Methods of performing artificial respiration and external cardiac massage. Occupational Safety and Health. Indirect cardiac massage and artificial respiration - rules and techniques for performing it How to do artificial respiration correctly

Manual artificial respiration methods in mines

If first aid is provided by one person, then artificial respiration is better and easier to carry out using the Schaefer or Nilson method, the advantage of which is simplicity and ease and which is not difficult to learn after short exercises.

To apply artificial respiration using the Schaefer method, you need to put the victim face down on overalls (jacket), place one of his hands under his head, turn his head to the side, and extend the other hand forward, along the head, as shown in Fig. 53. After this, you should kneel over the victim facing his head so that the victim’s hips are between the knees of the person performing artificial respiration. Place your palms on the victim’s back, on the lower ribs, clasping them from the sides with your fingers.

Rice. 53. Artificial respiration using the Schaefer method:
a - exhale; b - inhale

Counting “one, two, three,” gradually lean forward so that the weight of your body leans on your outstretched arms, thus pressing on the victim’s lower ribs, squeezing his chest and stomach, and exhale. Then, without removing your hands from the victim’s back, also lean back in the count of “four, five, six,” allowing the victim’s chest and stomach to straighten, and inhale. Having inhaled again in a count of “one, two, three”, gradually bend forward, exhaling, etc.

When artificial respiration is used correctly using the Schaefer method, a sound (like a slight groan) is usually produced as air passes through the victim's windpipe as the chest compresses and expands. This sound indicates that air is actually entering the victim's lungs. If such a sound is not heard, you need to look again to see if there is anything in the victim’s respiratory organs that is blocking the passage of air, or if the tongue has sunk into the larynx.

It is also necessary to remember that if the victim’s ribs are compressed very strongly, food may be squeezed out of the stomach and then it will again be necessary to clean his mouth and nose.

Breathing movements (exhalation and inhalation) should be performed approximately 12-18 times per minute.

Nilson method

Artificial respiration using the Nilson method is performed by one person. Place the victim on his stomach, his head on his hands, palms down. The person providing assistance kneels behind the victim’s head (Fig. 54) facing his feet, puts his hands on the victim’s shoulder blades and, in a count of “one, two, three, four,” slowly leans forward, squeezing the chest with the weight of his body—exhale.

Rice. 54. Artificial respiration using the Nilson method:
a - exhale; b - inhale

On the count of “five, six, seven, eight”, the person performing artificial respiration leans back, moves his hands to the middle of the victim’s shoulders and, holding them, lifts the victim’s arms up with his elbows - inhale.

Howard method

The victim is placed on his back, under which a cushion is placed. The victim's arms are thrown back to the top, his head is turned to the side. The person providing assistance kneels over the victim’s pelvis and thighs, placing their palms on the lower ribs on either side of the xiphoid process. Then he leans forward and, using his palms, presses his mass on the victim’s chest for 2 - 3 s (exhale). Then the pressure on the chest is immediately stopped, the victim’s chest expands - inhalation occurs.

Carrying out artificial respiration manually (according to Sylvester, Schaefer, etc.) does not provide sufficient air into the lungs and is excessively tiring.

Mouth to mouth method

The simplest and best method of artificial respiration is “mouth to mouth” or “mouth to nose”. This method of artificial respiration - blowing air from the mouth of the person providing assistance into the mouth or nose of the victim - provides significantly greater ventilation of the lungs and allows breathing to be restored more quickly. In addition, the increased content of carbon dioxide in the air blown into the victim stimulates the breathing process.

The victim is placed on his back on a hard surface. The person providing assistance tilts the victim’s head sharply back (place a cushion, a bundle of clothes, a folded blanket, etc. under the shoulders) and holds it in this position. Then the person providing assistance takes a deep breath, brings his mouth closer to the victim’s mouth and, pressing his lips tightly (through gauze from a bandage or an individual bag) to the victim’s mouth, blows the collected air into his lungs (Fig. 55).

Rice. 55. Artificial respiration using the mouth-to-mouth method

If there is a rubber tube or air duct, then air is blown through them. When blowing air through the mouth, the victim's nose is pinched so that the blown air does not escape out. When air is blown into the victim's lungs, his chest expands. After this, the person providing assistance leans back; at this time the chest collapses - exhalation occurs. Such air injections are performed from 14 to 20 times per minute, which corresponds to the rhythm of normal breathing. It is better to breathe at a less frequent rhythm, but with a greater depth of inspiration; this is not so tiring and better ensures ventilation of the victim's pulmonary air.

The effectiveness of artificial respiration is checked by the expansion of the victim’s chest each time air is blown into the mouth. If this does not happen, it is necessary to ensure a more complete sealing of the openings of the mouth and nose when inhaling and check the position of the victim’s head.

Artificial respiration should be carried out until the victim regains his own deep and rhythmic breathing. The appearance of the first weak breaths does not provide grounds for stopping artificial respiration. You should only time the artificial inhalation to coincide with the start of spontaneous inhalation.

If there is a pulse in the carotid artery, but there is no breathing, begin artificial ventilation immediately. At first provide restoration of airway patency. For this the victim is placed on his back, head maximum tipped 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 of foreign bodies. To comply with safety measures You can use a bandage, napkin, or handkerchief wrapped around your index finger. If you have a spasm in your masticatory muscles, you can open your mouth with a flat, blunt object, such as a spatula or the handle of a spoon. To keep the victim's mouth open, you can insert a rolled up bandage between the jaws.

To perform artificial lung ventilation using the "mouth to mouth" It is necessary, while holding the victim’s head back, take a deep breath, pinch the victim’s nose with your fingers, press your lips tightly against his mouth and exhale.

When performing artificial lung ventilation using the "mouth to nose" air is blown into the victim’s nose, while covering his mouth with his palm.

After inhaling air, it is necessary to move away from the victim; his exhalation occurs passively.

To comply with safety and hygiene measures Insufflation 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, you need to spend 4-5 seconds on each cycle. The effectiveness of the process can be assessed by the rise of the victim’s chest when his lungs are filled with inhaled air.

In that case, When the victim simultaneously lacks breathing and pulse, urgent cardiopulmonary resuscitation is performed.

In many cases, restoration of heart function can be achieved by precordial stroke. To do this, place the palm of one hand on the lower third of the chest and apply a short and sharp blow to it with the fist of the other hand. Then they re-check the presence of a pulse in the carotid artery and, if it is absent, begin indirect cardiac massage and artificial ventilation.

For this victim placed on a hard surface The person providing assistance places his crossed palms on the lower part of the victim’s sternum and vigorously presses on the chest wall, using not only his hands, but also the weight of his own body. The chest wall, shifting towards the spine by 4-5 cm, compresses the heart and pushes blood out of its chambers along its natural course. In an adult person, such an operation must be performed 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 frequency 80 compressions per minute.

The correctness of the massage is determined by the appearance of a pulse in the carotid artery in time with pressing on the chest.

Every 15 compressions assisting 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, That one of which carries out heart massage, the other is artificial respiration in mode one blow every five presses on the chest wall. At the same time, it is periodically checked whether an independent pulse has appeared in the carotid artery. The effectiveness of resuscitation is also judged by the constriction of the pupils and the appearance of a reaction to light.

When restoring breathing and cardiac activity of the victim in an unconscious state, must be laid on its side to prevent him from suffocating with his own sunken tongue or vomit. The retraction of the tongue is often indicated by breathing that resembles snoring and severe difficulty in inhaling.

In any accident, be it loss of consciousness, drowning or carbon monoxide poisoning, Assistance to the victim must begin with restoring breathing and heart function.. This can be done using cardiopulmonary resuscitation. However, as practice shows, in most cases, eyewitnesses of the incident either do not know what to do or provide first aid incorrectly. Let's figure it out how to do artificial respiration and cardiac massage correctly in case of clinical death.

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Fact . After breathing stops and heartbeats stop, clinical death occurs. It lasts only 5-6 minutes, during which you can bring a person back to life. After this period, due to the lack of oxygen, irreversible changes occur in the tissues. After which, with extremely rare exceptions, it is no longer possible to resuscitate the victim.

To bring a person out of clinical death and restore respiratory and cardiac activity need to perform cardiopulmonary resuscitation, which includes two main procedures - artificial respiration (ventilation) and chest compressions (chest compression).

Procedure for cardiopulmonary resuscitation

1. Determine the presence or absence of signs of life: breathing, heartbeat, reaction of the pupils to light.

Signs of respiratory arrest

• Bring your ear to your mouth and place your hand on your chest: if you don’t feel the movement of air and don’t feel your chest heaving, there is no breathing, which means lungs need artificial ventilation.

Signs of cardiac arrest

• Check the pulse by placing your index and middle finger on the carotid artery (on the side of the larynx under the chin), or by placing your ear on your chest: if no pulsation is observed – the heart needs an indirect massage.

2. Lay the victim on his back, and use a hard surface: floor, asphalt or earth. Performing cardiac massage on the beach or on a bed is not effective– the pressure will be on the sand or mattress, and not on the heart. So, if the scene of action is a sandy shore or a bed, you need to move the body to a more solid area, or put something like a board under your back.

3. If breathing and heartbeat are not observed, immediately begin resuscitation. You need to start with artificial respiration, and then start cardiac massage. Keep the ratio - 2 to 30, that is 2 exhalations for 30 chest pushes. And so on in a circle until signs of life are detected, or until an ambulance arrives. Remember to check for a pulse or breathing every minute.

How to do artificial respiration correctly

1. After you have placed the victim on his back, tilt his head back– this is necessary for unhindered access of air to the lungs. To fix this position, place a cushion of folded clothing or a towel under your shoulders. Keep in mind: You should not tilt your head back if there is a suspicion of a neck fracture..

2. With a finger wrapped in a napkin or handkerchief, in a circular motion clean the inside of your mouth from foreign objects: sand, pieces of food, blood, mucus, vomit.

3. After making sure that the airways are not clogged with anything, begin artificial respiration using the mouth-to-mouth method, or if the jaw cannot be opened due to spasm, use the “mouth to nose” method.

4. With the “mouth to mouth” method, you need to hold the open jaw with one hand, and with the other hold your nose tightly. Take a deep breath and blow the air into the rescued person's mouth. It is important that your lips are pressed tightly against the victim's mouth, to eliminate “leakage” between the lips. With the “mouth to nose” method, everything is the same, only now you need to close your mouth tightly with your palm, and blow air into it accordingly.

5. You need to blow air hard, but smoothly. In no case in short bursts, because with such a pressure of air, the diaphragm in the throat will not open, and oxygen will not flow into the lungs, but into the stomach, which can lead to vomiting.

6. Frequency: 10-12 blows per minute or 1 exhale for 5 seconds. Inhale (1-1.5 seconds), release your nose and count to 4. Then repeat the procedure, remembering to tightly close the victim’s nose during inhalations. You need to count not quickly, but as expected. If pulmonary resuscitation is performed on a one-year-old child, insufflation is done more often, 1 exhalation for three seconds.

7. Watch for chest rise during inflation– this is your control. If the chest does not rise, it means that air is not entering the lungs. This may indicate that the tongue is stuck due to an incorrect position of the head, or that there are foreign objects in the throat. If so, then correct the situation.

8. If the air still goes through the esophagus and the stomach is inflated, you need to gently press on it at the top point so that the air comes out. Be prepared to vomit afterwards– turn your head to the side and quickly clean your mouth.

How to do indirect cardiac massage correctly

1. Take the correct posture. You should be on the side of the person lying down, sitting on your knees- this way the center of gravity of your body will be stable.

2. Determine the place where compression will be performed. Contrary to popular belief, a person’s heart is not located on the left, but in the center of the chest. You need to put pressure on the heart, not higher and not lower. This is very important, since compression in the wrong place can not only have minimal effect, but also cause harm. The required point is located in the center of the chest, at a distance of two longitudinal fingers from the end of the sternum (this is where the ribs touch).

3. Place the heel of your palm on this point so that your thumb faces either the chin or the stomach of the victim, depending on which side you are sitting on. On top of the first, place the second palm crosswise. Only the base of the palm should be in contact with the patient’s body, the fingers should be angled. In the case of children from 1 to 8 years old, only one palm is used, with infants under 1 year old, the massage is done with only two fingers.

4. Do not bend your elbows during compression. The line of your shoulders should be strictly above the lying one and parallel to the body. The main force of pressure should come from your weight, and not from the muscles of the arms, otherwise you will quickly get tired, and the compression will not be effective or the same in each push.

5. When pressed, the victim's chest should drop 4-5 cm, so the shocks must be quite strong. Otherwise, the compression of the heart will not be sufficient to disperse blood throughout the body to deliver oxygen to the body.

6. The compression frequency should be 100 shocks per minute. Please note that this is the frequency of punches, not the number of punches. Just a reminder, need to do 30 times, replacing compression with artificial ventilation. After which, we again move on to cardiac massage. Remember to check every minute for signs of life: pulse, breathing and pupil reaction to light.

7. Very often, ribs break during compression of the heart.. There is no need to be afraid of this. The ribs will heal later, now the main thing is to revive the person. So, when you hear a characteristic crackling sound, do not stop and continue the heart massage.

We invite you to watch a video from a seminar on first aid for cardiac and respiratory arrest. A professional rescuer clearly explains and shows in detail how to properly perform cardiopulmonary resuscitation.

We wish you that accidents will bypass both you and your loved ones. However, in any case, knowledge of how to perform artificial respiration and cardiac massage will never be superfluous. To practice, we recommend taking a couple of first aid classes; it won’t hurt. Good luck.

Often the life and health of an injured person depends on how correctly first aid is provided to him.

According to statistics, in case of cardiac and respiratory arrest, it is first aid that increases the chance of survival by 10 times. After all, oxygen starvation of the brain for 5-6 minutes. leads to irreversible death of brain cells.

Not everyone knows how resuscitation measures are carried out if the heart has stopped and there is no breathing. And in life, this knowledge can save a person’s life.

Causes and signs of cardiac and respiratory arrest

The reasons that led to cardiac and respiratory arrest may be:

Before starting resuscitation measures, you should assess the risks for the victim and volunteer helpers - is there a threat of building collapse, explosion, fire, electric shock, gas contamination of the room. If there is no threat, then you can save the victim.

First of all, it is necessary to assess the patient’s condition:

The person should be called out and questions asked. If he is conscious, then it is worth asking about his condition and well-being. In a situation where the victim is unconscious or fainting, it is necessary to conduct an external examination and assess his condition.

The main sign of absence of heartbeat is the absence of pupil reaction to light rays. Under normal conditions, the pupil contracts when exposed to light and dilates when the light intensity decreases. Extended indicates dysfunction of the nervous system and myocardium. However, disruption of pupil reactions occurs gradually. Complete absence of the reflex occurs 30-60 seconds after complete cardiac arrest. Some medications, narcotic substances, and toxins can also affect the width of the pupils.

The functioning of the heart can be checked by the presence of blood impulses in the large arteries. It is not always possible to find the victim’s pulse. The easiest way to do this is on the carotid artery, located on the side of the neck.

The presence of breathing is judged by the noise of air escaping from the lungs. If breathing is weak or absent, then characteristic sounds may not be heard. It is not always possible to have a fogging mirror at hand, which can be used to determine whether there is breathing. Movement of the chest may also not be noticeable. Leaning towards the victim’s mouth, note the change in sensations on the skin.

A change in the shade of the skin and mucous membrane from natural pink to gray or bluish indicates circulatory problems. However, when poisoned by certain toxic substances, the pink color of the skin remains.

The appearance of cadaveric spots and waxy pallor indicates the inappropriateness of resuscitation efforts. This is also evidenced by injuries and damage incompatible with life. Resuscitation measures should not be carried out in case of a penetrating wound to the chest or broken ribs, so as not to pierce the lungs or heart with bone fragments.

After the victim’s condition has been assessed, resuscitation should be started immediately, since after breathing and heartbeat stop, only 4-5 minutes are allotted to restore vital functions. If it is possible to revive after 7-10 minutes, then the death of some brain cells leads to mental and neurological disorders.

Insufficiently prompt assistance can lead to permanent disability or death of the victim.

Algorithm for resuscitation

Before starting pre-medical resuscitation measures, it is recommended to call an ambulance.

If the patient has a pulse, but is in a deep state of unconsciousness, he will need to be laid on a flat, hard surface, the collar and belt should be loosened, his head turned to the side to prevent aspiration in case of vomiting; if necessary, the airways and oral cavity must be cleared from accumulated mucus and vomiting.

It is worth noting that after cardiac arrest, breathing can continue for another 5-10 minutes. This is the so-called “agonal” breathing, which is characterized by visible movements of the neck and chest, but low productivity. The agony is reversible, and with properly performed resuscitation measures the patient can be brought back to life.

If the victim does not show any signs of life, then the rescuer must perform the following steps step by step:

When resuscitating the patient, the patient’s condition is periodically checked - the appearance and frequency of the pulse, the light response of the pupil, breathing. If the pulse is palpable, but there is no spontaneous breathing, the procedure must be continued.

Only when breathing appears can resuscitation be stopped. If there is no change in condition, resuscitation continues until the ambulance arrives. Only a doctor can give permission to complete the revival.

Method of performing respiratory resuscitation

Restoration of respiratory function is carried out using two methods:

Both methods do not differ in technique. Before resuscitation begins, the victim's airway is restored. For this purpose, the mouth and nasal cavity are cleaned of foreign objects, mucus, and vomit.

If dentures are present, they are removed. The tongue is pulled out and held to prevent blockage of the airway. Then they begin the actual resuscitation.

Mouth-to-mouth method

The victim is held by the head, placing 1 hand on the patient’s forehead, the other pressing the chin.

They squeeze the patient’s nose with their fingers, the resuscitator takes the deepest possible breath, presses his mouth tightly against the patient’s mouth and exhales air into his lungs. If the manipulation is carried out correctly, the chest will rise noticeably.

If movement is observed only in the abdominal area, then the air has entered the wrong direction - into the trachea, but into the esophagus. In this situation, it is important to ensure that air gets into the lungs. 1 artificial breath is performed within 1 s, strongly and evenly exhaling air into the victim’s respiratory tract with a frequency of 10 “breaths” per 1 min.

Mouth-to-nose technique

The mouth-to-nose resuscitation technique is completely identical to the previous method, except that the person performing the resuscitation exhales into the patient’s nose, tightly closing the victim’s mouth.

After artificial inhalation, the air should be allowed to leave the patient's lungs.

Respiratory resuscitation is carried out using a special mask from the first aid kit or by covering the mouth or nose with a piece of gauze or cloth, or a handkerchief, but if they are not there, then there is no need to waste time looking for these items - it is worth carrying out rescue measures immediately.

Cardiac resuscitation technique

To begin with, it is recommended to free the chest area from clothing. The person providing assistance is located to the left of the person being resuscitated. Perform mechanical defibrillation or pericardial shock. Sometimes this measure restarts a stopped heart.

If there is no reaction, then perform an indirect cardiac massage. To do this, you need to find the end of the costal arch and place the lower part of the palm of your left hand on the lower third of the sternum, and place your right hand on top, straightening your fingers and raising them up (butterfly position). The push is carried out with the arms straightened at the elbow joint, pressing with the entire body weight.

The sternum is pressed to a depth of at least 3-4 cm. Sharp hand pushes are performed with a frequency of 60-70 pressures per minute. – 1 press on the sternum in 2 seconds. The movements are performed rhythmically, alternating a push and a pause. Their duration is the same.

After 3 min. The effectiveness of the activity should be checked. The fact that cardiac activity has been restored is indicated by palpation of the pulse in the area of ​​the carotid or femoral artery, as well as a change in complexion.

Carrying out simultaneous cardiac and respiratory resuscitation requires a clear alternation - 2 breaths per 15 pressures on the heart area. It is better if two people provide assistance, but if necessary, the procedure can be performed by one person.

Features of resuscitation in children and the elderly

In children and older patients, the bones are more fragile than in young people, so the force of pressing on the chest should be commensurate with these features. The depth of chest compression in elderly patients should not exceed 3 cm.

In children, depending on the age and size of the chest, massage is performed:

Newborns and infants are placed on the forearm, placing the palm under the baby's back and holding the head above the chest, slightly tilted back. The fingers are placed on the lower third of the sternum.

You can also use another method in infants - the chest is covered with the palms, and the thumb is placed in the lower third of the xiphoid process. The frequency of kicks varies in children of different ages:

When performing respiratory resuscitation in children, it is done with a frequency of 18-24 “breaths” per 1 minute. The ratio of resuscitation movements of the cardiac impulse and “inhalation” in children is 30:2, and in newborns – 3:1.

The life and health of the victim depends on the speed at which resuscitation measures begin and the correctness of their implementation.

It is not worth stopping the victim’s return to life on your own, since even medical workers cannot always visually determine the moment of death of the patient.

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What kind of poisoning can cause breathing and heartbeat to stop?

Death as a result of acute poisoning can happen from anything. The main causes of death in case of poisoning are cessation of breathing and heartbeat.

Arrhythmia, atrial and ventricular fibrillation and cardiac arrest can be caused by:

In what cases is artificial respiration necessary? Respiratory arrest occurs due to poisoning:

In the absence of breathing or heartbeat, clinical death occurs. It can last from 3 to 6 minutes, during which there is a chance of saving the person if you start artificial respiration and chest compressions. After 6 minutes, it is still possible to bring a person back to life, but as a result of severe hypoxia, the brain undergoes irreversible organic changes.

When to start resuscitation measures

What to do if a person falls unconscious? First you need to identify signs of life. The heartbeat can be heard by placing your ear to the victim's chest or by feeling the pulse in the carotid arteries. Breathing can be detected by the movement of the chest, leaning towards the face and listening for inhalation and exhalation by holding a mirror to the victim’s nose or mouth (it will fog up when breathing).

If no breathing or heartbeat is detected, resuscitation should begin immediately.

How to do artificial respiration and chest compressions? What methods exist? The most common, accessible to everyone and effective:

• external cardiac massage;
• mouth-to-mouth breathing;
• breathing "from mouth to nose".

It is advisable to conduct receptions for two people. Cardiac massage is always carried out together with artificial ventilation.

Procedure in the absence of signs of life

1. Free the respiratory organs (oral, nasal cavity, pharynx) from possible foreign bodies.
2. If there is a heartbeat, but the person is not breathing, only artificial respiration is performed.
3. If there is no heartbeat, artificial respiration and chest compressions are performed.

How to do indirect cardiac massage

The technique of performing indirect cardiac massage is simple, but requires the right actions.

Why is indirect cardiac massage impossible if the victim is lying on something soft? In this case, the pressure will be released not on the heart, but on the pliable surface.

Very often, ribs are broken during chest compressions. There is no need to be afraid of this, the main thing is to revive the person, and the ribs will grow together. But you need to take into account that broken ribs are most likely the result of incorrect execution and you should moderate the pressing force.

Artificial respiration from mouth to mouth

If a poisoned person has secretions in the mouth that are dangerous for the resuscitator, such as poison, poisonous gas from the lungs, or an infection, then artificial respiration is not necessary! In this case, you need to limit yourself to performing an indirect cardiac massage, during which, due to pressure on the sternum, about 500 ml of air is expelled and again absorbed.

How to do mouth-to-mouth artificial respiration?

For your own safety, it is recommended that artificial respiration is best done through a napkin, while controlling the tightness of the pressure and preventing air “leakage”. Exhalation should not be sharp. Only strong but smooth (for 1–1.5 seconds) exhalation will ensure proper movement of the diaphragm and filling of the lungs with air.

Artificial respiration from mouth to nose

Artificial respiration “mouth to nose” is performed if the patient is unable to open his mouth (for example, due to a spasm).

1. Having laid the victim on a straight surface, tilt his head back (if there are no contraindications for this).
2. Check the patency of the nasal passages.
3. If possible, the jaw should be extended.
4. After a maximum inhalation, you need to blow air into the injured person’s nose, tightly covering his mouth with one hand.
5. After one breath, count to 4 and take the next one.

Features of resuscitation in children

In children, resuscitation techniques differ from those in adults. The chest of babies under one year old is very tender and fragile, the heart area is smaller than the base of the palm of an adult, so pressure during indirect cardiac massage is performed not with the palms, but with two fingers. The movement of the chest should be no more than 1.5–2 cm. The frequency of compressions is at least 100 per minute. From 1 to 8 years of age, massage is done with one palm. The chest should move 2.5–3.5 cm. Massage should be performed at a frequency of about 100 pressures per minute. The ratio of inhalation to compression on the chest in children under 8 years old should be 2/15, in children over 8 years old - 1/15.

How to perform artificial respiration for a child? For children, artificial respiration can be performed using the mouth-to-mouth technique. Since babies have small faces, an adult can perform artificial respiration by immediately covering both the child’s mouth and nose. The method is then called “mouth to mouth and nose.” Artificial respiration is given to children at a frequency of 18–24 per minute.

How to determine if resuscitation is being performed correctly

Signs of effectiveness when following the rules for performing artificial respiration are as follows.

When artificial respiration is performed correctly, you may notice the chest moving up and down during passive inspiration.

1. If the movement of the chest is weak or delayed, you need to understand the reasons. Probably a loose fit of the mouth to the mouth or nose, a shallow breath, a foreign body preventing the air from reaching the lungs.
2. If, when you inhale air, it is not the chest that rises, but the stomach, then this means that the air did not go through the airways, but through the esophagus. In this case, you need to press on the stomach and turn the patient's head to the side, as vomiting is possible.

The effectiveness of cardiac massage also needs to be checked every minute.

1. If, when performing an indirect cardiac massage, a push appears on the carotid artery, similar to a pulse, then the pressing force is sufficient for blood to flow to the brain.
2. If resuscitation measures are performed correctly, the victim will soon experience heart contractions, blood pressure will rise, spontaneous breathing will appear, the skin will become less pale, and the pupils will narrow.

All actions must be completed for at least 10 minutes, or better yet, before the ambulance arrives. If the heartbeat persists, artificial respiration must be performed for a long time, up to 1.5 hours.

If resuscitation measures are ineffective within 25 minutes, the victim has cadaveric spots, a symptom of a “cat” pupil (when pressure is applied to the eyeball, the pupil becomes vertical, like a cat’s) or the first signs of rigor - all actions can be stopped, since biological death has occurred.

The sooner resuscitation is started, the greater the likelihood of a person returning to life. Their correct implementation will help not only restore life, but also provide oxygen to vital organs, prevent their death and disability of the victim.

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Artificial respiration (Artificial ventilation)

If there is a pulse but no breathing: carry out artificial ventilation.

Artificial ventilation. Step one

Provide restoration of airway patency. To do this, the victim is placed on his back, his head is thrown back as much as possible and, grabbing the corners of the lower jaw with his fingers, he pushes it forward so that the teeth of the lower jaw are located in front of the upper ones. Check and clean the oral cavity of foreign bodies. To comply with safety measures, you can use a bandage, napkin, or handkerchief wrapped around your index finger. To keep the victim's mouth open, you can insert a rolled up bandage between the jaws.

Artificial ventilation. Step two

To carry out artificial ventilation of the lungs using the mouth-to-mouth method, it is necessary, while holding the victim’s head back, take a deep breath, pinch the victim’s nose with your fingers, press your lips tightly to his mouth and exhale.

When performing artificial lung ventilation using the mouth-to-nose method, air is blown into the victim’s nose while covering his mouth with his hand.

Artificial ventilation. Step three

After inhaling air, it is necessary to move away from the victim; his exhalation occurs passively.
To comply with safety and hygiene measures, insufflation 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, you need to spend 4-5 seconds on each cycle. The effectiveness of the process can be assessed by the rise of the victim’s chest when his lungs are filled with inhaled air.

Indirect cardiac massage

If there is no pulse or breathing: time for indirect cardiac massage!

The sequence is as follows: first, indirect cardiac massage, and only then inhalation of artificial respiration. But! If discharge from the mouth of a dying person poses a threat (infection or poisoning by poisonous gases), only chest compressions should be performed (this is called non-ventilation resuscitation).

With each compression of the chest by 3-5 cm during chest compressions, up to 300-500 ml of air is expelled from the lungs. After the compression stops, the chest returns to its original position and the same volume of air is sucked into the lungs. Active exhalation and passive inhalation occur.
With indirect cardiac massage, the rescuer’s hands are not only the heart, but also the lungs of the victim.

You must act in the following order:

Indirect cardiac massage. Step one

If the victim is lying on the ground, be sure to kneel in front of him. At the same time, it does not matter from which side you approach it.

Indirect cardiac massage. Step two

For indirect cardiac massage to be effective, it must be performed on a flat, hard surface.

Indirect cardiac massage. Step three

Place the base of the right palm above the xiphoid process so that the thumb is directed towards the chin or abdomen of the victim. Place your left palm on top of the palm of your right hand.

Indirect cardiac massage. Step four

Move your center of gravity to the victim's sternum, keeping your arms straight at the elbows. This will allow you to maintain strength for as long as possible. Bend your elbows when performing chest compressions - the same as doing push-ups from the floor (example: resuscitate the victim with pressure at a rate of 60-100 times per minute, at least 30 minutes, even if resuscitation is ineffective. Because only after this time signs of biological death clearly appear. Total: 60 x 30 = 1800 push-ups).

For adults, indirect cardiac massage is performed with two hands, for children - with one hand, for newborns - with two fingers.

Indirect cardiac massage. Step five

Push the chest at least 3-5 cm with a frequency of 60-100 times per minute, depending on the elasticity of the chest. In this case, the palms should not come off the victim’s sternum.

Indirect cardiac massage. Step six

You can begin applying pressure on the chest only after it has completely returned to its original position. If you don't wait for the sternum to return to its original position and press, the next push will turn into a monstrous blow. Performing chest compressions can result in fracture of the victim's ribs. In this case, the indirect cardiac massage is not stopped, but the frequency of compressions is reduced to allow the chest to return to its original position. At the same time, be sure to maintain the same depth of pressing.

Indirect cardiac massage. Step seven

The optimal ratio of chest compressions and mechanical ventilation breaths is 30/2 or 15/2, regardless of the number of participants. With each pressure on the chest, an active exhalation occurs, and when it returns to its original position, a passive inhalation occurs. Thus, new portions of air enter the lungs, sufficient to saturate the blood with oxygen.

Anyone can find themselves in a situation where a person walking nearby loses consciousness. We immediately begin to panic, which must be put aside, because that person needs help.

Every person is obliged to know and apply at least basic resuscitation actions. These include chest compressions and artificial respiration. Most people undoubtedly know what it is, but not everyone will be able to provide assistance correctly.

If there is no pulse or breathing, it is necessary to take immediate action, ensure air access and rest the patient, and also call an ambulance. We will tell you how and when it is necessary to perform indirect cardiac massage and artificial respiration.

The human heart has four chambers: 2 atria and 2 ventricles. The atria provide blood flow from the vessels to the ventricles. The latter, in turn, release blood into the small (from the right ventricle into the vessels of the lungs) and large (from the left - into the aorta and further, to other organs and tissues) circulatory circles.

In the pulmonary circulation, an exchange of gases occurs: carbon dioxide leaves the blood into the lungs, and oxygen into it. More precisely, it binds to the hemoglobin of red blood cells.

In the systemic circulation the reverse process occurs. But, besides it, nutrients come from the blood to the tissues. And the tissues “give back” the products of their metabolism, which are excreted by the kidneys, skin and lungs.

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

1. Ventricular asystole.
2. Paroxysmal tachycardia.
3. Ventricular fibrillation, etc.

Among the predisposing factors are:

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

Sudden cardiac arrest sometimes occurs due to injury or drowning, possibly due to an obstructed airway as a result of electric shock.

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

1. Consciousness is lost.
2. Rare convulsive sighs appear.
3. There is a sharp pallor on the face.
4. The pulse disappears in the area of ​​the carotid arteries.
5. Breathing stops.
6. The pupils dilate.

Indirect cardiac massage is performed until independent cardiac activity is restored, among the signs of which are the following:

1. The man regains consciousness.
2. A pulse appears.
3. Pallor and cyanosis decrease.
4. Breathing resumes.
5. The pupils narrow.

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

In case of circulatory arrest, tissue exchange and gas exchange stops. Metabolic products accumulate in the cells, and carbon dioxide accumulates in the blood. This leads to a stop in metabolism and cell death as a result of “poisoning” with metabolic products and lack of oxygen.

Moreover, the higher the initial metabolism in the cell, the less time is needed for its death due to cessation of blood circulation. For example, for brain cells this is 3-4 minutes. Cases of revival after 15 minutes refer to situations where, before cardiac arrest, the person was in a state of cooling.

Indirect cardiac massage involves compression of the chest, which must be done to compress the chambers of the heart. At this time, blood leaves the atria through the valves into the ventricles, then it is directed into the vessels. Thanks to rhythmic pressure on the chest, the movement of blood through the vessels does not stop.

This method of resuscitation must be done to activate the heart’s own electrical activity, and this helps restore the organ’s independent functioning. Providing first aid can bring results in the first 30 minutes after the onset of clinical death. The main thing is to correctly carry out the algorithm of actions and follow the approved first aid technique.

Massage in the heart area should be combined with mechanical ventilation. Each pressing of the victim’s chest, which must be done by 3–5 cm, provokes the release of about 300–500 ml of air. After the compression stops, the same portion of air is sucked into the lungs. By compressing/releasing the chest, an active inhalation is performed, then a passive exhalation.

What is direct and indirect cardiac massage?

Cardiac massage is indicated for palpitations and cardiac arrest. It can be done:

• open (straight).
• closed (indirect) method.

Direct cardiac massage is carried out during surgery when the chest or abdominal cavity is opened, and the chest is also specially opened, often even without anesthesia and observing the rules of asepsis. After exposing the heart, it is carefully and gently squeezed with your hands at a rhythm of 60-70 times per minute. Direct cardiac massage is performed only in an operating room.

Indirect cardiac massage is much simpler and more accessible in any conditions. It is done without opening the chest simultaneously with artificial respiration. By pressing on the sternum, you can move it 3-6 cm towards the spine, compress the heart and force blood out of its cavities into the vessels.

When the pressure on the sternum ceases, the cavities of the heart straighten, and blood from the veins is sucked into them. Indirect cardiac massage can maintain pressure in the systemic circulation at a level of 60-80 mmHg. Art.

The technique of indirect cardiac massage is as follows: the person providing assistance places the palm of one hand on the lower third of the sternum, and the other on the back surface of the previously applied hand to increase pressure. 50-60 pressures are applied to the sternum per minute in the form of quick thrusts.

After each pressure, the hands are quickly removed from the chest. The period of pressure should be shorter than the period of chest expansion. For children, massage is performed with one hand, and for newborns and children up to one year old - with the tips of 1 - 2 fingers.

The effectiveness of cardiac massage is assessed by the appearance of pulsation in the carotid, femoral and radial arteries, and an increase in blood pressure to 60-80 mm Hg. Art., constriction of the pupils, the appearance of their reaction to light, restoration of breathing.

When and why is cardiac massage done?

Indirect cardiac massage is necessary in cases where the heart has stopped. In order for a person not to die, he needs outside help, that is, he needs to try to “start” the heart again.

Situations when cardiac arrest is possible:

• Drowning,
• Transport accident,
• Electric shock,
• Damage due to fire,
• The result of various diseases,
• Finally, no one is immune from cardiac arrest for unknown reasons.

Symptoms of cardiac arrest:

• Loss of consciousness.
• Absence of pulse (usually it can be felt on the radial or carotid artery, that is, at the wrist and neck).
• Lack of breathing. The most reliable way to determine this is to hold a mirror to the victim's nose. If it does not fog up, then there is no breathing.
• Dilated pupils that do not respond to light. If you open your eye a little and shine a flashlight, you will immediately understand whether they react to light or not. If a person’s heart is beating, the pupils will immediately constrict.
• Gray or blue complexion.

Cardiac compression (CCM) is a resuscitation procedure that saves many lives every day around the world. The sooner you start giving the victim NMS, the greater his chances of survival.

NMS includes two steps:

1. mouth-to-mouth artificial respiration, restoring breathing in the victim;
2. compression of the chest, which, together with artificial respiration, forces blood to move until the victim’s heart can pump it throughout the body again.

If a person has a pulse but is not breathing, he requires artificial respiration, but not chest compressions (the presence of a pulse means the heart is beating). If there is no pulse or breathing, both artificial respiration and chest compressions are needed to force air into the lungs and maintain blood circulation.

Closed heart massage must be performed when the victim has no reaction of the pupils to light, breathing, cardiac activity, or consciousness. External cardiac massage is considered to be the simplest method used to restore cardiac activity. It does not require any medical equipment to perform it.

External cardiac massage is represented by rhythmic squeezing of the heart through compressions performed between the sternum and the spine. For victims who are in a state of clinical death, it is not difficult to perform chest compressions. This is explained by the fact that in this state muscle tone is lost and the chest becomes more pliable.

When the victim is in a state of clinical death, the person providing assistance, following the technique, easily displaces the victim’s chest by 3–5 cm. Each compression of the heart provokes a decrease in its volume and an increase in intracardiac pressure.

By performing rhythmic pressure on the chest area, a difference in pressure occurs inside the heart cavities, the blood vessels extending from the heart muscle. Blood from the left ventricle is sent through the aorta to the brain, and from the right ventricle blood flows to the lungs, where it is saturated with oxygen.

After the pressure on the chest stops, the heart muscle straightens, intracardiac pressure decreases, and the heart chambers fill with blood. External cardiac massage helps restore artificial circulation.

Closed heart massage is performed only on a hard surface; soft beds are not suitable. When performing resuscitation, you must follow this algorithm of actions. After placing the victim on the floor, it is necessary to perform a precordial punch.

The blow should be directed to the middle third of the chest, the required height for the blow is 30 cm. To perform a closed heart massage, the paramedic first places the palm of one hand on the other hand. After this, the specialist begins to perform uniform pushes until signs of blood circulation restoration appear.

In order for the resuscitation measure to be performed to bring the required effect, you need to know and follow the basic rules, which consist in the following algorithm of actions:

1. The person providing assistance must determine the location of the xiphoid process.
2. Determine the compression point, which is located in the center of the axis, 2 fingers above the xiphoid process.
3. Place the heel of your palm on the calculated compression point.
4. Perform compression along the vertical axis, without sudden movements. Compression of the chest must be performed to a depth of 3–4 cm, the number of compressions per chest area is 100/minute.
5. For children under one year of age, resuscitation is performed with two fingers (second, third).
6. When performing resuscitation on small children under one year old, the frequency of compressions on the sternum should be 80 - 100 per minute
7. For teenage children, assistance is provided with the palm of one hand.
8. For adults, resuscitation is performed in such a way that the fingers are raised and do not touch the chest area.
9. It is necessary to alternate between two breaths of mechanical ventilation and 15 compressions on the chest area.
10. During resuscitation, it is necessary to monitor the pulse in the carotid artery.

Signs of the effectiveness of resuscitation measures are the reaction of the pupils and the appearance of a pulse in the area of ​​the carotid artery. Method of performing indirect cardiac massage:

• put the victim on a hard surface, the resuscitator is located 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 your palms in rhythmically, with pushes, using your own body weight and the efforts of both hands;
• if a rib fracture occurs during chest compressions, it is necessary to continue the massage by placing the base of the palms on the sternum;
• The pace of the massage is 50-60 shocks per minute; in an adult, the amplitude of the chest oscillations should be 4-5 cm.

Simultaneously with cardiac massage (1 push per second), artificial respiration is performed. For 3-4 compressions on the chest, there is 1 deep exhalation into the victim’s mouth or nose, if there are 2 resuscitators. If there is only one resuscitator, then every 15 compressions on the sternum with an interval of 1 second, 2 artificial breaths are required. Inhalation frequency is 12-16 times per minute.

For children, the massage is performed carefully, with 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.

Indirect cardiac massage should also be performed with caution on the elderly, since rough actions may result in fractures in the chest area.

How to perform cardiac massage on an adult

Stages of implementation:

1. Get ready. Gently shake the victim's shoulders and ask, “Is everything okay?” This way you will make sure that you are not going to perform NMS on a conscious person.
2. Quickly check to see if he has any serious injuries. Focus your attention on the head and neck as you manipulate them.
3. Call an ambulance if possible.
4. Lay the victim on his back on a hard, flat surface. But if you suspect a head or neck injury, do not move it. This can increase the risk of paralysis.
5. Provide air access. Kneel near the victim's shoulder for easy access to the head and chest. Perhaps the muscles that control the tongue have relaxed, causing it to block the airway. To restore breathing, you need to free them.
6. If there is no neck injury. Open the victim's airway.

Place the fingers of one hand on his forehead and the other on his lower jaw near his chin. Gently push your forehead back and pull your jaw upward. Keep your mouth slightly open so that your teeth are almost touching. Do not place your fingers on the soft tissue under your chin - you may inadvertently block the airway you are trying to clear.

If there is a neck injury. In this case, movement of the neck can cause paralysis or death. Therefore, you will have to clear the airways in another way. Kneel behind the victim's head with your elbows on the ground.

Curl your index fingers over your jaw near your ears. With a strong movement, lift your jaw up and out. This will open the airway without moving the neck.

7. Make sure the victim's airway is open.

Bend toward his mouth and nose, looking toward his feet. Listen for sound from air movement, or try to catch it with your cheek, see if your chest moves.

8. Start artificial respiration.

If breathing is not caught after opening the airways, use the mouth-to-mouth method. Pinch your nostrils with the index finger and thumb of the hand on the victim's forehead. Take a deep breath and close the victim's mouth tightly with your lips.

Take two full breaths. After each exhalation, inhale deeply until the victim's chest collapses. This will also prevent abdominal swelling. Each breath should last one and a half to two seconds.

9. Check the victim's reaction.

To make sure there is a result, see if the victim's chest rises. If not, move his head and try again. If your chest still doesn't move after this, a foreign body (such as dentures) may be blocking your airway.

To release them, you need to push the stomach. Place one hand with the heel of the palm on the middle of the abdomen, between the navel and chest. Place your other hand on top and interlace your fingers. Lean forward and make a short, sharp push up. Repeat up to five times.

Check your breathing. If he is still not breathing, repeat thrusting until the foreign body is expelled from the airway or help arrives. If a foreign body is expelled from the mouth but the person is not breathing, the head and neck may be in an abnormal position, causing the tongue to block the airway.

In this case, move the victim's head by placing your hand on the forehead and tilting it back. If you are pregnant and overweight, use chest thrusts instead of abdominal thrusts.

10. Restore blood circulation.

Keep one hand on the victim's forehead to keep the airway open. With your other hand, check the pulse in your neck by feeling the carotid artery. To do this, place your index and middle fingers in the hole between the larynx and the muscle next to it. Wait 5-10 seconds to feel your pulse.

If there is a pulse, do not compress your chest. Continue artificial respiration at a rate of 10-12 exhalations per minute (one every 5 seconds). Check your pulse every 2-3 minutes.

11. If there is no pulse and help has not yet arrived, begin chest compressions.

Spread your knees for a secure nap. Then, with the hand closest to the victim’s legs, feel the lower edge of the ribs. Run your fingers along the edge to feel where the ribs meet the sternum. Place your middle finger on this place, next to it your index finger.

It should be located above the lowest point of the sternum. Place the heel of your other palm on your sternum next to your index finger. Remove your fingers and place this hand on top of the other. Fingers should not rest on the chest. If the arms are positioned correctly, all effort should be concentrated on the sternum.

This reduces the risk of a rib fracture, lung puncture, or liver rupture. Elbows tight, arms straight, shoulders directly above your hands - you're ready. Using your body weight, press the victim's sternum 4-5 centimeters. You need to press with the heels of your palms.

After each compression, release the pressure so that the chest returns to its normal position. This gives the heart a chance to fill with blood. To avoid injury, do not change the position of your hands when pressing. Make 15 presses at a rate of 80-100 presses per minute. Count “one-two-three...” until 15. Press the count, release for a break.

Alternate compression and artificial respiration. Now take two breathing movements. Then find the correct position for your hands again and do another 15 presses. After four complete cycles of 15 compressions and two breaths, check the carotid pulse again. If it is still not there, continue NMS in cycles of 15 presses and two breathing movements, starting with inhalation.

Watch the reaction. Check your pulse and breathing every 5 minutes. If the pulse is palpable, but breathing is not heard, take 10-12 breathing movements per minute and check the pulse again. If there is both a pulse and breathing, check them more closely. Continue NMS until the following occurs:

• the victim’s pulse and breathing will be restored;
• doctors will arrive;
• You will get tired.

Features of resuscitation in children

In children, resuscitation techniques differ from those in adults. The chest of babies under one year old is very tender and fragile, the heart area is smaller than the base of the palm of an adult, so pressure during indirect cardiac massage is performed not with the palms, but with two fingers.

The movement of the chest should be no more than 1.5–2 cm. The frequency of compressions is at least 100 per minute. From 1 to 8 years of age, massage is done with one palm. The chest should move 2.5–3.5 cm. Massage should be performed at a frequency of about 100 pressures per minute.

The ratio of inhalation to compression on the chest in children under 8 years old should be 2/15, in children over 8 years old - 1/15. How to perform artificial respiration for a child? For children, artificial respiration can be performed using the mouth-to-mouth technique. Since babies have small faces, an adult can perform artificial respiration by immediately covering both the child’s mouth and nose. The method is then called “mouth to mouth and nose.”

Artificial respiration is given to children at a frequency of 18–24 per minute. In infants, indirect cardiac massage is performed with only two fingers: the middle and ring fingers. The frequency of massage pressure in infants should be increased to 120 per minute.

The causes of cardiac and respiratory arrest can be not only injuries or accidents. A baby's heart may stop due to congenital diseases or sudden death syndrome. In preschool children, only the base of one palm is involved in the process of cardiac resuscitation.

There are contraindications for performing chest compressions:

• penetrating wound to the heart;
• penetrating injury to the lung;
• closed or open traumatic brain injury;
• absolute absence of a hard surface;
• other visible wounds incompatible with emergency resuscitation.

Without knowing the rules for resuscitation of the heart and lungs, as well as existing contraindications, you can aggravate the situation even further, leaving the victim no chance of salvation.

External massage for a baby

Carrying out indirect massage for babies is as follows:

1. Shake the baby gently and say something loudly.

His reaction will allow you to make sure that you are not going to give NMS to a conscious baby. Quickly check for injuries. Focus on the head and neck as you will be manipulating these parts of the body. Call an ambulance.

If possible, have someone else do this. If you are alone, do NMS for one minute, and only then call professionals.

2. Clear your airways. If the baby is choking or has something stuck in the airway, give 5 chest thrusts.

To do this, place two fingers between his nipples and push quickly in an upward direction. If you are concerned about head or neck injury, move your baby as little as possible to reduce the risk of paralysis.

3. Try to regain your breathing.

If the baby is unconscious, open the baby's airway by placing one hand on the forehead and gently lifting the chin with the other to allow air to flow. Do not press on the soft tissue under the chin, as this may block the airway.

The mouth should be slightly open. Make two mouth-to-mouth breathing movements. To do this, inhale and tightly close the baby's mouth and nose with your mouth. Gently exhale some air (a baby's lungs are smaller than an adult's). If the chest rises and falls, the amount of air appears to be appropriate.

If the baby does not start breathing, move his head slightly and try again. If nothing has changed, repeat the airway opening procedure. After removing objects blocking the airway, check your breathing and pulse.

Continue NMS if necessary. Continue artificial respiration with one breath every 3 seconds (20 breaths per minute) if the infant has a pulse.

4. Restore blood circulation.

Check the pulse at the brachial artery. To find it, feel the inside of your upper arm, above the elbow. If there is a pulse, continue artificial respiration, but do not compress the chest.

If the pulse cannot be felt, begin to compress the chest. To determine the position of your baby's heart, draw an imaginary horizontal line between the nipples.

Place three fingers below and perpendicular to this line. Raise your index finger so that your two fingers are one finger below the imaginary line. Press them on the sternum so that it drops 1-2.5 cm.

5. Alternate compressions and artificial respiration. After five presses, make one breathing movement. In this way, you can do about 100 presses and 20 breathing movements. Do not stop NMS until the following occurs:
   • the baby will begin to breathe on his own;
   • he will have a pulse;
   • doctors will arrive;
   • You will get tired.

Having laid the patient on his back and throwing his head back as much as possible, you should twist the roller and place it under the shoulders. This is necessary in order to fix the position of the body. You can make a roller yourself from clothes or a towel.

You can perform artificial respiration:

• mouth to mouth;
• from mouth to nose.

The second option is used only if it is impossible to open the jaw due to a spasmodic attack. In this case, you need to press the lower and upper jaws so that the air does not escape through the mouth. You also need to clasp your nose tightly and blow in air not sharply, but energetically.

When performing the mouth-to-mouth method, one hand should cover the nose and the other should fix the lower jaw. The mouth should fit tightly against the victim's mouth so that there is no leakage of oxygen.

It is recommended to exhale air through a handkerchief, gauze or napkin with a hole in the middle measuring 2-3 cm. The exhalation should not be sharp, since the esophagus may open under the influence of a strong jet. This means that air will enter the stomach.

The person carrying out resuscitation measures of the lungs and heart must take a deep, long breath, hold the exhalation and lean towards the victim. Place your mouth tightly against the patient's mouth and exhale. If the mouth is not pressed tightly or the nose is not closed, then these actions will not have any effect.

The air supply by the rescuer's exhalation should last for about 1 second, the approximate volume of oxygen being 1 to 1.5 liters. Only with this volume can lung function resume.

After this, you need to free the victim’s mouth. In order for a full exhalation to take place, you need to turn his head to the side and slightly raise the shoulder of the opposite side. This takes about 2 seconds.

If pulmonary measures are carried out effectively, the victim's chest will rise when inhaling. You should also pay attention to the stomach, it should not be swollen. When air enters the stomach, you need to press under the stomach so that it comes out, as this complicates the entire process of revival.

Pericardial stroke

If clinical death occurs, a pericardial stroke can be applied. It is such a blow that can start the heart, as there will be a sharp and strong impact on the sternum.

To do this, you need to clench your hand into a fist and strike with the edge of your hand in the area of ​​the heart. You can focus on the xiphoid cartilage; the blow should fall 2-3 cm above it. The elbow of the hand that will strike should be directed along the body.

Often this blow brings victims back to life, provided that it is delivered correctly and in a timely manner. The heartbeat and consciousness can be restored instantly. But if this method does not restore function, artificial ventilation and chest compressions should be immediately applied.

Signs of effectiveness when following the rules for performing artificial respiration are as follows:

1. When artificial respiration is performed correctly, you may notice the chest moving up and down during passive inspiration.
2. If the movement of the chest is weak or delayed, you need to understand the reasons. Probably a loose fit of the mouth to the mouth or nose, a shallow breath, a foreign body preventing the air from reaching the lungs.
3. If, when you inhale air, it is not the chest that rises, but the stomach, then this means that the air did not go through the airways, but through the esophagus. In this case, you need to press on the stomach and turn the patient's head to the side, as vomiting is possible.

The effectiveness of cardiac massage also needs to be checked every minute:

1. If, when performing an indirect cardiac massage, a push appears on the carotid artery, similar to a pulse, then the pressing force is sufficient for blood to flow to the brain.
2. If resuscitation measures are performed correctly, the victim will soon experience heart contractions, blood pressure will rise, spontaneous breathing will appear, the skin will become less pale, and the pupils will narrow.

All actions must be completed for at least 10 minutes, or better yet, before the ambulance arrives. If the heartbeat persists, artificial respiration must be performed for a long time, up to 1.5 hours.

If resuscitation measures are ineffective within 25 minutes, the victim has cadaveric spots, a symptom of a “cat” pupil (when pressure is applied to the eyeball, the pupil becomes vertical, like a cat’s) or the first signs of rigor - all actions can be stopped, since biological death has occurred.

The sooner resuscitation is started, the greater the likelihood of a person returning to life. Their correct implementation will help not only restore life, but also provide oxygen to vital organs, prevent their death and disability of the victim.

How to do a massage correctly To achieve the exceptional effectiveness of indirect cardiac massage, namely the resumption of normal blood circulation and the air exchange process, and bringing a person to life through tactile acupressure on the heart through the chest, you need to follow some simple recommendations:

1. Act confidently and calmly, do not fuss.
2. Due to lack of self-confidence, do not leave the victim in danger, but be sure to carry out resuscitation measures.
3. Carry out preparatory procedures quickly and thoroughly, in particular, freeing the oral cavity from foreign objects, tilting the head to the position necessary for artificial respiration, freeing the chest from clothing, and a preliminary examination to detect penetrating wounds.
4. Do not tilt the victim’s head back excessively, as this may create obstacles to the free flow of air into the lungs.
5. Continue to resuscitate the victim’s heart and lungs until doctors or rescuers arrive.

In addition to the rules for performing chest compressions and the specifics of behavior in an emergency situation, do not forget about personal hygiene measures: you should use disposable napkins or gauze during artificial respiration (if available).

The phrase “saving a life is in our hands”, in cases where it is necessary to immediately perform chest compressions on an injured person who is on the verge of life and death, takes on a direct meaning.

When carrying out this procedure, everything is important: the position of the victim and especially his individual parts of the body, the position of the person performing chest compressions, clarity, measuredness, timeliness of his actions and absolute confidence in a positive outcome.

When to stop resuscitation?

It should be noted that pulmonary-cardiac resuscitation should be continued until the medical team arrives. But if the heartbeat and lung function are not restored within 15 minutes of resuscitation, then they can be stopped. Namely:

• when there is no pulse in the area of ​​the carotid artery in the neck;
• breathing is not performed;
• dilated pupils;
• the skin is pale or bluish.

And of course, cardiopulmonary resuscitation measures are not carried out if a person has an incurable disease, for example, oncology.