How is indirect massage performed? How is an indirect heart massage performed for adults and children. Method of carrying out artificial lung ventilation

Air enriched with oxygen enters the human body and is excreted through the lungs, depleted in oxygen (but still containing oxygen) and saturated with carbon dioxide, due to respiratory movements. With the cessation of respiratory movements, these processes also stop. They can be maintained by artificial respiration.

Methods of carrying out artificial respiration by the methods of "mouth to mouth" and "mouth to nose".

• lay the victim on their back on a hard surface
• unfasten clothing, belt, etc., so that nothing restricts breathing movements
• push forward the lower jaw of the victim, open the mouth with a mouth expander (spoon, other flat object), free the oral cavity from vomit, fragments of teeth, dentures and mucus
• tilt the head of the victim back (putting a hand or a roller under the neck to ensure unhindered passage of air) and breathe air into his mouth
• continue artificial respiration using the mouth-to-mouth method (with one hand to close the victim’s nasal passages to reduce air leakage) or mouth-to-nose breathing through a gauze pad or handkerchief. If there is a rubber tube, then you can resort to the "mouth-to-tube" method by inserting it into the victim's throat
• expiration occurs passively due to a spontaneous decrease in the volume of the chest
• the duration of air blowing should be 2 times shorter than the duration of its exit from the lungs of the victim
• after making 10-12 breaths per minute until spontaneous breathing is restored, it is advisable not to stop artificial respiration even after spontaneous breathing is restored (within 2-3 minutes) - to consolidate the therapeutic effect.

From frequent respiratory movements, the resuscitator may feel dizzy, then it should be replaced.

An indicator of the effectiveness of artificial respiration is the expansion of the chest and the pinking of the skin.

Indirect cardiac massage.

Oxygen is distributed throughout the organs due to cardiac activity - the rhythmic contraction of the heart muscle, which works like a pump. In severe conditions, after respiratory arrest, as a rule, cardiac arrest occurs within a few minutes. The idea of ​​indirect or external heart massage is mechanical rhythmic compression of the heart between the sternum and spine, which expels blood from the cavities of the heart. After the cessation of pressure on the sternum, the cavities of the heart passively refill with blood.

The method of conducting an indirect heart massage.

• put the victim on a hard surface, the resuscitator is on the side of the victim
• rest the palms (not fingers) of one or both straight arms on the lower third of the sternum
• press the palms rhythmically, in jerks, using the weight of one's own body and the efforts of both hands
• if during an indirect heart massage a fracture of the ribs occurs, it is necessary to continue the massage by placing the base of the palms on the sternum
• massage rate - 50-60 pushes per minute, in an adult, the amplitude of chest oscillations should be 4-5 cm

Simultaneously with a heart massage (1 push per second), artificial respiration is performed.

For 3-4 pressures on the chest, there is 1 deep exhalation into the mouth or nose of the victim, if there are 2 resuscitators. If there is only one resuscitator, then every 15 pressures on the sternum with an interval of 1 second, 2 artificial breaths are required. The frequency of inspiration is 12-16 times per minute.

For children, massage is performed carefully, with the brush of one hand, and for newborns - only with the fingertips. The frequency of chest compressions in newborns is 100-120 per minute, and the point of application is the lower end of the sternum.

It is also necessary to carefully perform an indirect heart massage for the elderly, since with rough actions, fractures in the chest area are possible.

Signs of the effectiveness of artificial respiration and heart massage

Signs of revival of the victim after clinical death during first aid - a feeling of spontaneous heartbeats in the palm of the one who produces an indirect heart massage, after which the massage can be stopped.

Heart massage and artificial respiration should be continued until the restoration of cardiac activity or during the period until it is possible to provide blood circulation sufficient to maintain the vital activity of the higher parts of the brain, or until an ambulance arrives to resuscitate the victim.

In those cases when within 30-40 minutes, despite correctly performed cardiopulmonary resuscitation, signs of clinical death persist, resuscitation is stopped. It should be noted that not in all cases, even an experienced specialist can be sure of the futility of resuscitation, therefore, even with the slightest doubt in this matter, it is necessary to continue full-fledged resuscitation. Only in the presence of signs of biological death, such as the symptom of "cat's pupil" (when the eyeball is squeezed from the sides, the pupil narrows and looks like a vertical slit), cardiopulmonary resuscitation is not performed.

The effectiveness of the measures taken is judged by the appearance of a pulse and the establishment of independent breathing, a change in skin color, a contraction of the pupils and the appearance of their reaction to light.

What not to do during artificial respiration and heart massage

• Fuss, act slowly and uncertainly.
• Forget that the victim can become a source of infectious diseases for those resuscitating him. Therefore, personal safety measures should come first.
• Leave the victim without first aid (including resuscitation).
• Perform artificial respiration without releasing the airways from foreign bodies, water, mucus, without protruding the lower jaw and extending the head.
• Excessively unbend the victim's head for artificial respiration. This can lead to narrowing of the airways.
• Stop resuscitation until the arrival of the ambulance in the absence of visible signs of death of the victim.

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Seizures are a temporary violation of brain function, manifested by paroxysmal involuntary muscle contractions and accompanied by disorders of perception, psyche and life support functions (digestive, excretory and other systems).

Clinical death occurs with circulatory arrest. This can happen when drowning, and in some other cases, when squeezing or blocking the airways.

Early signs of circulatory arrest, which appear in the first 10-15 seconds, are: the disappearance of the pulse on the carotid artery, lack of consciousness, convulsions. Late signs of circulatory arrest, which appear in the first 20-60 s, are: pupil dilation in the absence of their reaction to light, the disappearance of breathing or convulsive breathing (2-6 breaths and exhalations per minute), the appearance of an earthy-gray color of the skin (in the first turn of the nasolabial triangle).

This condition is reversible, with it a complete restoration of all body functions is possible, if irreversible changes have not occurred in the brain cells. The patient's body remains viable for 4-6 minutes. Timely resuscitation measures taken can bring the patient out of this state or prevent it.

Immediately after signs of clinical death appear, it is necessary to turn the victim on his back and apply precordial stroke. The purpose of such a blow is to shake the chest as much as possible, which should serve as an impetus for starting a stopped heart.

The blow is applied with the edge of a hand clenched into a fist to a point located on the lower middle third of the sternum, 2-3 cm above the xiphoid process, which ends with the sternum. Do it in a short, sharp motion. In this case, the elbow of the striking arm should be directed along the body of the victim.

Correctly and on time, a strike can bring a person back to life in a matter of seconds: his heartbeat is restored, consciousness returns. However, if this did not happen, then they begin to conduct an indirect heart massage and artificial respiration, which are carried out until signs of revival of the victim appear: a good pulsation is felt on the carotid artery, the pupils gradually narrow, the skin of the upper lip turns pink.

Indirect cardiac massage, its implementation

Indirect cardiac massage carried out in the following sequence (Fig. 1):

1. The victim is laid on his back on a hard base (ground, floor, etc., since massage on a soft base can damage the liver), unfasten the waist belt and the top button on the chest. It is also helpful to raise the victim's legs about half a meter above chest level.

2. The rescuer stands on the side of the victim, one hand palm down (after a sharp extension of the arm in the wrist joint) puts on the lower half of the victim's sternum so that the axis of the wrist joint coincides with the long axis of the sternum (the median point of the sternum corresponds to the second - third button on the shirt or blouse). The second hand to increase pressure on the sternum, the rescuer puts on the back surface of the first. In this case, the fingers of both hands should be raised so that they do not touch the chest during the massage, and the hands should be strictly perpendicular to the surface of the victim’s chest in order to ensure a strictly vertical push of the sternum, leading to its compression. Any other position of the rescuer's hands is unacceptable and dangerous for the victim.

3. The rescuer becomes as stable as possible and so that it is possible to press on the sternum with his hands straightened in the elbow joints, then quickly leans forward, transferring the weight of the body to his hands, and thereby bends the sternum by about 4-5 cm. so that the pressure is not applied to the region of the heart, but to the sternum. The average pressing force on the sternum is about 50 kg, so the massage should be carried out not only due to the strength of the hands, but also the mass of the body.

Rice. 1. Artificial respiration and indirect heart massage: a - inhale; b - exhale

4. After a short pressure on the sternum, you need to quickly release it so that the artificial contraction of the heart is replaced by its relaxation. During the relaxation of the heart, do not touch the chest of the victim with your hands.

5. The optimal pace of chest compressions for an adult is 60-70 compressions per minute. Children under 8 years of age are massaged with one hand, and infants with two fingers (index and middle) with a frequency of up to 100-120 pressures per minute.

In table. 1. The requirements for conducting an indirect heart massage are given, depending on the age of the victim.

Table 1. Chest Compression

A possible complication in the form of a fracture of the ribs during an indirect heart massage, which is determined by the characteristic crunch during compression of the sternum, should not stop the massage process.

Artificial respiration, its implementation

Artificial respiration mouth-to-mouth method is carried out in the following sequence (see Fig. 1):

1. Quickly clean the victim's mouth with two fingers or a finger wrapped in a cloth (handkerchief, gauze), and tilt his head back at the occipital joint.

2. The rescuer stands to the side of the victim, puts one hand on his forehead, and the other under the back of the head and turns the victim's head (while the mouth usually opens).

3. The rescuer takes a deep breath, slightly delays the exhalation and, bending down to the victim, completely seals the area of ​​\u200b\u200bhis mouth with his lips. In this case, the nostrils of the victim must be clamped with the thumb and forefinger of the hand lying on the forehead, or covered with your cheek (air leakage through the nose or corners of the victim's mouth negates all the efforts of the rescuer).

4. After sealing, the rescuer makes a quick exhalation, blowing air into the respiratory tract and lungs of the victim. In this case, the victim's breath should last about a second and reach 1-1.5 liters in volume in order to cause sufficient stimulation of the respiratory center.

5. After the end of the exhalation, the rescuer unbends and releases the victim's mouth. To do this, without unbending the head of the victim, turn to the side and raise the opposite shoulder so that the mouth is below the chest. The exhalation of the victim should last about two seconds, in any case, be twice as long as the inhalation.

6. In a pause before the next breath, the rescuer needs to take 1-2 small ordinary breaths for himself. After that, the cycle repeats from the beginning. The frequency of such cycles is 12-15 per minute.

When a large amount of air enters the stomach, it swells, which makes it difficult to revive. Therefore, it is advisable to periodically release the stomach from air by pressing on the epigastric region of the victim.

Artificial respiration "mouth to nose" is almost no different from the above. For sealing with fingers, you need to press the victim's lower lip to the upper one.

When reviving children, blowing is performed simultaneously through the nose and mouth.

If two people provide assistance, then one of them does an indirect heart massage, and the other - artificial respiration. At the same time, their actions must be coordinated. During the blowing of air, it is impossible to press on the chest. These events are carried out alternately: 4-5 pressures on the chest (on exhalation), then one blowing of air into the lungs (inhalation). If assistance is provided by one person, which is extremely tiring, then the sequence of manipulations changes somewhat - every two quick injections of air into the lungs, 15 chest compressions are performed. In any case, it is necessary that artificial respiration and chest compressions be carried out continuously for the right time.

In the absence of a pulse in the victim, in order to maintain the vital activity of the body (to restore blood circulation), it is necessary, regardless of the reason that caused the cessation of the heart, to carry out an external heart massage simultaneously with artificial lung ventilation (artificial respiration). At the same time, it should be borne in mind that without correct and timely preliminary assistance to the victim, the help of the arriving doctor may be belated and ineffective.

External (indirect) massage is performed by rhythmic contractions through the anterior chest wall with pressure on the relatively mobile lower part of the sternum, behind which the heart is located. In this case, the heart is pressed against the spine, and the blood from its cavities is squeezed into the blood vessels. By repeating pressure at a frequency of 60-70 times per minute, you can ensure sufficient blood circulation in the body in the absence of heart work.

To conduct an external heart massage, the victim should be laid with his back on a hard surface (low table, bench or floor), expose his chest, remove the belt, suspenders and other items of clothing that restrict breathing. The person providing assistance should stand on the right or left side of the victim and take a position in which a more or less significant inclination over the victim is possible. Having determined the position of the lower third of the sternum, the assisting person should put on it the upper edge of the palm of the arm extended to failure, and then put the other hand on top of the arm and press on the victim’s chest, while slightly helping by tilting his body.

Pressing should be done with a quick push so as to move the lower part of the sternum down towards the spine by 3-4 cm, and in obese people - by 5-6 cm. the lower ribs is movable. The upper part of the sternum is fixedly attached to the bone ribs and can break when pressed. Pressure on the end of the lower ribs should also be avoided, as this can lead to their fracture. In no case should you press below the edge of the chest (on soft tissues), as you can damage the organs located here, primarily the liver. Pressing on the sternum should be repeated approximately 1 time per second.

After a quick push, the hands remain in the reached position for about one third of a second. After that, the hands should be removed, releasing the chest from pressure to allow it to straighten out. This favors the flow of blood from the large veins into the heart and its filling with blood.

Since pressure on the chest makes it difficult to expand during inspiration, insufflation should be performed in the intervals between pressures or during a special pause provided every 4-6 pressures on the chest.

If the assisting person does not have an assistant and is forced to perform artificial respiration and external heart massage alone, these operations should be alternated in the following order: after 2-3 deep blows into the mouth or nose of the victim, the assisting person performs 4-6 pressures on the chest , then again makes 2-3 deep blows and again repeats 4-6 pressures in order to massage the heart, etc.

If there is an assistant, one of the caregivers - less experienced in this matter - should carry out artificial respiration by blowing air as a less complicated procedure, and the second - more experienced - should perform an external heart massage. At the same time, air blowing should be timed to coincide with the time of cessation of pressure on the chest or interrupting the heart massage for the time of blowing (for about 1 s).

With equal qualifications of persons providing assistance, it is advisable for each of them to carry out artificial respiration and external heart massage, alternately replacing each other every 5-10 minutes. Such an alternation will be less tiring than the continuous performance of the same procedure, especially heart massage.

The effectiveness of external heart massage is manifested primarily in the fact that each pressure on the sternum leads to the appearance of a pulsating oscillation of the walls of the arteries in the victim (checked by another person).

With proper artificial respiration and heart massage, the victim has the following signs of recovery:

• improvement in the complexion, acquiring a pinkish tint instead of a gray-earthy color with a bluish tinge, which the victim had before assistance;
• the emergence of independent respiratory movements, which become more and more uniform as the measures to provide assistance (revival) continue;
• constriction of the pupils.

The degree of pupillary constriction can serve as the most accurate indicator of the effectiveness of the assistance provided. Narrow pupils in the person being revived indicate a sufficient supply of oxygen to the brain, and the beginning expansion of the pupils indicates a deterioration in the supply of blood to the brain and the need to take more effective measures to revive the victim. To do this, incl., you should raise the victim's legs by about 0.5 m from the floor and leave them in a raised position during the entire time of external heart massage. This position of the victim's legs contributes to a better blood flow to the heart from the veins of the lower body. To keep the legs in a raised position, something should be placed under them.

Artificial respiration and external cardiac massage should be carried out until independent breathing and heart work appear, however, the appearance of weak sighs (in the presence of a pulse) does not give grounds for stopping artificial respiration. In this case, as already mentioned above, the blowing of air should be timed to coincide with the start of the victim's own inhalation.

The recovery of heart activity in the victim is judged by the appearance of his own regular pulse, not supported by massage. To check the pulse, the massage is interrupted for 2-3 seconds, and if the pulse persists, this indicates an independent work of the heart. If there is no pulse during the break, you must immediately resume the massage.

It should be remembered that even a short-term cessation of revitalizing activities (1 minute or less) can lead to irreparable consequences.

After the appearance of the first signs of revival, external heart massage and artificial respiration should be continued for 5-10 minutes, timing the blowing to the moment of one's own inspiration.

Clinical death is a condition in which there is no heartbeat and respiratory functions in the human body, but irreversible processes have not yet begun. During this period, correctly performed resuscitation actions can save a human life, therefore, each of us should know what an indirect heart massage (execution technique) is. Quite often, pathologies such as stroke, heart attack, thrombosis, hemorrhage and other diseases associated with the functioning of the cardiovascular system and the brain lead to cardiac arrest. The provision of first aid is the duty of every conscientious person, and its conduct must be in accordance with medical standards. Therefore, below we will consider a step-by-step technique for performing an indirect heart massage, and also tell you how to perform artificial ventilation of the lungs.

Let's turn to physiology: what happens after the heart has stopped

Before analyzing how to properly perform artificial respiration and heart massage, let's turn to human physiology and consider how the heart and vascular system work, and what are the consequences of stopping blood flow in the body.

The human heart has a four-chamber structure and consists of two atria and two ventricles. Thanks to the atria, blood enters the ventricles, which, during systole, push it back into the pulmonary and systemic circulation to carry oxygen and nutrients throughout the body.

The work of the blood is as follows:

• blood flow: passing through a large circle of blood flow, it carries vital substances for cells, while taking away decay products from them, which are then excreted from the body through the kidneys, lungs and skin;
• the task of the small circle of blood flow is to replace carbon dioxide with oxygen, this exchange occurs in the lungs during inhalation and exhalation.

When the heart stops working, blood stops flowing through the arteries, veins and vessels. The entire process described above is stopped. Decay products accumulate in the cells, the lack of respiration leads to saturation of the blood exclusively with carbon dioxide. Metabolism stops and cells die as a result of "intoxication" and lack of oxygen. For example, for the death of brain cells, it is enough to stop the blood flow for up to 3-4 minutes, in exceptional cases this period is slightly increased. Therefore, it is so important to carry out resuscitation, for the first time minutes after stopping the work of the heart muscles.

Indirect heart massage: execution technique

To perform an indirect heart massage, place one hand (palm down) on 1/3 of the lower part of the sternum. The main center of pressure should be on the pastern. Put the other hand on top. The main condition is that both hands must be kept straight, then the pressure will be rhythmic with the same force. The optimal force is considered when the sternum during an indirect heart massage drops by 3-4 cm.

What happens in the body during resuscitation? When exposed to the chest, the chambers of the heart are compressed, while the inter-chamber valves open, and blood penetrates from the atria into the ventricles. The mechanical effect on the muscles of the heart contributes to pushing the blood into the vessels, which prevents the blood flow from stopping completely. If the actions are synchronous, then your own cardiac electrical impulse is activated, thanks to which the heart “starts up” and blood flow is restored.

Rules for resuscitation massage

Before conducting an indirect heart massage, it is necessary to find out if there is a pulse, as well as respiratory processes. In their absence, a number of mandatory actions should be performed before starting a heart massage and ventilation of the lungs.

1. Lay the person straight, preferably on a flat hard surface.
2. Loosen clothing and determine pressure point.
3. Get on your knees next to him on the side that is convenient for you.
4. Clear the airways of possible vomit, mucus, foreign objects.
5. For an adult, a heart massage is performed with two hands, for a child - with one, for a baby - with two fingers.
6. Repeated pressure is made only after the complete return of the sternum to its original position.
7. The norm is 30 impacts on the chest, for 2 breaths, this is justified by the fact that when exposed to the sternum, passive inhalations and exhalations occur.

How to resuscitate the victim: the actions of one person

1 person can do indirect heart massage and artificial respiration by himself. Initially, the “preparatory” actions described above are performed, after the algorithm of the execution technique, should be as follows:

1. Initially, two air injections are made, lasting 1–2 seconds. After the first blow, you need to make sure that the chest descends (the air comes out) and only then make the second blow. It can be done by blowing through the mouth or nose. If artificial ventilation of the lungs is carried out through the mouth, then the nose is clamped by hand, if through the nose, then the mouth is fixed by hand, respectively. In order to protect yourself from the possibility of pathogenic microflora entering your body, you need to blow through a napkin or handkerchief.
2. After the second blow of air, proceed to chest compressions. Hands should be straight, their correct position is described above. Controlling the force to produce 15 pressures.
3. Repeat actions from the beginning. Resuscitation should continue until emergency help arrives. If 30 minutes have passed since the beginning of the “revival” of a person, and no signs of life (pulse, breathing) have appeared, then biological death is declared.

If an indirect heart massage and artificial respiration is performed by 1 person, the frequency of impacts on the chest should normally be about 80–100 pressures per minute.

How should the victim be resuscitated? Actions of two people

If an indirect heart massage and artificial respiration are performed by 2 people, then the algorithm and execution technique are different. Firstly, it is much easier to perform resuscitation together, and secondly, each of those providing assistance is responsible for a separate process, heart massage or ventilation of the lungs. The technique for performing resuscitation is as follows:

1. The person doing artificial respiration kneels at the head of the victim.
2. The person responsible for the process of indirect massage lays the brushes on the patient's sternum.
3. Initially, two blows are made into the mouth or nose.
4. After, two impacts on the sternum.
5. Blowing is repeated again, after pressing.

The normal frequency of pressure during resuscitation by two people is about 80 times in one minute.

Features of resuscitation of children

The main difference (features) of resuscitation in children are as follows:

• using only one pussy or only two fingers;
• the frequency of pressure for babies should be about 100 times per minute;
• the depth of breast prolapse when pressed is not more than 1-2 cm;
• children are blown with air during resuscitation through the oral cavity and through the nasal canals, the frequency of blows is about 35-40 times per minute;
• since the volume of the lungs of the child is small, then the air blown in should not exceed the volume contained in the mouth of the resuscitator.

Remember that you can only bring a person back to life for the first time minutes after a cardiac arrest, so do not hesitate, but immediately begin resuscitation actions.

An indirect heart massage (NMS) is the first medical aid upon termination of its work, the provision of which can be carried out without professional medical training.

Resuscitation actions vary, depending on the number of participants and the condition of the resuscitated. However, discrepancies in the technique are visible only at the last stages - during compression. Preparation for massage in all cases is the same.

The rules for conducting also depend on age: an infant, a child under 8 years old, a teenager and an adult are resuscitated in different ways. The procedure increases the chances of survival and makes it possible to wait for the ambulance to arrive.

An indirect heart massage (also external, or closed) in medicine is a resuscitation event, the purpose of which is to maintain blood circulation.

The principle of the procedure is that the rhythmic squeezing of the organ imitates its natural work and contributes to the restoration of cardiac activity.

Problems with blood circulation can provoke congenital and acquired diseases, an overdose of drugs or medications, an accident, an electric shock, etc.

An indication for the beginning of the revival of the body is clinical death - the process of dying, which is characterized by the absence of external signs of life, while still maintaining metabolism in tissues and brain function.

The transitional period lasts up to ten minutes after the heart stops working, then the brain is destroyed and the restoration of vital activity becomes impossible.

How to determine whether a person has clinical death or has it already passed into the biological stage?

The main reason for resuscitation is always a complete cardiac arrest. The rescuer must make sure that there is no heartbeat and only then proceed to revive the body. And also, a prerequisite for the procedure is a constant assessment of the state of the resuscitated.

The effectiveness of the procedure is evaluated by the return of the body to normal.

The reanimated must:

• feel the pulse (the pulse is considered stable if it does not stop within a few minutes);
• increase blood pressure;
• pupils move (constriction);
• normalize skin tone;
• restore the ability to breathe.

Algorithm and execution rules

The technique of execution depends on how effective the resuscitation will be.

Incorrect hand position and a broken sequence of stages can lead to complications: rib fractures, pneumothorax, ruptures of internal organs (incorrect posture will also lead to a decrease in the frequency of pressure and subsequent cessation of revival due to the fatigue of the resuscitator). It is the correct position of the hands that often determines the success of the event.

A training video is an instruction in which a medical assistant tells how many clicks and in what rhythm you need to do:

Some complications (tamponade, pneumothorax, funnel chest) may become contraindications for further assistance.

Closed heart massage is a specific algorithm of actions that should be followed for maximum efficiency and avoidance of complications:

• the victim should lie on his back, on a hard surface with a raised head thrown back and raised legs;
• the chest, neck and stomach should not be squeezed, so unbutton the buttons on the throat, loosen the belt;
• ensure the patency of the respiratory tract - the oral cavity must be clean and free of mucus, vomit, blood;
• the resuscitator should be located on the side so that the shoulders are above his chest (you can stand on either side, but for right-handed people, the position on the right is more convenient, and for left-handers on the left);
• the correct location of the hands is chosen in stages: find the junction of the lower ribs with the sternum, step back two fingers up and put the base of the palm on the found point;
• before the start of the revival of the body, a precordial blow is performed - a manipulation performed once along the inter-nipple line to the center of the sternum, is applied with a fist from a height of no more than 30 centimeters, without swinging (sometimes even with one blow made, blood circulation can be restored so that the heart works, but if there is no improvement in the condition followed, then proceed to resuscitation);
• interlock the fingers into the lock (the thumb of the main hand must be positioned in such a way that it points either to the chin or to the legs).

Compression technique:

• should be pressed strictly perpendicular and with straightened arms;
• the place of application of the hands should not change (displacement of the pressure point can cause fractures, hematomas, ruptures);
• the chest should be pressed 3-5 centimeters, the optimal rate of pressure is 60-100 per minute;
• you need to keep your hands tightly pressed to your chest;
• it is necessary to resume pressure only after the chest returns to its original position;
• it is important to observe the rhythm of pressure and the force applied when pressing.

External cardiac massage is inseparable from mechanical ventilation, and together they are called cardiopulmonary resuscitation (CPR).

Depending on the number of rescuers, the method of resuscitation is modified:

The time of the procedure depends only on the success of the actions taken, the arrival of the ambulance or your physical condition (broken ribs do not affect the duration of resuscitation). With 80-100 pressures on the sternum per minute, the minimum massage period is 15-20 minutes. The maximum period depends on the improvement of the condition or the onset of biological death.

Another method of revitalizing the body is also used -. With it, the resumption of blood flow is carried out with the help of surgical intervention.

An operation is performed on the open sternum, in which the doctor imitates the work of the heart, squeezing the organ in his hands with a frequency of 60-70 compressions per minute. These resuscitation actions are prohibited in the absence of professional training and outside the hospital.

At the moment, preference for resuscitation is given to indirect massage, and the use of direct massage may be due to:

• circulation disorders in the early postoperative period;
• circulatory disorders due to injury;
• circulation disorders during breast surgery.

Features of the conduct in children

A number of parameters of closed heart massage are carried out in different ways, depending on the age of the resuscitated. Several age limits can be drawn: a child up to a year old, up to 8 years old, everyone who is older than 8 years old (reanimation of adolescents does not differ from an adult). Different approaches to resuscitation of children and adults are due to the size of internal organs, fragile bone structure and physiological characteristics (for example, pulse rate). At the same time, the procedure for preparing for resuscitation is the same for all cases.

Newborns and children under one year old are placed on the forearm of the resuscitator. A palm is placed under the back, so that the head is higher than the body and thrown back. With children under 8 years of age, they immediately switch to massage and mechanical ventilation, without precordial shock.

Infant resuscitation technology:

• carried out with the middle and index fingers;
• pressure speed - 140 per minute;
• punching depth 1-2 centimeters;
• IVL - about 40 breaths per minute.

Resuscitation technology for children under 8 years old:

• carried out with one hand;
• the speed of pressure is 120 per minute;
• punching depth 3-4 centimeters;
• IVL - 30-35 breaths per minute.

The success of indirect heart massage is characterized by the restoration of the basic functions of the body that a person loses after circulatory arrest.

The indicator of effectiveness is the body returning to normal. The criterion for the effectiveness of revitalizing the body in children and adults is the same (this is evidenced by: a normalizing skin tone, pupil movement and shape, a palpable pulse). Massage performed with errors can lead to complications (for example, ribs break most often), but its absence is always fatal.

Therefore, with the onset of clinical death, it is necessary to urgently begin urgent resuscitation actions. The main thing is to make sure that there is no heartbeat and severe chest injuries. At the moment, there are many opportunities to learn how to properly perform heart massage. If you are not confident in your abilities, watch video tutorials on the topic or purchase an illustrated manual in which resuscitation is shown in pictures and photos.