Indirect cardiac massage: technique of execution. Heart massage and artificial respiration
In emergency situations, when you can save a person's life, you just need to know the basics of first aid. One of such basic skills is indirect cardiac massage, the technique of which is described in this publication. After studying some techniques of its application, it is possible to save human life.
Performing an indirect heart massage
First of all, determine a sudden cardiac arrest: lack of breathing, consciousness and then begin to perform intensive care, in parallel calling the ambulance. First place the patient on a firm surface.
Resuscitation should be performed immediately at the victim's detection site, if this is not dangerous for the reanimator.
If the assistance turns out to be a non-professional resuscitator, then only the pressure on the sternum is allowed. Indirect heart massage, the technique of which is described below, includes the following points.
Sequence of actions
- First determine the place of compression in the lower third of the sternum.
- Position one arm with a protrusion of the palmar surface( the "fifth brush") almost at the very bottom of the sternum. On top of it, another hand is installed in the same way. It is possible to place the palms on the principle of a lock.
- Compression movements are carried out by hands straightened at the elbows, thus transferring at pressure and weight of the body. When carrying out compression, hands from the chest are not torn.
- The frequency of pressure on the sternum should not be less than 100 times a minute or about 2 compressions per second. The displacement of the chest in depth is not less than five centimeters.
- If artificial respiration is performed, then two compressions must occur for 30 compressions.
It is highly desirable that periods of pressure on the sternum and lack of compression on time be the same. 
Nuances
Indirect cardiac massage, the technique of performing which is familiar to every doctor, requires if intubation of the trachea is performed, so that movements are made at a frequency of up to 100 times per minute without interruption to respiratory resuscitation. It is carried out in parallel, with 8-10 breaths per minute being performed.
Next, take a break for five seconds to determine the restoration of the heart( the presence of a pulse in the peripheral vessels).
Breast compression in children up to ten to twelve years is performed with one hand, and the ratio of the number of compressions should be 15: 2.
Since the fatigue of the reanimator can lead to a decrease in the quality of compression and death of the patient, if there are two or more persons assisting, it is advisable to replace the person performing pressure on the chest every two minutes to prevent a decrease in the quality of the indirect heart massage. Replacement of the reanimator, should last no longer than five seconds.
It must be remembered that the rules for carrying out an indirect heart massage require that the respiratory organs be passable.
Individuals with a lack of consciousness develop muscular atony and airway obstruction by the epiglottis and the root of the tongue. Obturation occurs in any position of the patient, even lying on his stomach. And if the head is inclined by the chin to the chest, then this condition occurs in 100% of cases.
Preceding the implementation of indirect cardiac massage following initial actions:
- The first thing to do: establish a lack of consciousness - call( ask to open your eyes, ask - what happened?).
- Next, beat on the cheeks, gently shake the shoulders.
- When unconsciousness is established, it is necessary to normalize air movement in the airways.
"Triple Reception" and intubation of the trachea are the gold standard in the course of restoring breathing.
"Triple Reception"
Safar has developed three consecutive actions that improve the effectiveness of resuscitation:
- Tilt the head.
- Open the patient's mouth.
- Lower the patient's jaw to extend forward.
When such a heart massage and artificial respiration are performed, the front muscles of the neck are stretched, after which the trachea opens. 
Caution
One must be careful and careful, since it is possible to damage the spine in the neck region when performing actions on the airways.
Most likely, spine injuries can occur in two groups of patients:
- victims of road accidents;
- in case of a fall from a height.
Such patients can not bend their necks, turn their heads on their sides. It is necessary to pull the head to the head, and then keep the head, neck, trunk in the same plane with a minimum drop of the head back, as indicated in the reception of Safar. Indirect cardiac massage, the technique of performing which requires special care in such cases, is performed only if these recommendations are observed.
Opening of the oral cavity, its revision
The passage of the airways after tilting the head is not always fully restored, because in some unconscious patients with atony of the muscles, the nasal passages are closed by a soft sky during breathing.
It may also be necessary to remove foreign objects from the oral cavity( blood clot, fragments of teeth, vomit, plug-in jaws)
Therefore, in the beginning, these patients are examined by the oral cavity and released from foreign objects.
To open your mouth, use "the reception of crossed fingers."The doctor becomes near the patient's head, opens and inspects the oral cavity. If there are foreign objects, they must be removed. The right index finger takes the corner of the mouth from the right to the bottom, this helps to free the oral cavity of the liquid contents. Wrapped napkins with your fingers, clean the mouth and pharynx.
An attempt is made to intubate the trachea with airways( no more than 30 seconds).If the goal is not achieved, stop trying and continue carrying out the ventilation using a face mask or an Ambu bag. The techniques are also used "mouth to mouth", "mouth to nose".Heart massage and artificial respiration in such cases are carried out depending on the result.
After 2 minutes of resuscitation, it is necessary to repeat the attempt of intubation of the trachea.
When an indirect cardiac massage is performed, the technique of which is described here, then during the mouth-to-mouth breathing, the duration of each inspiration should be 1 second. This method is considered effective if there are movements of the chest of the victim during artificial respiration. It is important to avoid excessive ventilation of the lungs( not more than 500 milliliters), since it can cause complications in the form of casting from the stomach and ingestion or ingestion of its contents. In addition, excessive ventilation increases the pressure in the chest cavity, which in turn reduces the return of venous blood to the heart and the survival rate with sudden cardiac arrest.