Restoring airway patency is necessary for successful resuscitation. Violation of airway patency may be associated with muscle relaxation and retention of the tongue, ingestion of vomit, water, excessive mucus formation, and also with foreign bodies.
Restoring airway patency, artificial respiration, indirect heart massage, especially.
If the victim is lying on his back and unconscious, then the root of the tongue is likely to fall. In this case, artificial respiration will be inconclusive. To restore airway patency, you need to put one hand on the victim’s head in the area of the hairline, and grab his chin with the other hand. Then, pressing the head, throw it back with your first hand and put your chin forward with your second hand.
The victim’s mouth will open slightly. Then the index and middle fingers of the left hand are introduced into the mouth and the oral cavity is examined. If necessary, foreign bodies are removed. To remove mucus, blood and other, you can wrap your fingers with a napkin. To remove fluid (water, stomach contents, blood) from the respiratory tract, use the drainage position.
It is necessary to turn the victim on his side, while maintaining the existing position of his head and body relative to each other. This position contributes to the outflow of fluid through the nose and mouth. Then its remains can be removed with a suction, a rubber spray, wiped in the mouth with a napkin. The position of the victim should not be changed in case of a spinal injury in the cervical spine.
When foreign bodies get stuck in the throat, they are removed with the index finger. It is deeply promoted in the victim’s oral cavity through the tongue. Then, bending the finger, they pick up a foreign object and push it out. This technique should be performed carefully so as not to push the foreign object even deeper.
When stuck in the larynx or trachea, large foreign bodies produce a tracheostomy. A trachea is cut through the front surface of the neck and a hollow tube is inserted through it into the trachea. Such manipulation is usually performed in a hospital setting. After restoration of airway patency, it is possible to start artificial respiration and indirect heart massage..
Artificial respiration, especially.
Artificial respiration is performed when breathing stops, severe oxygen deficiency, which often happens with head and neck injuries, acute poisoning, etc. When breathing stops, a person loses consciousness, his face turns blue. The respiratory arrest is determined by the absence of movements of the chest of the victim by applying a palm on it. When listening to the lungs with a phonendoscope, respiratory sounds are also not detected.
To perform artificial respiration, it is necessary to lay the victim on his back, throw his head back as far as possible to prevent tongue retention. There are two methods of artificial respiration: from mouth to mouth and from mouth to nose. If for some reason it is impossible to exhale the patient in the mouth, for example, his teeth are clenched or there is an injury to the lips or bones of the facial part of the skull, then his mouth is pinched and exhaled into the nose.
Before conducting artificial respiration, you need to take a handkerchief or any other piece of loose tissue, preferably gauze, as a pad when performing artificial respiration. A caretaker stands to the right of the victim. If a person is lying on the floor, it is necessary to kneel next to him. To clear an oral cavity of mucus, blood and other extraneous contents, then cover a mouth with the prepared clean scarf or gauze napkin.
With the left hand, the corners of the victim’s lower jaw should be pulled forward so that the lower teeth are in front of the upper ones, and the nose should be pinched with the right hand. Taking a deep breath, the person assisting, clutching the victim’s mouth with his mouth, exhales the maximum vigorous exhalation through his mouth. Moreover, it is very important to create tight contact with the lips of the victim. If this is not done, then the air inhaled into it will go through the corners of the mouth, and if you do not pinch your nose, then through it. Then all efforts will be in vain.
Artificial respiration can be carried out using an air duct (S-shaped tube). It is introduced into the oral cavity of the victim and with one hand is held together with the chin, the nose is clamped with the other hand. The victim’s passive breath should last approximately 1 second. After that, the carer frees the patient’s mouth and unbends. Passive exhalation of the victim should be 2 times longer than the inspiration, about 2 seconds. At this time, the caregiver takes 1-2 small regular exhale breaths for himself.
During resuscitation measures per minute, 10–15 air blows are made into the victim’s mouth or nose. If artificial respiration is carried out correctly and air enters his lungs, then the movement of his chest will be noticeable. If her movements are insufficient, then this indicates that either the patient’s tongue sinks or the volume of inhaled air is too small.
Simultaneously with the start of artificial respiration, the presence of heart contractions is checked. If they are absent, an indirect heart massage is performed simultaneously with artificial respiration..
Indirect cardiac massage, especially.
Indications for indirect cardiac massage are cardiac arrest, life-threatening cardiac arrhythmias (fibrillation). The victim is laid on his back on a hard surface (floor, asphalt, long table, hard stretcher), his head is thrown back. Determine the presence or absence of breathing, palpitations. Then the carer stands to the left of the victim or falls to his knees if the victim is lying on the ground.
He puts the palm of his left hand on the lower third of his sternum, and on top of it is the palm of his right hand. The left hand is located along the sternum, the right – across. He presses on the sternum quite strongly – so that it bends 5-6 cm, momentarily lingers in this position, and then quickly releases his hands. The frequency of pressure should be 50-60 in 1 minute. After every 15 pressures, 2 frequent inspirations are made to the victim by mouth-to-mouth or mouth-to-nose method.
Signs of the effectiveness of indirect heart massage are narrowing of previously dilated pupils, the appearance of a heartbeat, spontaneous breathing. Massage is carried out until the restoration of cardiac activity, the appearance of a distinct pulse on the arteries of the limbs.
If within 20 minutes it was not possible to achieve this, then resuscitation measures should be stopped and the death of the victim should be attested. If the first-aid provider has a companion, then optimal conduct of simultaneous indirect heart massage and artificial respiration in the ratio of 3: 1 – 5: 1, that is, for 3-5 massage movements in the sternum – 1 breath.
Based on the book “Quick help in emergency situations”.