Minimum time for chest compressions. Types and techniques of cardiac massage. Actions of two people

Article publication date: 02/08/2017

Article last updated: 12/18/2018

From this article you will learn: what is an indirect heart massage, for what, to whom and who can do it. Is it possible to harm a person by performing this procedure, and how to make it really help.

An indirect heart massage is a resuscitation emergency aimed at replacing and restoring stopped cardiac activity.

This procedure is the most important for saving the life of a person who has a cardiac arrest and is in a state of clinical death. Therefore, each person must be able to do cardiac massage. Even if you are not a specialist, but at least approximately know how this procedure should go, do not be afraid to do it.

You will not harm the patient if you do something not quite right, and if you do nothing, it will lead to his death. The main thing is to make sure that there are really no heartbeats. Otherwise, even a perfectly executed massage will hurt.

The essence and meaning of cardiac massage

The purpose of heart massage is to artificially recreate, replace cardiac activity in case of its stop. This can be achieved by squeezing the cavities of the heart from the outside, which imitates the first phase of cardiac activity - contraction (systole) with a further weakening of pressure on the myocardium, which imitates the second phase - relaxation (diastole).

This massage can be done in two ways: direct and indirect. The first is only possible with surgical intervention when there is direct access to the heart. The surgeon takes it in his hand and performs a rhythmic alternation of compression with relaxation.

An indirect heart massage is called indirect because there is no direct contact with the organ. Compression is carried out through the wall chest because the heart is located between the spine and the sternum. Effective pressure on this area is capable of ejecting about 60% of the blood volume into the vessels compared to the self-contracting myocardium. Thus, the blood can circulate in the most large arteries and vital important bodies(brain, heart, lungs).

Indications: who really needs this procedure

The most important thing in cardiac massage is to determine whether a person needs it or not. There is only one indication - complete. This means that even if an unconscious patient has pronounced violations rhythm, but at least some cardiac activity is preserved, it is better to refrain from the procedure. Squeezing the beating heart can cause it to stop.

The exception is cases of severe ventricular fibrillation, in which they seem to tremble (about 200 times per minute), but do not perform a single full-fledged contraction, as well as weakness sinus node and, in which the heartbeat is less than 25 beats per minute. If such patients are not helped, the condition will inevitably worsen, and cardiac arrest will occur. Therefore, they can also be given indirect massage if there is no other way to help.

The justification for the expediency of this procedure is described in the table:

Clinical death is the stage of dying after the cessation of cardiac activity lasting 3-4 minutes. After this time, irreversible processes occur in the organs (primarily in the brain) - biological death occurs. Therefore, the only time when you need to do cardiac massage is the period of clinical death. Even if you do not know when the cardiac arrest occurred and are not sure if there is a heartbeat, look for other signs of this condition.

The sequence of actions that make up the technique indirect massage hearts includes:

1. Determine if the patient has a pulse and heartbeat:

• Feel with your fingers the anterolateral surfaces of the neck in the projection of the location carotid arteries. The absence of a pulsation indicates cardiac arrest.
• Listen with your ear or phonendoscope to the left half of the chest.

2. If you doubt the absence of heartbeats, before doing chest compressions, determine other signs of clinical death:

3. If these signs occur, feel free to proceed with an indirect heart massage, observing the technique of execution:

• Lay the patient on his back, but only on hard surface.
• Open the patient's mouth, if there is mucus, vomit, blood or any foreign bodies in it, clean oral cavity fingers.
• Tilt the victim's head back well. This will prevent the tongue from slipping. It is advisable to fix it in this position by placing any roller under the neck.
• Stand to the right of the patient at chest level.
• Place the hands of both hands on the sternum at a point that is located two fingers above the lower end of the sternum (the border between the middle and lower thirds).
• Hands should lie in this way: the fulcrum of one hand is the soft part of the palm in the area of ​​elevation thumb and the little finger just below the wrist. Place the second brush on the one located on the chest and interlace their fingers into the castle. Fingers should not lie on the ribs, as they can cause fractures during the massage.
• Lean over the victim in such a way that, with correctly located brushes, you seem to rest against the sternum. The arms should be straight (unbent at the elbows).

The technique for performing pressure on the chest should be as follows:

1. At least 100 times per minute.
2. So that it is pressed 3-5 cm.
3. Apply compression not by flexing and extending your arms at the elbows, but by pressing your whole body. Your hands should be a kind of transmission lever. So you will not get tired and will be able to massage as much as you need. This procedure requires a lot of effort and energy.

An indirect heart massage can last about 20 minutes. Check every minute for a pulse in the carotid arteries. If, after this time, the heartbeats have recovered, further massage is not advisable.

It is not necessary to do artificial respiration at the same time as cardiac massage, but it is possible. Correct technique execution in this case: after 30 pressures, take 2 breaths.

Forecast

The effectiveness of indirect heart massage is unpredictable - from 5 to 65% ends with the restoration of cardiac activity and saving a person's life. The prognosis is better when performed in young people without concomitant diseases and damage. But cardiac arrest without indirect massage in 100% ends in death.

An indirect heart massage is performed if it is necessary to resuscitate a person in case of cardiac arrest and lack of breathing.

At the same time, by pressing (pressing), the chest is compressed and artificial respiration is carried out, that is, the victim is given first aid along with artificial lung ventilation (IVL).

Physiology of circulation

The heart consists of four chambers: 2 atria and 2 ventricles. The atria provide blood flow to the ventricles from the vessels. The right ventricle ejects blood into the vessels of the lungs (pulmonary circulation), the left ventricle into the aorta, tissues and organs (large circulation).

Through the pulmonary circulation, metabolic processes gases: it enters the lungs from the blood carbon dioxide, and into the blood - oxygen from the lungs by binding to the hemoglobin of erythrocytes. Reverse exchange processes occur in big circle blood circulation, and besides this, micronutrients. Excreted from tissues by kidneys, skin and light products exchange into the blood of the aorta.

What happens when circulation stops?

With circulatory arrest, tissue and gas exchange will stop. Cells accumulate metabolic products, and blood - carbon dioxide. The metabolism will stop, and the cells will die from poisoning with waste products and oxygen starvation.

What does indirect heart massage give?

Immediately after cardiac arrest, an indirect heart massage (closed heart massage) is performed to restore its activity. This will maintain continuous blood flow until recovery. functional work hearts.

The chest is compressed, which means that the chambers of the heart and blood will leave the atria into the ventricles through the opened valves, then enter the vessels. An indirect heart massage activates his own electrical activity and normalizes the work of the vascular center. Closed heart massage helps to restore the functional work of the heart.

Causes of cardiac arrest

• spasm of the coronary vessels;
• acute heart failure;
• myocardial infarction;
• defeat electric shock or lightning;
• severe injuries.

Cardiac arrest is characterized by signs:

• sharp pallor;
• loss of consciousness;
• the disappearance of the pulse;
• cessation of breathing or the appearance of convulsive and rare breaths with dilated pupils.

Closed (or external) heart massage - a technique for conducting

An indirect heart massage (or external) is combined with other resuscitation measures for the flow of blood from the heart into the vessels and restoration of breathing.

• one hand is placed with the palm on the sternum in the lower part, the main emphasis is placed on the metacarpus;
• the other hand is placed on top and both arms are straightened at the elbows to perform rhythmic pressure on the sternum;
• when lowering the sternum by 3-4 cm, the pressure force is considered normal, with a wide sternum - by 5-6 cm.

Algorithm cardiopulmonary resuscitation consists of a sequence of fast resuscitation. Closed heart massage is combined with mechanical ventilation (tempo - 15x2). 2 breaths are added to 15 clicks if resuscitation is carried out by 2 people. If one person - then the pace is - 4x1.

The rules establish that the combination of indirect heart massage with defibrillation allows you to stop the massage for only 5-10 seconds, no more.

1. The technique of indirect heart massage provides for the definition and location xiphoid process.
2. The victim should lie on a hard and flat surface: board, ground, floor. The soft bed is not suitable. The resuscitator becomes to the left or right of the patient. His palms are on the lower end of the sternum.
3. The resuscitator palpates the compression point. Its location from the xiphoid process is at a distance of 2 fingers strictly in the center of the body axis vertically. The resuscitator places his palms with the base on the compression point. Increases pressure with the second hand and the weight of the body. Movements should be fast, rhythmic. The frequency of shocks is one shock per second.
4. To deoxygenated blood freely filled the heart, and facilitated the flow of venous blood to the heart, the resuscitator must raise his hands above the sternum after each pressure, and the victim's legs are laid on a roller to give them an elevated position.

External heart massage is carried out strictly vertically at 101-112 strokes per minute.

External heart massage for infants is carried out with the pads of the second and third fingers, for adolescents - with the palm of one hand. For adults, when pressing, the thumb is directed strictly to the head or legs, which depends on which side the resuscitator is on. During the closed massage fingers are raised so that they do not touch the ore cell.

The technique of external heart massage for children depends on the age of the baby. The procedure is as follows: the baby is laid with its back on a hard surface with its head towards itself. They press on the sternum with two fingers, and the thumbs are located on the chest in front. The other two fingers are held under the back.

For children under 7 years of age, it is more convenient to conduct an indirect heart massage with the base of the palm of the hand, standing on the side. In newborns, the deflection of the chest should be 1-1.5 cm, in infants up to a year - 2-2.5 cm, in babies older than a year - by 4-4 cm.

The number of chest compressions per minute always corresponds to the child's pulse rate according to age. That's why:

During the massage, the resuscitator alternates two breaths (carries out artificial ventilation of the lungs - ALV) with 15 compressions.

To determine the effectiveness of mechanical ventilation and the performance of indirect heart massage, the resuscitator controls the pulse on the carotid artery and the reaction of the pupils to bright light.

Performing an indirect heart massage and mechanical ventilation should be carried out by 2 resuscitators. First aid to the victim allows you to save his life. It is carried out until the doctor arrives.

• The main signs of cardiac arrest
• How NMS is carried out
• Mandatory steps in the process of heart massage
• Recommendations for effective massage
• Closed heart massage for a child 10-12 years old
• Technique and rules for NMS and artificial respiration for infants

The first and main method of rescuing a person who has stopped breathing is chest compressions, or NMS. It can be carried out in order to restore the work of the heart muscle simultaneously with blood circulation, since it requires mechanical action. Only after this is the restoration of the vital activity of the body and the continuous blood flow normalizes.

If a cardiac arrest occurs, then in almost any case it is necessary to do artificial respiration. The patient will need first aid to maintain the vital activity of his body, until he arrives Ambulance. To carry out all the activities associated with NMS, significant efforts are required, which involve artificial respiration.

The main signs of cardiac arrest

Cardiac arrest is considered sudden and complete cessation cardiac activity, which in certain cases can occur simultaneously with the bioelectric activity of the myocardium. The main reasons for stopping are:

1. Asystole of the ventricles.
2. Paroxysmal tachycardia.
3. and etc.

Predisposing factors include:

1. Smoking.
2. Age.
3. Alcohol abuse.
4. Genetic.
5. Excessive stress on the heart muscle (for example, playing sports).

Sudden sometimes occurs due to injury or drowning, possibly due to blocked airways as a result of electric shock.

In the latter case, clinical death inevitably occurs. It should be remembered that the following signs can signal a sudden stop cardiac activity:

1. Consciousness is lost.
2. Rare convulsive sighs appear.
3. There is a sharp pallor on the face.
4. In the region of the carotid arteries, the pulse disappears.
5. Breathing stops.
6. Pupils dilate.

An indirect heart massage is performed until the restoration of independent cardiac activity occurs, among the signs of which the following can be distinguished:

1. The person comes to consciousness.
2. A pulse appears.
3. Decreases pallor and blueness.
4. Breathing resumes.
5. Pupils constrict.

Thus, in order to save the life of the victim, it is necessary to carry out resuscitation, considering all the circumstances, and at the same time call an ambulance.

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How NMS is carried out

Carrying out NMS, or external heart massage, is performed with artificial ventilation of the lungs.

This is done by alternating between ventilation and massage, regardless of the reasons why the heart stopped. The main thing is to remember the timeliness and correctness of the actions taken related to cardiac resuscitation of a patient whose body has lost its vital functions. This leads to the death of the victim before the arrival of the ambulance.

The body of the victim has signs of cardiac arrest, so he needs an ambulance. It can only be provided by those people who at that moment were near him. First, they kneel near the patient's chest, determine the area on the palm, which should be pressed. The base of the palm can easily be bent with sufficient pressure.

It is necessary to follow the massage technique correctly, rhythmically squeezing the chest and pressing on it with both hands, which causes blood to be squeezed out of the heart muscle, which begins to spread through the vessels. There is a pressing of the heart to the spine. The process of blood circulation in the body of the victim is resumed if about 60-70 pressings with both hands are performed per minute. If there is no cardiac activity, then these manipulations will be enough.

If clinical death has occurred, then it is significantly reduced muscle tone, therefore, the mobility of the chest increases, which makes it easier to perform actions related to simulating the work of the heart muscle. Whether there is blood circulation is established simultaneously with the observation of the pulse. It is measured at the wrist, neck, or femoral artery.

If the condition is terminal, then the pulse should be felt where the area of ​​the carotid artery is located, since it is not possible to determine it at the level of the wrist. For this purpose, fingers are placed on the larynx, on top of the so-called Adam's apple, after which they are moved along the neck.

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Mandatory steps in the process of heart massage

According to the methodology, the NMS rescuer begins to conduct, standing up from right side from the patient. To detect the xiphoid process, first run a finger along the ribs of a person. With the help of the index and middle fingers, a small tubercle is found on the sternum, which should be lower than the level of the nipples, or on it. Then it is necessary, having measured two fingers above the xiphoid process, to place the left hand with the palm down in this place.

The palm of the base is placed on the found place. Next, with the palm on top of the left hand, place the right hand on its back side so that the fingers are pointing up. This position of the hands will allow you to block the hands due to the fingers fastened with a lock. It is important to ensure that the shoulders of the rescuer are located directly above the chest of the patient, placing his palms on his sternum and straightening his elbows.

At the next stage, they already begin to massage, pressing with both hands on the chest. The chest is pressed through no less than 3-5 cm. The rescuer must squeeze the sternum in jerks so that it can be displaced exactly 3-5 cm in the direction of the spine, holding for about half a second (if the victim is an adult). After that, the rescuer should relax his hands, but do not tear them off his chest. We should not forget about artificial respiration which is done to the patient.

With NMS, it is required to compress the heart, that is, its muscles, where the sternum and spine are located, which is associated with squeezing blood into the arteries. When the pressure stops, the heart fills with blood through the veins. It must be remembered that when proper conduct NMS provides only 20-40% of the circulatory norm healthy person, which is sufficient to keep the body alive for an hour before the arrival of the ambulance. In this regard, you cannot stop actions, but you can interrupt for seconds by continuing actions.

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Should be paid Special attention on the location of the rescuer, who needs to be much higher than the body of the patient. He can sit on a chair or kneel near the victim if he is lying on the floor. It is necessary to ensure that the arms are straight during the massage, so you need to press when the strength of the hands is used simultaneously with the severity of the victim's torso. This allows for efficiency to conserve energy, so that NMS can be carried out for a long time.

The fingers should not lie on the chest, as it is necessary to make effective massage. All forces must be directed to the lower third of the sternum, and not to the area itself chest wall which will reduce the risk of rib fractures.

If the patient is in horizontal position on a hard, level surface, it is easier for the rescuer to apply pressure on the sternum so that the heart muscle can contract. The NMS scheme involves not only correct location, but also the right way pressure.

Quickly starting to implement the NMS, forcefully press on the sternum area. It can go to a depth equal to half the height of the entire chest. After pressing, relaxation immediately follows.

It is important to monitor the coincidence of moments associated with pressure and relaxation. It is necessary to squeeze the patient's sternum with such force that it is pressed against the spine by 5-6 cm, at a pace close to normal heart rhythms.

Cardiac massage should be performed for at least 30 minutes. Performing outdoor massage heart must remember that you can not stop the massage process until 30 clicks have been made. If you often rest, then this will only harm the victim, since resuscitation carried out in these rhythms causes the cessation of the blood circulation process completely.

Having made 30 clicks on the chest area, about two breaths are taken into the patient's mouth, which can be done after 150 times. It is necessary to observe the pressure rate of about 100 times per minute, which is suitable for any patient, with the exception of a newborn.

You should wait for an ambulance or take the necessary actions until the pulse in the carotid artery resumes. If there is no pulse, then the massage should be continued until signs begin to appear. biological death developing after the onset of clinical death within an hour.

When cardiac contractions stop, a competently performed external heart massage can save a life. This implies rhythmic pressure on lower part sternum for artificial blood pumping. Such actions help restore myocardial electrical activity and prevent the death of brain cells.

Read in this article

When you need artificial massage

The main indication for an indirect heart massage is to stop its work. This may be when:

• drowning,
• electric shock,
• arrhythmia (ventricular fibrillation, weakness of the sinus node),
• stroke and
• pulmonary embolism,
• hypothermia (excessive hypothermia),
• shock due to blood loss, anaphylaxis,
• poisoning carbon monoxide, alcohol, drugs.

In order to be sure of cardiac arrest, you need to determine the following signs:

• there is no pulsation of the carotid arteries (check with the second and third fingers);
• there is no breathing (the chest is motionless, there is no fogging on the glass, mirror when approaching the face);
• the pupils are dilated, if you shine a flashlight on them, then there is no constriction;
• loss of consciousness is determined by a pat on the face or loud sounds if the patient does not respond to them, then this is a sign of an unconscious state;
• the skin of the face and body is pale with a grayish-bluish tinge.

If the person conducting resuscitation does not know how to correctly determine the pulse, then he is considered absent. To start a closed massage, the absence of consciousness and breathing is enough.

The most important factor determining the future life of a clinically dead patient is the first 7 minutes after cardiac arrest. Brain cells begin to die after 3-5 minutes of stopping the flow of blood into them. After 30 minutes, any resuscitation will be useless.

The correct sequence of actions

A complete complex for the prevention of death consists of the following steps:

1. Recognize cardiac arrest.
2. Call an ambulance.
3. Start external massage and ventilation of the lungs (massage is a priority).
4. Intensive drug therapy.

First aid to the victim is often provided by a person who does not have special knowledge and experience, therefore, according to the latest recommendations of resuscitators, before the arrival of a special team, one can limit oneself to only a closed heart massage.

A break in chest compressions greatly disrupts the blood supply to the brain, so a break in ventilation of the lungs should not be done longer than 10 seconds after every 30 compressions.

The position of the patient before the manipulation

In order to compress the chest, the back of the victim must be on a hard surface. Therefore, it is laid on the floor or ground. A bed or sofa is not suitable for this purpose. The chest is released from clothing, the belt is unfastened.

The respiratory tract should be freed from the contents as far as possible. To do this, clean the oral cavity with a spoon or similar object. If the mouth is closed, then lower jaw it is required to push forward: throw back your head, place index fingers by the ears and strong movement pull the jaw up and forward.

Execution technique

When providing first aid, a closed massage technique and artificial ventilation of the lungs are used. Direct impact on the heart can only be performed during the period of cardiac surgery.

Indirect outdoor (closed)

Before starting, a precordial blow is applied to the region of the heart. It is sometimes enough to start independent contractions. To do this, with a clenched fist, you need to sharply hit the sternum 2-3 cm higher from the xiphoid process. A blow to the heart is more effective if no more than 20 seconds have passed since the stop. Contraindicated for children weighing up to 15 kg.

For effective resuscitation, indirect massage is much more important than all other activities, so it should be carried out as early as possible and for a long time before the arrival of the medical team or the appearance of signs of biological death.

Rules for conducting closed cardiac massage:

• Get on your knees near your chest.
• Place straightened arms on the lower third of the sternum 2 cm above the costal angle, the shoulders of the caregiver are above the patient's chest.
• Pressing is done by the lower zone of the palm with both hands (one on top of the other, fingers crossed).
• The pressure on the chest should not be due to the muscles of the arms, but the weight of the torso, the direction is strictly perpendicular.
• Depth of deflection - 5 cm, rhythm - 100 compressions per minute.

With intense pressure, fracture of the ribs can occur. It is more common in the elderly, but is not a reason for stopping resuscitation.

Watch the video about the technique of performing chest compressions:

with ventilator

When inhaling air into the patient's mouth, check the patency respiratory tract, free your mouth and nasal passages, tilt your head back so that your chin is pointing up. Principles artificial ventilation lungs:

• take a deep breath,
• pinch the patient's nose and exhale into the mouth,
• repeat after 4 seconds,
• continue external cardiac massage.

To protect the resuscitator and the victim, barriers are used - a handkerchief or special masks available in the first aid kit. Efficiency is assessed by raising the chest.

The main differences between direct and indirect

To perform a direct heart massage, the surgeon must squeeze his ventricles in a rhythm of up to 60 contractions with one or both hands, forcing blood to move through the arteries. This method is used if a straight line is fixed on the ECG during an operation in a patient. It is justified only in case of cardiac arrest with an open chest or if there is an operative access near the diaphragm. Most often, such actions are carried out with.

For indirect massage, the integrity of the chest is required, since it is produced when it is compressed. Both types of massage lose their significance if they are started late, when the body has had time to metabolic disorders or came terminal stage serious illness internal organs.

How to massage children

The basic rules for cardiopulmonary resuscitation after 1 year are the same. Newborns cover the chest with their palms, while on the lower third of the sternum they have thumbs, and the rest are placed under the back (the resuscitator is located on the side of the head). Pressure is carried out with one finger, their depth is about 1.5 - 2 cm, and the frequency is 130 - 140 per minute.

Older children are assisted as adults, but up to 2 years it is enough to use 2-3 fingers, and after that the power of one palm is enough. Adolescents can squeeze the chest with both hands, but the effect should be less intense than in adults.

Defibrillation of the heart is performed for such indications as a violation of the rhythm of heart contractions. The technique of electrical defibrillation is quite simple, it is performed by trainers, hotel staff, and flight attendants.

The indirect method of cardiac massage is one of the methods of resuscitation carried out by pressing on the chest. This event must be performed as a result of stopping the heartbeat to restore blood circulation.

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The concept of indirect massage

Getting injuries associated with blood loss entails shutting down the functioning of the heart muscle. To prevent cell death, resuscitation of the victim must be applied.

In terms of time it takes no more than 0.5 hour, but if this period has expired, then clinical death occurs.

In total, there are two ways to provide first aid to the victim - indirect and direct massage heart muscle. When blood circulation ceases to circulate, the exchange of gases in the tissues at the intercellular level in the body stops.

Cells begin to die, and the internal organs are poisoned by decay products. Cell death depends on the speed of synthesis of useful components. This especially affects the brain, it gradually dies after 4 minutes after cessation of access to the brain blood.

Circumstances of resuscitation

External cardiac massage should be performed if the injured person has the following:

• lack of consciousness;
• pupils during forced opening do not react to light;
• no signs of a heartbeat;
• breath is not felt.

Chest compression is the most acceptable way to show signs of life, especially if drugs are not used for this.

An indirect heart massage, including the technique for performing it, involves squeezing the bones between the chest and spine. In the victim during this period, the ribs become the most pliable.

If a person is in a state of clinical death, it is easy to move the chest, during the event, the pressure in the heart muscle simultaneously increases and its volume decreases.

When performing movements in a given rhythm, the blood pressure in the cavities of the heart and in the vessels becomes unequal. From the left ventricle, blood enters the aorta of the brain, and from the right ventricle - to the lungs, where the cells of the organs are saturated with oxygen.

Important! When the pressure on the chest stops, the muscle expands and fills with blood, and when pressed, it is pushed out again. Thus, the heartbeat created artificially is maintained.

How to restore blood circulation

External cardiac massage is performed rib compression method. The following happens in the body:

• passing from the atrial region through the cavities of the valves, the blood fluid enters the region of the ventricles, and then spreads through the vessels;
• since the pressure is applied periodically, the circulation of the blood is not inhibited, and the blood continues to spread.

How to do a heart massage

This technique is necessary to create an electrical impulse of the heart muscle, which ensures the restoration of the functioning of the organ. If this process is not stopped, then within 0.5 hours you can regain consciousness, but you should know how to do chest compressions and have basic skills.

Advice! Be sure to perform these steps when performing artificial inhalations and exhalations. The force of pressure on the chest should not exceed 3 to 5 cm, which ensures the release of air masses in an amount of approximately 500 ml with each press. In this case, IVL is carried out.

What actions are performed with an indirect heart massage?

Performing indirect massage

Every person should know the rules for conducting an indirect heart massage for an adult.

chest compressions training

Execution technique contains the following information:

1. The injured person lies on a solid foundation or on the ground. If the first aid provider is right-handed, then it will be preferable for him to kneel on the right to perform the precordial strike with his right hand. If, on the contrary, you are left-handed, then the location on the left will be most convenient.
2. The maximum result from a closed massage will be provided if the victim is found on a flat and firm surface.
3. For pressure, palm right hand it is necessary to place it about 4 cm above the xiphoid process, but at the same time, the location of the thumb must be oriented to the stomach or chin of the victim. The other palm should be placed on the first at a right angle.
4. When directly performing the event, you do not need to bend your elbows, and the center of gravity should be kept relative to the chest. Restoration of the work of the heart is quite not an easy task, as it would seem, and therefore the forces for holding must be able to save, and when bending the elbows, you can quickly become exhausted. To make sure that brings results, you should periodically check the presence of a pulse in an injured person. The number of clicks in one minute 60 - 100 times is the optimal pace of chest compressions.
5. The pressure between the ribs should not exceed 3 to 5 cm. This depends on how elastic the bones are. Do not take your hands off the body of an injured person. The chest should return to its previous position, but if you remove your palms and put them back, then such an action is equivalent to a powerful blow. So can injure the victim even more.
6. For 30 pressures, 2 breaths should be taken. As a result, inhalation and passive exit occur, which contributes to the saturation of the lungs with oxygen.

As mentioned earlier, after 0.5 hours, signs of life should appear, but if this does not happen, then death comes.

heartbeat

To know how to do chest compressions correctly, must be remembered following:

1. If the ribs are broken, you should not stop working, you can only reduce the number of pressures, but the depth of pressure should be left the same.
2. When performing resuscitation, it is worth paying more attention to pressing, and not to artificial inhalation of air.
3. Before performing resuscitation directly, make a precardinal punch from a height of about 0.3 m and only after that carry out the prescribed measures.

Resuscitation of children

What sequence of actions should be followed when providing first aid to children under the age of one year and older?

Helping kids is different than helping adults. The difference is in the depth of pressure and the area of ​​impact on the body area. Actions should be performed with one palm. For newborn babies, perform compression using two fingers.

Where to learn to do chest compressions

Indirect cardiac massage in children produced in this way:

1. Place your fingers below the level of the nipples and start pressing, with a frequency of more than 120 times per minute, the depth of pushing from 1.5 to 2 cm, while air inlets should be performed at least one in 5 presses.
2. If the baby is one year old and not more than 7 years old, then the optimal pace of indirect heart massage is from 100 to 200 pressures with a depth of 3 to 4 cm. The number of breaths is 1 with 5 pressures. Before holding, 2 fingers are placed higher from the xiphoid process.
3. If the child is over 7 years old, then the location of the fingers is the same as in the previous version, the depth of pressing is from 4 to 5 cm with a frequency of 80 to 100 times. Air is blown in at the rate of 2 times for 15 pressures.

Important nuances

When indirect massage should not be used hearts? It depends on a number of circumstances. The technique of resuscitation is associated with cardio - vascular system, so there are a number of contraindications:

1. Fractured ribs and other chest injuries.

2. If the heart muscle does not work for half an hour.

3. In the presence of a heartbeat, even if it is weak.

4. With an increased degree of risk to one's own life.

5. With open wounds and bleeding you have to make your own decision for such first aid.

Advice! It is necessary to massage the heart muscle according to the technology. AT regulatory framework there is an article on the right of everyone to provide first aid, but only in relation to an adult. If you resuscitate the baby, then it should be consent from parents. The effectiveness of the event depends on the readiness for action and skills.

Video: Performing chest compressions

In the event of an accident or finding a person in an unconscious state, this area of ​​\u200b\u200bthe area must not be left until the ambulance arrives. Properly performed closed heart massage, and timely assistance to the victim contribute to the preservation of life.