and tissues of the body. Therefore, the blood must be enriched with oxygen, which is achieved by artificial respiration. In this way, Simultaneously with cardiac massage, artificial respiration should be performed.

The restoration of normal natural contractions of the heart, i.e., its independent work, during massage occurs as a result of mechanical irritation of the heart muscle (myocardium).

The blood pressure in the arteries, resulting from indirect heart massage, reaches a relatively large value - 10 - 13 kPa (80-100 mm Hg) and is sufficient for blood to flow to all organs and tissues of the victim's body. This keeps the body alive for as long as the heart massage (and artificial respiration) is performed.

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

To perform the massage, it is necessary to lay the victim on his back on a hard surface (bench, floor, or in extreme cases, put a board under his back). It is also necessary to expose his chest, unfasten clothing that restricts breathing.

In the production of a heart massage, the assisting person stands on either side of the victim and occupies a position in which a more or less significant tilt over him is possible.

Having determined by probing the place of pressure (it should be about two fingers above the soft end of the sternum), the assisting person should put the lower part of the palm of one hand on it, and then put the second hand at a right angle on top of the upper hand and press on the victim’s chest, slightly helping with this tilt of the entire body.

The forearms and humerus bones of the assisting hands should be extended to failure. The fingers of both hands should be brought together and should not touch the victim's chest. Pressing should be done with a quick push, so as to move the lower part of the sternum down by 3-4, and in obese people by 5-6 cm. The pressure should be concentrated on the lower part of the sternum, which is more mobile. Pressure should be avoided on the upper part of the sternum, as well as on the ends of the lower ribs, as this can lead to their fracture. It is impossible to press below the edge of the chest (on soft tissues), as it is possible to damage the organs located here, primarily the liver.

Pressure (push) on the sternum should be repeated about 1 time per second or more often to create sufficient blood flow. After a quick push, the position of the hands should not change for about 0.5 s. After that, you should straighten up slightly and relax your hands without taking them away from the sternum.

In children, massage is performed with only one hand, pressing 2 times per second.

To enrich the blood of the victim with oxygen, simultaneously with a heart massage, it is necessary to carry out artificial respiration according to the “mouth-to-mouth” (or “mouth-to-nose”) method.

If there are two people assisting, then one of them should perform artificial respiration, and the other - a heart massage. It is advisable for each of them to do artificial respiration and heart massage alternately, replacing each other every 5-10 minutes. In this case, the order of assistance should be as follows: after one deep breath, five pressures are applied to the chest If it turns out that after blowing the chest of the victim remains immobile (and this may indicate an insufficient amount of air blown in), it is necessary to provide assistance in a different order, after two deep breaths, do 15 pressures. You should be careful not to press on the sternum during inspiration.

If the assisting person does not have an assistant and performs artificial respiration and external heart massage alone, you need to alternate these operations in the following order: after two deep blows into the victim’s mouth or nose, the helper presses the chest 15 times, then again makes two deep blows and repeats 15 pressures for cardiac massage, etc.

The effectiveness of external heart massage is manifested primarily in the fact that with each pressure on the sternum on the carotid artery, the pulse is clearly felt. To determine the pulse, the index and middle fingers are placed on the victim's Adam's apple and, moving the fingers to the side, carefully feel the surface of the neck until the carotid artery is determined.

Other signs of the effectiveness of massage are the narrowing of the pupils, the appearance of independent breathing in the victim, a decrease in the cyanosis of the skin and visible mucous membranes.

The effectiveness of the massage is controlled by the person performing artificial respiration. To increase the effectiveness of the massage, it is recommended that the victim's legs be elevated (by 0.5 m) for the time of external heart massage. This position of the legs contributes to a better flow of blood to the heart from the veins of the lower body.

Artificial respiration and external cardiac massage should be performed until spontaneous breathing appears and the heart activity is restored, or until the victim is transferred to medical personnel.

The restoration of the activity of the heart of the victim is judged by the appearance of his own, not supported by massage, a regular pulse. To check the pulse every 2 minutes interrupt the massage for 2 - 3 seconds. The preservation of the pulse during the break indicates the restoration of independent work of the heart.

If there is no pulse during the break, you must immediately resume the massage. A prolonged absence of a pulse with the appearance of other signs of revival of the body (spontaneous breathing, constriction of the pupils, attempts by the victim to move his arms and legs, etc.) is a sign of heart fibrillation. In this case, it is necessary to continue providing assistance to the victim until the doctor arrives or until the victim is taken to a medical facility where the heart will be defibrillated. On the way, you should continuously do artificial respiration and heart massage until the moment the victim is transferred to medical personnel.

In preparing the article, materials from the book by P. A. Dolin "Fundamentals of electrical safety in electrical installations" were used.

Artificial respiration and indirect heart massage are a small part of resuscitation and everyone should be able to do them. If you see a person lying on the ground, you can provide first aid and save someone's life if you know how to act correctly.

It is no secret that the wrong actions to save a life can not only harm a person, but also aggravate the situation. In the United States, for example, a victim can sue for improper first aid resulting in injury or ill health.

It may seem strange that in American films, a person lying on the road is asked the question: “Are you OK?” (Are you okay?). After all, only after the consent of the victim, you can begin to provide assistance.

It is not uncommon for a person with a spinal fracture to be lifted and taken to the hospital, while it is forbidden to do so - the transportation of such patients requires special skills and equipment. Such patients can simply die at the hands of "rescuers". And ignorance of the rules for rendering assistance will not save them from responsibility.

If you find yourself in a lifeguard position and think that you are able to provide first aid, you should know that there are clear instructions for this. Today we will learn that and chest compressions.

Performing cardiopulmonary resuscitation (AHA latest recommendations)

1. First, you need to make sure that you and the victim are safe. If you also suffer, then you will also need to be saved. 2. Check if the victim is conscious. You can shout loudly, try to draw his attention. If there is no consciousness, we proceed further.

Checking for Consciousness

3. Immediately check for pulse and breathing.

Check for breathing by sound and chest movement

Breath check. For this put with one palm on the victim’s forehead, and with two fingers of the other hand, raise your chin, tilting your head back and pushing your lower jaw forward and upward, then bend over to the victim’s mouth and nose and try to hear normal breathing, feel the exhaled air with your cheek, put your other hand on his chest . We call an ambulance (or ask someone about it).

Checking the pulse on the carotid artery

Checking the pulse in the carotid artery. We apply p pads of 4 fingers on the side of the neck, on the sides of the Adam's apple (Adam's apple), no more than 10 seconds. 4. We proceed to compression (compression) of the chest (i.e. chest compressions).

Chest compression 30 times, then 2 breaths.

To do this, the base of the palm is placed in the middle of the person’s chest, while the hands are taken into the castle, and the arms are straightened at the elbow joints. Pressing the chest with the hands is done on a hard, flat surface, the depth of compression is 5-6 cm, the frequency is 100 times per minute.

Compression is done from top to bottom. Periodic chest compressions allow us to compress the chambers of the heart, thereby helping to push blood through the blood vessels. 5. After the compression, we check the airways, if necessary, release them and begin to do artificial respiration, i.e. artificial lung ventilation.

Artificial respiration. The victim's nostrils are closed at this time.

How to do artificial respiration?

Artificial respiration is when we exhale air from our lungs and inhale it into the lungs of another person. Very important do artificial respiration correctly, otherwise the air will not enter the human respiratory tract and your actions will be useless. For breaths, put with one palm on the victim's forehead, and with two fingers of the other hand, raise the chin, tilting the head back and pushing the lower jaw forward and up. Next with one hand open his mouth a little, and with the other pinch his nose with two fingers.

Next, inhale mouth-to-mouth for 1 second. If you do artificial respiration correctly, then the person's chest will rise, which indicates the flow of air into his lungs. After that, you need to let the chest go down and then repeat the breath.

For artificial ventilation of the lungs, it is best to use a special device for artificial ventilation of the lungs from the car first-aid kit. You need to continue to give chest compressions and artificial respiration, alternating between them in the following sequence: 30 chest compressions and 2 breaths.

Resuscitation is hard work. To maintain strength during chest compressions, keep your arms straight (at the elbows). If during resuscitation you see that the victim has arterial bleeding, then you need to stop it yourself or by calling an assistant.

How long should resuscitation take?

Resuscitation measures that are carried out by the person providing first aid should be carried out before the arrival of the ambulance and the order of the doctors to stop resuscitation or until visible signs of life appear in the person (spontaneous breathing, pulse, cough, movements).

If breathing occurs, but the person is still unconscious, they should be placed on their side (to avoid retraction of the tongue or entry of vomit into the respiratory tract) and examine them for injuries. It is also necessary to monitor the presence of signs of life before the arrival of the ambulance team.

Resuscitation activities may be terminated in case of physical fatigue of the person providing first aid and the absence of an assistant nearby. Resuscitation may not be carried out on those victims who have clear signs of non-viability (for example, severe injuries incompatible with life, cadaveric spots) or when the absence of signs of life is associated with the outcome of a long-term incurable disease (for example, cancer). first aid

Artificial respiration and indirect heart massage are a small part of resuscitation and everyone should be able to do them. If you see a person lying on the ground, you can provide first aid and save someone's life if you know how to act correctly. It's no secret that the wrong actions to save lives can not only ...

Artificial respiration and chest compressions. Options and procedure.

The main methods of resuscitation are artificial respiration and chest compressions. In people who are unconscious, the retraction of the tongue is the main obstacle to the entry of air into the lungs, therefore, before proceeding with artificial ventilation of the lungs, this obstacle must be eliminated by tilting the head, moving the lower jaw forward, and removing the tongue from the oral cavity.

For ease of memorization, resuscitation measures are divided into 4 groups, denoted by the letters of the English alphabet:
A - Air way open(ensuring the patency of the airways)
B - Breath for victum(artificial respiration)
C - Circulation of blood(indirect cardiac massage)
D-Drugs therapy(drug therapy). The latter is the prerogative of exclusively doctors.

Artificial respiration

Currently, the most effective methods of artificial respiration are recognized as blowing from mouth to mouth and from mouth to nose. The rescuer forcefully exhales air from their lungs into the lungs of the patient, temporarily becoming a "respirator". Of course, this is not the fresh air with 21% oxygen that we breathe. However, as studies by resuscitators have shown, the air exhaled by a healthy person still contains 16-17% oxygen, which is enough to carry out full-fledged artificial respiration, especially in extreme conditions.

In order to blow "the air of his exhalation" into the patient's lungs, the rescuer is forced to touch the victim's face with his lips. For hygienic and ethical reasons, the following method can be considered the most rational:

1. take a handkerchief or any other piece of cloth (preferably gauze)
2. bite a hole in the middle
3. expand it with your fingers up to 2-3 cm
4. put a tissue with a hole on the nose or mouth of the patient (depending on the chosen method of artificial respiration)
5. press your lips tightly against the face of the victim through the tissue, and blow through the hole in this tissue

Artificial respiration from mouth to mouth

The rescuer stands on the side of the victim's head (preferably on the left). If the patient lies on the floor, you have to kneel. Quickly clears the oropharynx of the victim from vomit. This is done as follows: the patient's head is turned to one side and with two fingers, previously wrapped with a cloth (handkerchief) for hygienic purposes, the oral cavity is cleaned in a circular motion.

If the jaws of the victim are tightly compressed, the rescuer pushes them apart, pushes the lower jaw forward (a), then moves his fingers to his chin and, pulling it down, opens his mouth; with the second hand, placed on the forehead, throws the head back (b).

Then, putting one hand on the forehead of the victim, and the other on the back of the head, he overbends (i.e., throws back) the patient's head, while the mouth, as a rule, opens (a). The rescuer takes a deep breath, slightly delays his exhalation and, bending down to the victim, completely seals the area of ​​\u200b\u200bhis mouth with his lips, creating, as it were, an air-tight dome over the patient's mouth opening (b). In this case, the patient's nostrils must be clamped with the thumb and forefinger of the hand (a) lying on his forehead, or covered with his cheek, which is much more difficult to do. Lack of tightness is a common mistake in artificial respiration. In this case, air leakage through the nose or corners of the mouth of the victim nullifies all the efforts of the rescuer.

After sealing, the person conducting artificial respiration makes a quick, strong exhalation, blowing air into the respiratory tract and lungs of the patient. Exhalation should last about 1 s and reach 1-1.5 liters in volume in order to cause sufficient stimulation of the respiratory center. In this case, it is necessary to continuously monitor whether the chest of the victim rises well during artificial inspiration. If the amplitude of such respiratory movements is insufficient, then the volume of air blown is small or the tongue sinks.

After the end of the exhalation, the rescuer unbends and releases the victim's mouth, in no case stopping the overextension of his head, because. otherwise, the tongue will sink and there will be no full-fledged independent exhalation. The exhalation of the patient should last about 2 seconds, in any case, it is better that it be twice as long as the inhalation. In a pause before the next breath, the rescuer needs to take 1-2 small ordinary breaths - exhalation “for himself”. The cycle is repeated first with a frequency of 10-12 per minute.

Artificial respiration from mouth to nose

Artificial respiration from mouth to nose is performed if the patient's teeth are clenched or there is an injury to the lips or jaws. The rescuer, putting one hand on the forehead of the victim, and the other on his chin, hyperextends his head and at the same time presses his lower jaw to the upper

With the fingers of the hand supporting the chin, he should press the lower lip, thereby sealing the mouth of the victim. After a deep breath, the rescuer covers the victim's nose with his lips, creating the same air-tight dome above him. Then the rescuer makes a strong blowing of air through the nostrils (1-1.5 l), while watching the movement of the chest.

After the end of artificial inhalation, it is necessary to release not only the nose, but also the patient's mouth, the soft palate can prevent air from escaping through the nose, and then there will be no exhalation at all when the mouth is closed! It is necessary with such an exhalation to keep the head overbent (i.e., thrown back), otherwise the sunken tongue will interfere with exhalation. The duration of the exhalation is about 2 s. In a pause, the rescuer takes 1-2 small breaths - exhalations “for himself”.

Artificial respiration should be carried out without interruption for more than 3-4 seconds, until full spontaneous breathing is restored or until a doctor appears and gives other instructions. It is necessary to continuously check the effectiveness of artificial respiration (good inflation of the patient's chest, absence of bloating, gradual pinking of the skin of the face). Constantly make sure that vomit does not appear in the mouth and nasopharynx, and if this happens, before the next breath, a finger wrapped in a cloth should be cleared through the mouth of the victim's airways. As artificial respiration is carried out, the rescuer may feel dizzy due to a lack of carbon dioxide in his body. Therefore, it is better that two rescuers carry out air injection, changing after 2-3 minutes. If this is not possible, then every 2-3 minutes, breaths should be reduced to 4-5 per minute, so that during this period the level of carbon dioxide in the blood and brain rises in the person who performs artificial respiration.

When carrying out artificial respiration in a victim with respiratory arrest, it is necessary to check every minute whether he also had a cardiac arrest. To do this, periodically feel the pulse with two fingers on the neck in the triangle between the windpipe (laryngeal cartilage, which is sometimes called the Adam's apple) and the sternocleidomastoid (sternocleidomastoid) muscle. The rescuer places two fingers on the lateral surface of the laryngeal cartilage, after which he “slips” them into the hollow between the cartilage and the sternocleidomastoid muscle. It is in the depths of this triangle that the carotid artery should pulsate.

If there is no pulsation on the carotid artery, an indirect heart massage should be started immediately, combining it with artificial respiration.

If you skip the moment of cardiac arrest and perform only artificial respiration without heart massage for 1-2 minutes, then, as a rule, it will not be possible to save the victim.

Indirect cardiac massage

Mechanical action on the heart after it has stopped in order to restore its activity and maintain continuous blood flow until the heart resumes its work. Signs of sudden cardiac arrest - a sharp pallor, loss of consciousness, the disappearance of the pulse in the carotid arteries, cessation of breathing or the appearance of rare, convulsive breaths, dilated pupils.

An indirect heart massage is based on the fact that when you press the chest from front to back, the heart, located between the sternum and spine, is compressed so much that blood from its cavities enters the vessels. After the cessation of pressure, the heart expands and venous blood enters its cavity.

Cardiac massage is most effective if started immediately after cardiac arrest. For this, the patient or victim is laid on a flat hard surface - the ground, floor, board (on a soft surface, such as a bed, heart massage cannot be performed).

At the same time, the sternum should bend by 3-4 cm, and with a wide chest - by 5-6 cm. After each pressure, the hands are raised above the chest so as not to prevent it from straightening and filling the heart with blood. To facilitate the flow of venous blood to the heart, the legs of the victim are given an elevated position.

An indirect heart massage must be combined with artificial respiration. Heart massage and artificial respiration are more convenient for two persons. At the same time, one of the caregivers makes one blowing of air into the lungs, then the other makes four to five chest compressions.

The success of an external heart massage is determined by the narrowing of the pupils, the appearance of an independent pulse and breathing. Cardiac massage should be carried out before the doctor arrives.

The sequence of resuscitation measures and contraindications to them

Sequencing

1. lay the victim down on a hard surface
2. unfasten the trouser belt and squeezing clothing
3. clean the mouth
4. eliminate retraction of the tongue: straighten the head as much as possible, push the lower jaw
5. if resuscitation is carried out by one person, then make 4 respiratory movements to ventilate the lungs, then alternate artificial respiration and heart massage in the ratio of 2 breaths 15 chest compressions; if resuscitation is carried out together, then alternate artificial respiration and heart massage in the ratio of 1 breath 4-5 chest compressions

Contraindications

Resuscitation measures are not carried out in the following cases:

• traumatic brain injury with brain damage (trauma incompatible with life)
• fracture of the sternum (in this case, during a heart massage, the heart will be injured by fragments of the sternum); therefore, before resuscitation, you should carefully feel the sternum