What to do if water gets into the bronchi. What happens if water enters the lungs

MOSCOW, January 27 - RIA Novosti, Olga Kolentsova. Although the fetus lives in the water for nine months, and swimming is good for health, the aquatic environment is dangerous for humans. Anyone can drown - a child, an adult, a well-trained swimmer ... And the rescuers do not have much time to save a person not only life, but also his mind.

overcome the tension

When a person drowns, water enters his lungs. But why can't people live at least for a short time, scooping oxygen from water? To understand this, let's look at how a person breathes. The lungs are like a bunch of grapes, where the bronchi branch out like shoots into many airways (bronchioles) and crown with berries - alveoli. The fibers in them are compressed and unclenched, passing oxygen and other gases from the atmosphere into the blood vessels or releasing CO 2 out.

“To renew the air, it is necessary to make a respiratory movement, which involves the intercostal muscles, the diaphragm and part of the neck muscles. However, the surface tension of water is much greater than that of air. The molecules inside the substance are attracted to each other evenly due to the fact that there are neighbors on all sides. There are fewer molecules on the surface of the neighbors, and they are attracted to each other more strongly, which means that in order for the tiny alveoli to be able to draw in water, an immeasurably greater effort is required from the muscle complex than when inhaling air, "says Alexei Umryukhin, Doctor of Medical Sciences, Head of the Department normal physiology of the First Moscow State Medical University named after I.M. Sechenov.

The lungs of an adult human contain 700-800 million alveoli. Their total area is about 90 square meters. It is not easy to tear apart even two smooth glasses if there is a layer of water between them. Imagine what effort you need to make when inhaling to unstick such a huge area of the alveoli.

By the way, it is the force of surface tension that is a huge problem in the development of liquid breathing. It is possible to saturate the solution with oxygen and choose its parameters so that the bonds between the molecules are weakened, but in any case, the surface tension force remains significant. The muscles involved in breathing will still need much more effort to drive the solution into the alveoli and expel it from there. On liquid breathing, you can hold out for several minutes or an hour, but sooner or later the muscles will simply get tired and will not be able to cope with the work.

Rebirth won't work

The alveoli of a newborn are filled with a certain amount of amniotic fluid, that is, they are in a sticky state. The child takes the first breath, and the alveoli open - already for life. If water enters the lungs, surface tension causes the alveoli to stick together, and it takes a lot of effort to pull them apart. Two, three, four breaths in the water - this is the maximum of a person. All this is accompanied by convulsions - the body works to the limit, the lungs and muscles burn, trying to squeeze everything out of themselves.

In the popular series "Game of Thrones" there is such an episode. The pretender to the throne is consecrated as king in the following way: the head is kept under water until he stops floundering and showing signs of life. Then the body is pulled ashore and they wait for the person to take a breath, clear his throat and get up. After that, the applicant is recognized as a full-fledged ruler. But the creators of the series embellished the reality: after a series of breaths in the water, the body gives up - and the brain stops sending signals that it is necessary to try to breathe.

Mind is the weak link

A person can hold their breath for three to five minutes. Then the level of oxygen in the blood decreases, the desire to take a breath becomes unbearable and completely uncontrollable. Water enters the lungs, but there is not enough oxygen in it to saturate the tissues. The brain is the first to suffer from the lack of oxygen. Other cells are able to survive for some time on anaerobic, that is, oxygen-free respiration, although they will produce 19 times less energy than in the aerobic process.

“The structures of the brain consume oxygen in different ways. The cerebral cortex is especially “gluttonous”. It is she who controls the conscious sphere of activity, that is, is responsible for creativity, higher social functions, intelligence. Its neurons will be the first to use up oxygen reserves and die,” the expert notes .

If a drowned person manages to regain life, his consciousness may never return to normal. Of course, much depends on the time spent under water, the state of the body, and individual characteristics. But doctors believe that the average drowning man's brain dies in five minutes.

Often, those who drowned turn into invalids - they lie in a coma or are almost completely paralyzed. Although the body is formally normal, the affected brain cannot control it. This happened to 17-year-old Malik Akhmadov, who in 2010 saved a drowning girl at the cost of his health. For the past seven years, the guy has been undergoing rehabilitation course after course, but his brain has not fully recovered.

Exceptions are rare, but they do happen. In 1974, a five-year-old boy in Norway stepped onto the ice of a river, fell through and drowned. He was taken out of the water only after 40 minutes. Doctors performed artificial respiration, heart massage, and resuscitation was successful. The child lay unconscious for two days, and then opened his eyes. Doctors examined him and were surprised to state that his brain was in an absolute norm. Perhaps the ice water slowed down the metabolism in the child's body so much that his brain seemed to freeze and did not need oxygen, like the rest of the organs.

Doctors warn: if a person has already gone under water, the rescuer has literally a minute to save him. The faster the victim removes water from the lungs, causing a gag reflex, the greater the chance of a full recovery. It is important to remember that a drowning person rarely gives himself away by screaming or actively trying to stay on the water, he simply does not have enough strength for this. Therefore, if you suspect something is wrong, it is better to ask if everything is in order, and if there is no answer, take measures to save the drowning person.

Hello! It seems to me that there is practically no reason for your concern. It is possible that the water did not get into your lungs at all. But, even if it hit, then probably in the smallest amount. And, if you are a healthy person, then a small amount of water should very quickly dissolve on its own by the tissue of the respiratory tract. Especially since you coughed up phlegm. Cough is a protective reaction of the body to irritation of the human respiratory tract. Whether water accidentally got into the respiratory tract, a crumb of bread, whether you inhaled a pungent smell, for example, tobacco smoke, coughing is a natural defensive reaction. During coughing, the body tries to get rid of mucus, or foreign particles that have entered the respiratory tract. I think you can now increase your physical activity to make your breathing more frequent and deep. Just do some breathing exercises.

However, if you still fear for your health, I think it's better to play it safe and seek the advice of a doctor.

Water in the lungs can be dangerous in a drowning situation or in case of any serious illness. For example, with hydrothorax, when free fluid accumulates in the pleural cavity, the peripulmonary sac. It occurs for the same reason as ascites - stagnation of blood and sweating of its liquid part into the cavity. Considering that the fluid compresses the lung tissue over time, the patient develops shortness of breath or its sharp aggravation, if it existed even before the development of hydrothorax. In addition, the lung tissue itself is “stuffed” with water, and this, even to a greater extent than hydrothorax, increases shortness of breath.

It is possible to diagnose hydrothorax when examining the patient, while in the place where the fluid has accumulated, changes will be detected during percussion (a special tapping with the fingers, which the doctor always uses). In the same area, when listening with a phonendoscope, breathing will be weakened or completely absent. If such data is revealed, the doctor will certainly refer the patient to a chest x-ray, which finally removes all questions, since the fluid and its level are clearly visible in the picture.

It must be said that the diagnosis of hydrothorax is established, regardless of the cause of its occurrence and the amount of accumulated fluid. The cause of hydrothorax can be not only cardiological. In addition, even a small amount of fluid that does not even make itself felt will also be called hydrothorax.

If fluid accumulates in the lungs, this always indicates the presence of a disease. This phenomenon can be observed in the following cases:

It is very dangerous. Most neoplasms in the lung area are malignant. Therefore, they should be removed as soon as possible.

Tuberculosis. In this case, purulent sputum, particles of blood and lung tissue accumulate in the lungs due to the onset of organ decay.
Injuries in the chest area. They lead to various ruptures, which entail the accumulation of exudate. The fluid is formed gradually, the patient also notes severe pain in the area of injury. Perhaps blueing of the place where the blow fell.
Diseases of the internal organs, leading to an inflammatory process in the pleura. Often this occurs with cirrhosis of the liver.

Pathology may appear after heart surgery. The organ begins to work with some failures, so blood can be thrown into the lungs. This is a fairly common phenomenon that occurs approximately 1-2 weeks after surgery, so doctors prepare the patient for possible complications in advance.

Water in the lungs can also be from outside. For example, if a person choked. Part of the liquid may remain in the respiratory tract, and then it will enter the main respiratory organ.

Each of the above pathologies is dangerous in its own way. The sooner treatment is started, the greater the chance that recovery will come quickly without provoking serious complications.

Fluid accumulation in older people

Fluid in the lungs of the elderly may accumulate due to long-term use of acetylsalicylic acid. Old people drink it to relieve pain.

In addition, water in the lungs of the elderly may occur due to their sedentary lifestyle. This leads to a violation of the pulmonary circulation, stagnation occurs. Therefore, to prevent such phenomena, older people need to move more.

Main manifestations

In the presence of fluid in the lungs of a person, a variety of symptoms are tormented. Their severity depends on the amount of accumulated exudate. The patient may experience the following symptoms:

If any of the above symptoms occur, you should immediately consult a doctor. Otherwise, there is a possibility of developing serious complications.

Diagnostic studies

The diagnosis is made only after a series of diagnostic procedures. These include:

Examine the patient and listen to his lungs. The doctor must ask the patient what exactly worries him in order to have at least the slightest idea of \u200b\u200bthe pathology.
X-ray or fluorography. This is the most informative diagnostic method. Changes are clearly visible on the x-ray. The affected area is shaded.
Blood tests to determine whether a person has colds, whether the immune system is functioning normally.

Sometimes a differential diagnosis is required if the doctor cannot make an accurate diagnosis. In this case, additional diagnostic procedures may be performed.

How to treat

The causes and treatment of fluid in the lungs are interrelated. The doctor can prescribe therapy only after the name of the disease that provoked unpleasant symptoms is called. In almost 100% of cases, hospitalization of the patient is required.

Treatment can be conservative or surgical. Taking medication gives a result only if a little fluid has accumulated. To eliminate the disease, the following drugs can be used:

Is it treated at home? Self-medication for any disease accompanied by fluid accumulation can be very dangerous to health. The person may choke.

If taking medication does not give any result, the doctor adjusts the treatment regimen. In this case, it may be necessary to pump out the accumulated liquid.

How fluid is pumped out of the lungs

If fluid has accumulated in the pleural cavity, it must be pumped out. A healthy person also has it, but its amount does not exceed 2 ml. If more than 10 ml of fluid has accumulated, it must be removed. After pumping out, the patient's breathing should normalize, suffocation will pass.

Usually they resort to pumping out a liquid that has a non-infectious nature. It's called a transudate. If the pathology is associated with an inflammatory process, it must first be cured. If after that the liquid remains, it will need to be removed.

Before the procedure, the patient does not require special preparation. The process is performed according to the following algorithm:

The patient should sit down, bend forward, and put his hands on a special table.
Local anesthesia is performed. An injection of novocaine is also given to avoid pain. The puncture site is determined in advance on the basis of data obtained during ultrasound or X-ray.
The skin is wiped with alcohol. Then the doctor begins to make a puncture. He must act very carefully so as not to hurt the nerve endings and blood vessels. The depth must also be correct. If the needle is inserted too deep, it can damage the lung.

The doctor must insert the needle until there is a sense of failure. The upper layer of the lung is denser than its contents.

After that, the doctor pumps out the accumulated fluid.
At the end, the puncture site is treated with an antiseptic solution, and a sterile bandage is applied to its place.

In one procedure, no more than a liter of transudate can be removed from the lungs. If this limit is exceeded, serious complications may appear, up to and including death.

Pumping fluid should be carried out by an experienced specialist. You can not trust this procedure to an ambulance worker or a person without training. It must be performed under sterile conditions.

How many times can fluid be pumped out of the lungs

The number of repetitions of the procedure is determined by the attending physician. It is important to eliminate the reason why the liquid is collected. After that, it will accumulate less, so it will need to be pumped out less frequently until the need for this completely disappears.

Folk remedies for fluid stagnation

Treatment with folk remedies is possible only if there is an accumulation of a small amount of fluid. In very advanced cases, such therapy is very dangerous. The following remedies are effective for removing stagnant mucus:

It is impossible to completely remove the liquid at home. Requires the use of special tools. In addition, it is impossible to make a correct diagnosis on your own. And taking inappropriate funds may not give any result.

recovery forecasts

If therapy is started on time, the prognosis is favorable. The disease can be cured without the appearance of complications for the body. After that, people live a full life.

But if you hesitate and do not see a doctor on time, the consequences can be disastrous. The swelling will increase, squeezing the airways. The person may die due to respiratory failure.

Fluid in the lungs is always very dangerous. If the patient suspects this pathology, you should immediately go to the hospital. It can also take time to make a diagnosis. And in some cases, even a watch is important to save a person's life.

Source: pulmono.ru

First aid for water inhalation

The sequence of actions to help the victim depends on how much water has entered his body through the respiratory tract. Some conclusions can be drawn from the appearance of a person. If the victim chokes on a small amount of water, he will cough, hold on to his throat, his face may turn red. If at the same time the skin is pale, then the water has not reached the lungs.

The bluish color of the skin indicates that water has entered the lungs. The person turns blue, loses consciousness. Foamy liquid in such cases can pour out of the mouth and nose. Then you should immediately call an ambulance and immediately begin to do artificial respiration. If a person chokes on a sip of liquid while drinking, they tilt his head and tap between the shoulder blades on his back.

If such measures do not bring results, but the victim is conscious, then you can try the Heimlich method. The sequence of actions should be like this:

You should stand behind the patient.
The hand is clenched into a fist.
The thumb should be placed on the upper abdomen under the ribs, above the navel (epigastric region).
The other hand grabs a fist and pushes up, while the stomach is pressed in.

Such movements are performed several times until the person's breathing returns to normal.

If a person has swallowed a lot of water, then the following manipulations are performed:

The chest of the victim is placed on his knee, his face is turned down.
You need to press your finger on the root of the tongue to induce a gag reflex.
You just need to do claps on the back, tap gently between the shoulder blades.

If this does not help, artificial respiration is done, alternating it with an indirect heart massage. 30 clicks are made on the heart, then 2 breaths, and the cycle repeats again.

Such actions are taken before the arrival of the ambulance. If necessary, the doctor can refer the patient to the hospital. You may need to take an X-ray to make sure that there is no water in the lungs and trachea. The doctor will prescribe the necessary treatment, select antibiotics and medicines.

If water gets into the child's lungs

If the child is small, then he should always be supervised. After all, a baby can choke even in a shallow pond or at home, swimming in the bathroom. A child, being under water, is often frightened and continues to breathe. And then the airways are filled with fluid, which can get into the lungs. There is a spasm of the vocal cords. It becomes impossible for him to breathe.

If water has entered the lungs of a child, then the following actions should be taken:

Wrap your finger with a bandage, gauze or other clean cloth that is at hand. Then with your finger try to clean the victim's mouth from foam, mucus, possibly dirt and sand.

If someone is nearby, let him call an ambulance. After all, the rescuer needs to act at this time.
You should bend the leg and put the child on the knee so that his head hangs down. Next, with force, but gently press several times on the back in the area of the lungs (or pat on the back). This will help free the lungs from water.
If a very small child has swallowed water in the pool or bathroom, then you need to grab him by the legs and raise him so that his head is down. In this case, with the other hand, the lower jaw of the child should be pressed against the upper one so that the tongue does not interfere with the exit of water from the larynx.
When the water leaves the lungs, artificial respiration is done. If the heart does not beat, you should immediately switch to chest compressions.

Everything must be done quickly, without waiting for the help of doctors, because every minute is precious.

Do not rush to take the victim to the hospital, time may be lost. If the child himself cannot breathe, artificial ventilation of the lungs is carried out.

When the child comes to his senses, he must be dried, allowed to warm up, drink hot tea. And then take him to the hospital, where he will be examined and the necessary measures will be taken to prevent complications. It should be borne in mind that the child's heart may be unstable for some time.

Each person is obliged to learn how to provide first aid in case someone gets water into their lungs. It is important to know how to behave in other emergencies in order to save the life of a child or an adult if necessary.

Source: elaxsir.ru

Fluid in the lungs appears due to the penetration of the walls of the tissues of the lung due to a violation of their integrity. In this case, swelling of the lung tissues and the formation of exudate are observed. Turbid content seeps into the alveoli. This condition can be caused by:

inflammatory processes of lung tissues with pleurisy, tuberculosis intoxication and pneumonia;
with a weak heartbeat;
in heart failure, when the presence of fluid affects the increase in blood pressure;
congenital and hereditary heart diseases (malformation);
trauma to the chest and lungs;
with brain injuries;
during operations on the brain;
with pneumothorax;
oncological neoplasms;
renal or hepatic insufficiency;
in severe cases of cirrhosis of the liver.

Among other reasons, doctors call bacterial and viral etiology. It is possible that swelling and the appearance of fluid in the lung tissue are the result of systemic disorders of the body due to diseases: lupus erythematosus, rheumatoid arthritis, thromboembolism of the arteries of the lung, aneurysms and hemodialysis.

The physiological state during illness is related to how much fluid has accumulated in the walls of the lungs. Fluid symptoms:

The appearance of shortness of breath. Doctors consider this phenomenon the most important symptom. If the disease increases gradually, then shortness of breath may border on fatigue and vice versa. These signs appear in a fairly calm state and can occur without any reason. In acute cases, the patient may suffocate.
With the aggravation of the disease, a cough appears and mucus may be secreted. Against the background of these processes, dizziness, tachycardia, nervous breakdown and hunger appear.
Some patients feel pain in the lower part of the chest, with severe coughing attacks they intensify.
The symptom of oxygen starvation provokes a cyanotic tint of the skin.
In some cases, patients become restless, and nervous disorders are observed.

Attacks of coughing and shortness of breath most often appear in the early morning. At other times of the day, coughing is provoked by stressful conditions, physical activity, or chills during hypothermia. Against the background of heart failure, coughing can cause restless sleep.

Pulmonary formation of edema and fluid is a rather life-threatening disease. The blood vessels do not transport oxygen in the prescribed volume, and the nutrition of the lungs is insufficient. Hypoxia of the lungs increases with an increase in accumulated fluid and swelling of the lung tissue. The consequence of this phenomenon may be weakened or rapid breathing. Exacerbates swelling of the lungs intermittent cough. With such symptomatic attacks, the secretion of mucus increases, and the patient feels fear of death, showing external anxiety. By external signs, symptoms can be observed: pallor and chills of the body. In this case, the body temperature decreases. The symptom of pulmonary edema can be observed in the elderly.

If the first symptoms of swelling of the lung tissues are detected, preventive measures should be taken immediately and the patient should be sent to a medical institution. If this is not done, then in most cases the presence of such symptoms leads to death.

When the first symptoms appear, the patient is sent for a diagnostic study. This can be done quickly and results can be obtained within a short period of time.

To determine the exact diagnosis, the doctor will need to take a history of symptoms, make the patient a chest x-ray and an ultrasound of the lungs. In the latter case, the presence and amount of liquid exudate in the lung tissues is determined. Additional biochemical tests of blood, urine, and pulmonary exudate may be required to more accurately determine the diagnosis. Medical protocols define the following list of doctor's actions in the presence of the above symptoms in a patient:

classification of patient complaints;
examination and determination of the general condition (measurement of body temperature, determination of the color of the skin);
the conclusion of the X-ray examination;
ultrasound data;
analysis of blood, urine and exudate.

For additional diagnostics, an anamnesis is used in terms of studying pressure in the lung tissues, they study an analysis of blood coagulation, exclude or vice versa, diagnose a symptom of a heart muscle infarction. In the anamnesis of the patient's disease, biochemical analyzes and the presence of concomitant diseases - kidneys, liver and brain are carefully checked.

In case of concomitant symptoms, complex treatment is prescribed.

A complex of therapeutic measures is applied depending on the history of the disease and the severity of the patient. In the treatment of swelling of the lung tissue, methods are used:

In heart failure, treatment is carried out on the basis of the use of diuretics. Diuretics help to remove excess fluid from the body, thereby reducing the load on the lung tissue.
If the cause of the disease is an infectious environment, then antiseptic and antibiotic drugs are used in complex treatment.
The cause of the appearance of pulmonary exudate can be explained by renal failure during hemodialysis. In this case, the method of artificial removal of excess fluid from the patient's body is used. For these purposes, a catheter is used.
In severe cases, a ventilator is used. This maintains the general condition of the patient. Oxygen inhalations are also possible.

With a symptom of severe shortness of breath, fluid will be pumped out. To do this, a catheter is inserted into the lung cavity.

ethnoscience

The accumulation of fluid in the lungs is a dangerous phenomenon requiring hospitalization of the patient. However, in case of improvement in the condition, it is possible to deal with this problem with folk remedies.

A decoction of anise seeds will help. Anise seeds in the amount of 3 tsp boil in a glass of honey for 15 minutes. Then add ½ teaspoon of soda there and you can take it orally.

Flaxseed decoction: Boil 4 tablespoons of flaxseeds in a liter of water, then let it brew. Strain and take orally every 2.5 hours for 100-150 ml.

You can carefully grind the cyanosis root -1 tbsp. l. pour water - 0.5 l. and placed in a water bath for 40 minutes. Then all this must be filtered and taken during the day, 50 ml. You can take up to 4 times a day.

The treatment of pulmonary edema and the removal of accumulated fluid is a very complex process and requires patience and endurance of the patient. At the slightest suspicion of pulmonary edema, one should not neglect treatment and take one's health lightly. Moreover, prescribe yourself treatment in the form of antibiotics or antiviral drugs. This is not the case “I will lie down, and everything will pass”, it is necessary to treat it. Delay in medical care can cost the patient's life.

Possible consequences

With minor symptoms and the presence of fluid in the lungs, there is a positive trend in the treatment of such a disease. If all precautions and recommendations of doctors are observed, then a favorable outcome of treatment is inevitable. This mainly occurs with pleurisy or pneumonia, unless there are complications of another etiology. Severe forms of the disease and consequences can complicate further rehabilitation of recovery.

The consequences of severe edema may be deterioration in lung function, chronic conditions of hypoxia. A serious consequence of such a violation in the functioning of the pulmonary system can be an imbalance in the nervous system and the functioning of the brain. The consequences of the disease can provoke chronic diseases of the liver and kidneys. And disturbances in the work of the brain can cause vegetative-vascular disorders, strokes and lead to death. As a result, the prevention of diseases of the pulmonary system is important.

Preventive measures

It is impossible to exclude the risk of disease. Especially if the factors of a bacterial-infected environment can become the reason for this. It is impossible to save yourself from infectious pleurisy or pneumonia. But it is important to know the precautions during seasonal periods.

Patients with chronic diseases of the cardiovascular system should undergo a study at least 2 times a year.

Swelling of the lungs can provoke allergic reactions. Therefore, people prone to allergies should constantly use antihistamines or avoid provoking allergens as much as possible.

When in contact with harmful substances (chemical production, accidents at chemical plants), one should not forget about protective measures - a respirator and a protective suit. For such people, regular preventive examinations are provided.

An important role in the prevention of diseases of the pulmonary system is played by a healthy lifestyle, smoking cessation. This is not only about swelling, but also other lung diseases that this harmful addiction can provoke.

Recent studies by scientists have identified another reason for the appearance of fluid in the lungs - the ingress of toxic substances and carcinogens that tobacco smoke contains. Nicotinic substances that enter the lungs are transported through the vessels to other organs and systems and provoke chronic diseases. At the slightest opportunity, you should independently abandon this bad habit or seek help from a psychotherapist.

Basically, water in the lungs, with proper treatment, can have a favorable outcome.

Even after recovery, you should constantly monitor your well-being and respiratory system and constantly consult in the clinic.

Especially during seasonal temperature fluctuations.

Let's start with two examples. In the autumn of 1946, one of the best scuba divers of the twentieth century, Maurice Fargue from Groups of underwater surveys J.I.Cousteau” dived with scuba gear to a depth of 300 feet (91 m) and signaled: “Tout va bien” (everything is in order).

A few minutes later, he was pulled out by the signal end tied to his waist, unconscious and with the mouthpiece taken out of his mouth. Despite 12 hours of resuscitation attempts, he died without regaining consciousness. In October 2002, on the Dominican coast of La Romana, 28-year-old Frenchwoman Audre Mestre, wife of the famous Cuban diver Francisco Ferreras, attempted to set a new world record for deep diving while holding her breath.

She descended 561 feet (171 m), but she could not climb up on her own. After 9 min. and 44 sec. from the beginning of the test, her lifeless body was pulled out of the water by scuba divers who ensured safety. An autopsy performed at a hospital in Santo Domingo listed drowning as the main cause of death.

Of course, in both cases, the mechanism of violations that provoked misfortune and further led to the death of the heroes is completely different. (In the case of M. Farg, it was “deep intoxication”, and in O. Mestre, the so-called compression of the chest). However, the final phase was the same: after losing consciousness, both of them choked and drowned. If water hadn't gotten into their lungs, they might very well have survived. American statistics claim that 3 out of every 10 thousand scuba dives end in the death of a diver (Skydiving is an order of magnitude safer, driving a car leads to death 400 times less often), and the main immediate cause of death is drowning. That is why understanding what happens to the body during drowning, and the ability to help the victim, is very important for anyone who risks wearing diving equipment.

Unfortunately, most people's ideas about the most important problems associated with drowning are defined by myths that are in no way consistent with reality. Our task today is to dispel at least some of them.

Drowning is the death of a person deprived of the ability to breathe due to immersion in water. First of all, it's death from suffocation. Oxygen ceases to enter the body, and tissues, having used up internal reserves, cannot provide their own energy needs, since they have nothing to “burn” nutrients (there is no oxidizing agent). As a result, life processes stop, and intracellular structures disintegrate. The lethal outcome is not associated with the ingress of water into the windpipe or lungs, but with the cessation of oxygen supply to the tissues. Therefore, the main goal of medical care for a drowned person is to restore the flow of oxygen.

There are many tissues in the body, they tolerate oxygen deprivation in different ways. For example, nails and hair remain viable and continue to grow for several tens of hours after breathing has stopped. The brain cannot survive even 5-6 minutes: if breathing is not resumed, the cells of the central nervous system die irrevocably. It is clear that assistance must be provided in such a way as to restore the supply of oxygen before irreversible changes in the brain occur.

The first conclusion: the drowned man should be helped decisively, quickly, without wasting a single second.

What are the specific mechanisms of human death in water? In most cases this is the case. The victim of an accident, hidden for some reason by water, already losing consciousness, takes a desperate breath, and a portion of water enters the upper respiratory tract (mouth, pharynx, larynx, initial segment of the trachea). In response to the penetration of water, a spasm of the vocal cords occurs. The spasm is so strong that even if a drowning person suddenly finds himself on land at the same moment, he will still not be able to breathe, because his windpipe is blocked. The consciousness of the victim finally fades away, he "goes soft" and completely submits to the action of external forces. Heart contractions are still preserved, as well as weakening attempts to produce respiratory movements. Blood, deprived of oxygen and enriched with carbon dioxide, spreads throughout the body, giving the skin a bluish tint. [*footnote* Hence the name "blue drowning"] After a few minutes, as changes in brain cells and vocal cord muscles increase, the spasm of the glottis subsides, the windpipe opens, and water begins to enter the lungs.

Filling the lungs with water is a slow process. Remember, on land, a normal breath takes a few seconds, while water is a thousand times denser than air, its viscosity is several thousand times greater. Water through the respiratory tract can not run quickly. To visualize how long the whole process takes, remember how long it takes a liter jar to fill with tap water in the kitchen. About a minute. And this despite the fact that in water pipes the pressure reaches 6 atmospheres. Water rushes into the lungs under the influence of the residual negative pressure created by the inspiratory muscles. We are talking about a pressure of several centimeters of water column. It takes many minutes or even a couple of hours for the lungs to be completely filled with water.

Approximately one out of every five drowned people has a spasm of the glottis for too long. As a result, cardiac arrest and complete paralysis of the muscles occur first. The windpipe opens already when there is no action of the forces of the inspiratory muscles. In such cases, the lungs do not fill with water at all. This is commonly referred to as "dry drowning". In addition, situations are not uncommon when a person who finds himself in cold water, for a number of reasons, for example, when frightened, immediately stops his heart and breathing, and he does not even try to “breathe” the water. Such drowned people have a characteristic pale appearance, giving rise to the term "white drowning".

The second conclusion: in the lungs of a drowned man who has been under water for several minutes, there is almost no water.

How are the lungs arranged? Perhaps it would be correct to liken them to a sponge. An ordinary household sponge, which is customary to wash dishes. In the smallest pores-vesicles, called alveoli, the inhaled air gives oxygen to the blood and takes carbon dioxide. The walls of the vesicles-alveoli do not stick together, preserving the porous-air structure of the lung tissue, only because they are lined with a special surfactant - a surfactant. Just as soap dissolved in water ensures the existence of a stable foam, so the surfactant maintains the alveolar structure of the lungs. Water entering the lungs during drowning destroys the surfactant, and lung tissue loses its ability to be air-porous. In such cases, one speaks of "cooking" of the lungs, [*footnote* Medical jargon] that is, in appearance they begin to resemble not a sponge full of air, but beef liver soaked in blood. In addition, there are microscopic changes in the cells of the lung tissue associated with its edema and inflammation. Such tissue is not suitable for gas exchange.

The third conclusion: the longer a drowned person remains under water, the more water enters the lungs and the more their ability to provide normal breathing suffers.

Another remark important for understanding the features of assistance. The water temperature, even in the tropics, is rarely above 25-28°C. In the vast majority of cases, accidents associated with drowning occur against the background of a temperature not exceeding 10-12°C, a maximum of 14-16°C. In such water, a drowned person, even in a dry suit, cools down very quickly, since his body no longer produces its own heat, but only loses it. Remember, sometimes housewives to speed up the process of thawing meat throw a frozen piece into a pot of water at room temperature. The cooling of the victim occurs as quickly as the thawing of meat.

Fourth conclusion: after a few minutes of being in the water, the body temperature of the drowned person is reduced.

So, we have analyzed in the most general form what happens to a person when drowning: suffocation, gradual filling of the lungs with water and rapid hypothermia. Now we formulate the basic rules for rendering assistance. We will proceed from the fact that the reader owns universal first aid algorithms. (See the article on the site “The Basics of Medical Knowledge and Skills Needed by Everyone”).

The most important rule: in all cases of assistance without exception, the rescuer should not become the next victim.

We will not discuss this thesis, but simply take it for granted. Agree, the situation when there is an injured and a live-healthy rescuer at the scene is always preferable to the presence of two lifeless victims at the scene.

Rule one: remove the victim from the water as soon as possible.

Giving advice is easier than doing it. In the case when the one who is drowning still continues to actively fight for life, pulling him out of the water is as difficult as wrapping a burning person in a blanket. A drowning person is completely unaware of his actions, senselessly grasping at everything and everything. If you have not received special training and do not know how to release from seizures, do not try to swim close to a drowning person, it is better to call professional rescuers. If you consider it immoral to “observe from the outside”, try to acquire the necessary skills and abilities in advance. (we have such courses in our club, you can be taught some methods of retrieving a drowning person from the water by experienced instructors at the Baltika diving club). It is safest to help a drowning person from a boat.

If the victim has already stopped all active movements and lost consciousness, it is easier to deal with him. In any way convenient for you, it should be tow to the surface and remove from the water. The word "tow" is very important. In no case should the so-called independent ascent of the victim be allowed by filling his buoyancy compensator with air. On land, all the equipment and all the clothes that, in your opinion, are superfluous are quickly torn off or cut off with a knife from a drowned person.

Rule two: start artificial respiration and chest compressions as soon as possible.

The oral cavity is cleaned with a finger, removing silt and all possible foreign objects, including false teeth. Artificial respiration and indirect heart massage are carried out according to the usual method. Standard algorithm of actions corresponding to the situation "lack of consciousness". We discussed it in one of the first conversations. Foreign experts advise starting with artificial respiration: they fill the lungs of the victim with air, and then they listen carefully and look closely to see if natural breathing has been restored, if a pulse has appeared. If breathing and heartbeats are not restored, the full scope of artificial respiration and chest compressions is performed.

We note the following. Under any circumstances at the scene all taken from the water should be considered alive, regardless of their appearance and how viable they seem. That is, you have to try everyone provide the necessary assistance until the fact of death is established by a medical professional or an experienced rescuer. There are many cases when it was possible to bring back to life people who spent up to several tens of minutes in an unconscious state under water. Such “survivability” of victims of drowning is explained by their low temperature, which sharply reduces the need for oxygen in tissues and increases the oxygen-free critical time limit when the vital activity of the brain can still be restored.

Rule three: you do not need to pour water from the lungs of a drowned man.

All the manipulations to remove water from the lungs, colorfully illustrated by posters at rescue stations, are simply meaningless. (Official documents and emergency care standards of the Ministry of Health of the Russian Federation declare attempts to remove water from the lungs of a drowned person a defect) Either there is no water in the lungs, or it simply impossible to pour. For fun, try to “pour out” water from a wet household sponge hidden in a jug.

Water could be squeezed out of a sponge, squeezed out, but this is “completely different”. In order to "squeeze" the water out of the lungs, it would be necessary to squeeze the chest so that the sternum and spine come into contact - everyone understands that this is impossible. And there is also no point in squeezing water out of the lungs, the lung tissue, freed from water, is still unable to “breathe” normally. When providing first aid, it remains to hope for a chance: if there is little or no water in the lungs, the simplest measures will be effective, but if the lungs are filled with water to failure, then attempts at artificial respiration will not give anything even if it is completely drained.

Rule four: you should immediately heat the drowned man.

Simply removing wet clothing and wrapping yourself in a blanket is not enough. Can a stone wrapped in a woolen blanket warm itself? It cannot, because it does not emit internal heat, it must be warmed from the outside. The situation is similar with the drowned man. Due to an acute lack of oxygen, all the most important processes in the tissues are disrupted, and if you wait until they recover and lead to warming of the body, nothing good will come of it. It is necessary to actively warm the victim, for example with electric heating pads, hot air from a hair dryer, etc. Rubbing the skin in this case will not bring any benefit.

When the victim comes to his senses, in no case should you give him alcohol. Contrary to popular belief, alcohol has never truly warmed anyone. On the contrary, the vasodilation of the skin, caused by the action of ethyl alcohol that has entered the bloodstream, increases heat loss and aggravates hypothermia.

Rule five: all victims removed from the water must immediately be sent to the hospital.

The degree of impaired consciousness during drowning, as well as the condition of the victim and his well-being after rendering assistance, do not matter. If you considered someone drowning and pulled him out of the water - even if he is in excellent health and assures that he did not drown, but simply dabbled in the water - it is up to your conscience to accompany such a "spoiler" to the hospital. Seeing a doctor rarely hurts anyone. There are at least two grounds for concern for the immediate fate of the drowned man.

First . Water entering the lungs causes inflammation and increasing difficulty in breathing. An examination and special treatment is needed to combat changes in lung function. Otherwise, the formation of fatal complications is possible.

And second. In persons who have undergone hypothermia, attacks of heart rhythm disturbances are not uncommon - the so-called episodes of arrhythmia, sometimes ending in cardiac arrest, which requires immediate help.

The victims themselves, who suffered a lack of oxygen, are characterized by a decrease in the level of self-criticism, they inadequately perceive the severity of the experience. And the more actively they refuse the proposed examination by a doctor, the more it is shown to them.

Probably, this situation is familiar to everyone: he was in a hurry to eat quickly on the go, swallowed large pieces or talked while eating, and as a result, he choked. Asphyxia, which occurs when a foreign body (food, in this case) enters the respiratory tract, is very dangerous for human life. If emergency measures are not taken, oxygen will not enter the brain, the person subsequently loses consciousness. If breathing is not restored in time, the victim may die in a couple of minutes.

If a n a person is able to clear his throat. The best way to help him is to give a napkin or handkerchief to wipe his tears. In this situation, it is a natural defensive reaction n a small piece of food got into the respiratory tract, a function of the body that helps push an object out of the trachea, making it difficult to breathe. In this case, it is not necessary to interfere with a person with some other manipulations.
If you are choking, you need to straighten up and try to slowly inhale, and then exhale sharply, while bending at the waist. Thanks to this simple method, you will be able to cough better.
In no case should the victim be slapped on the back, as this can provoke the advancement of the foreign body even deeper and completely block breathing. But, if in a few minutes a person did not cough up what got into the trachea, or a large piece of food completely blocked it, stopping the respiratory process, you need to help the victim faster.

The fact that a person's life is in danger may be evidenced by the bluish-red color of his face, the inability to breathe. In this case, the victim may clutch at the throat or chest.
Call an ambulance. And before the arrival of doctors, take care of saving lives yourself. The Heimlich method will help here, which consists of the following activities:

Stand behind the back of the choking person, wrap your arms around him.
Clench one hand into a fist. Place your fist with the side where the thumb is located on the stomach in the area between the place where the ribs converge and the navel.
The palm of the other hand should be placed on top of the fist.
Sharply press your fist into your stomach, bending your arms at the elbows. In this case, you can not squeeze the chest.

Such movements must be repeated until breathing resumes, or until the person is conscious.
If the person who is choking has lost consciousness, you need to put him on a hard surface, face up. Cover your head with something cold. Then, with a strong push, press on the upper part of his abdomen, about 10 cm below the solar plexus. It is necessary to repeat until the resumption of the respiratory process.

When such a nuisance happened to a nursing baby, to resume breathing, put the baby on your arm so that his face is in your palm. Tilt the axis of his body forward, and the child's legs should be located on both sides of the adult's forearm. Then clap your palm between his shoulder blades until the baby coughs up the foreign body into your hand. If nothing comes out in this way, you can also use the Heimlich method, but carefully calculate your strength.

If you are choking and there is no one to help, you can also use this method. Place your fist on the area between your navel and where your ribs meet. Push in and up. Also, instead of a fist, the edge of the table, the railing or the back of the chair can protrude.

After normal breathing is restored, a person may also cough. Therefore, everything exactly needs to see a doctor to exclude the possibility that at least a small piece of food will remain in the airways.

Air enters the lungs through the trachea. When you exhale, the air from the lungs again enters the trachea. When swallowing, the epiglottis closes the entrance to the larynx, preventing food from entering the trachea. Thus, the epiglottis, upper larynx, vocal cords, and cough reflex are reliable defense mechanisms that prevent foreign bodies from entering the trachea. When a foreign object enters the trachea and the upper part of the larynx, pain occurs, spasm of the larynx, suffocation, the voice becomes hoarse or disappears altogether. If the protective mechanism does not work, then saliva, food or foreign bodies enter the respiratory tract. As a result, there is a strong cough and gag reflex. Thanks to these reflexes, a foreign object is removed from the trachea. If the foreign body cannot be removed, then breathing is disturbed, air does not enter the lungs. The person begins to choke, which causes him a strong fright. If a foreign object is not removed in a timely manner, then the person dies of suffocation.

Various foreign bodies can get into the trachea: small objects, pieces of food, powdered substances, etc.

small items

The risk group includes small children who pull any objects into their mouths. Children often choke on small pieces of food. Foreign objects can get not only into the trachea. They can also get stuck in the back of the mouth or in the throat. When a foreign object gets stuck, swelling of the mucous membrane of the respiratory tract occurs, which makes it difficult to remove the body.

Food fragments can get into the trachea when swallowing, for example, a piece that is too large. In an unconscious person, food can also enter the trachea. The fact is that when a person is unconscious, his body muscles relax and the contents of the stomach rise up.

Powdered substances

Powdered substances are very often inhaled by young children (for example, when playing with powder or flour). When inhaled, particles of a powdered substance penetrate deep into the trachea and, falling on the bronchi, stick them together.

Signs of a foreign object entering the trachea

The person providing first aid cannot see a foreign object in the airways. Its presence can be suspected by the characteristic symptoms:

Sudden cough.
Suffocation.
Strong fright.
Blueness of the skin (cyanosis).

First aid

The first aid provider must:

Keep calm, don't panic.
Reassure the victim.
Ask him to breathe calmly and control his breathing movements.

The best way to remove a foreign object from the trachea is a strong blow between the shoulder blades. The force of the blow should depend on the age of the victim. In addition, you can stand behind the victim, wrap your arms around him so that the hands folded into the lock are with the victim above the epigastric region, and sharply press on the epigastric region. As a result of these actions, air is pushed out of the lungs, and with it the foreign body. First aid for children and adults is different.

Foreign object in the trachea in children

Bend over the child while supporting him with one hand.
With the other hand, strike between the shoulder blades.

Previously, to remove a foreign body from the respiratory tract, the child was taken by the legs and, holding in this position, was tapped between the shoulder blades. However, due to possible injuries, this method is not currently used.

Help for babies

Lay your baby on your arm, belly down.
You must support his head with your hand. Make sure that your fingers do not cover his mouth.
Hit the child hard on the back (between the shoulder blades).

Help for an adult

Get on one knee.
Bend the victim over your knee.
Strike hard between the shoulder blades.

If after applying 2-3 blows to the back (between the shoulder blades) the foreign object is not removed, then urgently call an ambulance.

What to do if you choke, how to properly help the victim, and how to help yourself on your own?

Foreign body in the airways: how to recognize

How to recognize if a person has a foreign body stuck in the airways? Here are a few main signs:

. The victim has a cough, lacrimation and redness of the face.
Complicated breathing. Sometimes there is almost no breathing, cyanosis may appear around the lips.
. This is the final stage in which the victim stops breathing. After some time, cardiac arrest is possible, followed by clinical death. If the person loses consciousness, cardiopulmonary resuscitation should be performed immediately.

First aid for a foreign body in the respiratory tract

The first thing to understand is to determine whether a person is breathing or not. If the victim is breathing at least somehow, then he should be told to cough harder. Often these words (and the corresponding actions of the victim) are enough for a small foreign body to come out of the respiratory tract on its own. If within 30 seconds a person could not breathe, then it should be applied. What does it consist of?

You should stand behind the victim.
Grab the victim's torso with both hands. Cover the fist of your right hand with the palm of your left hand. Now with the knuckle of the thumb of the right hand, make five strong pressures on the upper abdomen. The direction should be up and towards you. If the foreign body is removed, then the victim will recover breathing.

The Heimlich method is carried out until the foreign body leaves the respiratory tract. If during these events the victim lost consciousness, then the Heimlich method should be stopped, and instead, cardiopulmonary resuscitation should be started.

To understand what happens when you choke, you must first understand how the back of your throat works. Everything you eat and the air you breathe passes through your throat to enter your body.

Food and liquid passes through the larynx into the esophagus, then into the stomach. The air goes down into another branch - the trachea or windpipe, and from there it enters the lungs. Both of these paths start at the back of the throat.

And if both holes are open, how does food get into one and air into the other? Fortunately for us, our body keeps everything under control. Next to the windpipe is the epiglottis, which comes into action every time you swallow. It closes the "little door" that prevents food from entering the respiratory tract, and directs it through the esophagus to the stomach.

But if you laugh or talk while eating, the epiglottis does not have time to close in time. Food particles can slide down and enter the windpipe. If the particles are small, your body will easily force them out of the wrong place, forcing you.

Heimlich method in children

If a foreign body is lodged in the airway of a child under 1 year of age, the rescuer should sit down, lay the child face down on the left forearm. The lower jaw of the baby should be held with fingers folded into a claw. Then, with the base of the palm, five blows of medium strength should be applied with the base of the palm to the area between the shoulder blades.

At the second stage of helping a child with foreign bodies - turn the child face up on the right forearm. Then you should apply five jerky movements along the sternum to a point that is located 1 finger below the inter-nipple line. Be careful not to push too hard to avoid damaging the baby's ribs.

When Food Gets Down the Wrong Throat

Everyone has had to deal with this problem. You take a sip and realize that the food went down the wrong throat. Then a cough begins, sometimes panic, but, as a rule, everything stops within a few seconds. This is because coughing is the body's natural defense against foreign bodies entering the trachea. Thanks to coughing, our body manages to get rid of “lost” pieces of food or other foreign particles that have accidentally entered the trachea.

But when the amount of food or its size is significant, suffocation can occur because the food or other object completely blocks the airways and air cannot pass through them into the lungs. In this case, a person can no longer get rid of a foreign body with a cough, stops breathing, talking, or even making some sounds. Usually, once in such a situation, the victim grabs his throat and / or begins to wave his arms. If the windpipe remains blocked for a long time, the person's face changes color from bright red to blue.

Our body needs oxygen to maintain life processes. When oxygen does not enter the lungs and brain for some time, a person may lose consciousness, and due to a prolonged lack of oxygen, irreversible changes occur in the brain, as a result of which a person may die.

What to do if someone is choking?

Respiratory arrest is a life-threatening condition. If you are trained in the Heimlich method, help immediately. If there is someone present who has the skill, give him the opportunity to help the victim. If the reception is performed incorrectly, you can harm the person and cause him pain. If the victim has stopped breathing and lost consciousness, the Heimlich maneuver should be performed simultaneously with (CPR).

Simple Precautions

Be especially careful when eating certain foods that are easy to choke on. These are: nuts, grapes, raw carrots, popcorn, and hard or gummy candies.
Try to eat while sitting, bite off food in small pieces, chew slowly. Don't try to speak with your mouth full. Remember, it's not even about good manners, it's about preventing choking.
Watch out for small children. Babies love to put things in their mouths and taste things. Try to protect the child and make sure that small objects are out of reach for your baby.
Learn the Heimlich maneuver. You can learn about it in first aid classes. For any person it will not be superfluous to own this skill. Who knows? Perhaps it is you who will have to become a savior when one of your relatives or friends chokes!

The topic of this article does not belong to the category of seasonal. But it is very relevant for anyone who has small children. However, in adults, such troubles also happen. I mean the ingress of a foreign body into the respiratory tract.

Let's talk briefly about adults first. How can a foreign body get into the airways of an adult? After all, he does not drag everything into his mouth, like children. Of course it doesn't drag. But some adults have a habit of holding some small objects in their teeth while working. Remember, didn’t you have a case that you held pins or small cloves, screws in your mouth. By the way, I often do this myself. Foreign bodies such as dentures can enter an adult's respiratory tract during sleep or when the person is unconscious. And of course, do not forget that you can simply choke on food.

According to statistics, in 95-98% of cases, foreign bodies of the respiratory tract occur in children aged 1.5 to 3 years.

Children are little explorers. Everything is included in their field of study. And they want not only to see, hear and touch the surroundings, but to taste everything that their hands can reach. And these pens do not always reach only for toys. Often these are completely inappropriate items, for example, beads, buttons, beans or peas, nuts, and so on. Children try to apply small objects to everything and most often push them into the most inappropriate places. And such unsuitable places include the ears, nose and mouth. Some small object that the child has put in his mouth “jumps” into the larynx during a deep breath. The reason for such a breath can be fright, crying, screaming.

In addition, a child of this age is just learning to properly chew and swallow solid food. And, of course, he does not succeed immediately. Therefore, it is at this age that the danger of getting pieces of solid food into the respiratory tract is maximum.

It is also bad that the child cannot always tell what exactly happened to him. And sometimes foreign bodies in the airways are detected too late.

Now for some anatomy.

The structure of the respiratory tract in humans is as follows: when inhaling, air enters the nasal passages, then into the nasopharynx and oropharynx (here the respiratory system crosses with the digestive system). Then - the larynx. In the larynx, air passes through the vocal cords and then into the trachea. Here is the first feature: in the subglottic space in a child under 3-5 years old, lymphoid tissue is strongly expressed, which has a tendency to rapid swelling. This is what leads to the development of false croup in viral infections. And when foreign bodies get into this area, edema of the subglottic space also develops very quickly, narrowing the airways. At the level of 4-5 thoracic vertebrae, the trachea is divided into two main bronchi - the right and left, through which air goes to the right and left lungs, respectively. Here is the second feature: the right main bronchus is, as it were, a continuation of the trachea, departing to the side at an angle of only 25-30 degrees, while the left departs at an angle of 45-60 degrees. That is why most often foreign bodies of the respiratory tract fall into the generations of the right main bronchus. The right main bronchus is divided into three bronchi: upper, middle and lower lobe bronchus. The left main bronchus is divided into two bronchi: upper and lower lobe. Most often, foreign bodies are in the right lower lobe bronchus.

According to the mechanism of obstruction (opposition to normal operation) of the airways, foreign bodies differ in:

* non-obturating lumen. Air passes freely past the foreign body during inhalation and exhalation. * completely obturating lumen. Air does not pass at all. * obturating the lumen as a "valve". On inhalation, air passes by the foreign body into the lung, and on exhalation, the foreign body blocks the lumen, thereby preventing the exit of air from the lung.

Also, foreign bodies differ in the method of fixation.

A fixed foreign body sits firmly in the lumen of the bronchus and practically does not move during breathing.

A balloting foreign body is not fixed in the lumen and, when breathing, can move from one section of the respiratory system to another. Its movement can be heard with a phonendoscope in the form of "clapping" when breathing. Sometimes it can be heard even from a distance. In addition, a running foreign body is also dangerous because when it hits the vocal cords from below, a persistent laryngospasm occurs, which in itself leads to an almost complete closure of the laryngeal lumen.

Foreign bodies can enter any part of the respiratory tract. But in terms of localization, the most dangerous place is the larynx and trachea. Foreign bodies in this area can completely block the access of air. If you do not provide immediate assistance, then death occurs in 1-2 minutes.

For young children, the most dangerous situation is when a foreign body gets stuck between the folds of the glottis. In this case, the child cannot make a single sound. This is explained by the fact that a spasm of the glottis occurs, which can lead to respiratory arrest and suffocation. The child develops cyanosis (blue) of the mucous membranes and skin of the face.

The fact that an adult or a child is choking becomes clear by a sudden cough. At the same time, the person’s face turns red, tears appear in the eyes. And those around him readily knock on the back with a fist. More often, of course, the crumb that got "in the wrong throat" is removed with a cough. But if it's not a crumb, but, let's say, a piece of sausage, an apple, or a bone from a fruit? Then with each blow of the fist on the back, this piece will move further and further into the respiratory tract. Normal breathing in this case will be replaced by stridor, that is, breathing with a characteristic wheeze on inspiration and with the participation of the muscles of the face, neck and chest. But not only does the piece block the access of air. It also irritates the mucous membrane of the larynx or trachea, and this, in turn, leads to their swelling and abundant secretion and accumulation of mucus. If a foreign body also has sharp edges, such as a stone from a plum, then it injures the mucous membrane and blood is added to the mucus. The condition of the victim is getting worse right before our eyes. The face, red at first, turns blue, the veins swell on the neck, a sip is heard on inhalation and the subclavian and supraclavicular fossae are seen to sink. Coughing movements become less and less frequent, and the movements are more and more sluggish. And very quickly a person loses consciousness. This condition is called blue asphyxia.

If the victim is not quickly assisted, then blue asphyxia in a few minutes will pass into the stage of pale asphyxia. The skin will become pale with a grayish tint, the reaction of the pupils to light and the pulse on the carotid artery will disappear. In other words, clinical death will occur.

How to provide first aid in such a situation?

First, you can not waste time examining the oral cavity. Secondly, do not try to get a foreign body with your fingers or tweezers. If this is a piece of food, sausage or an apple, for example, then under the influence of saliva it will soften so much that when you try to get it, it will simply fall apart into smaller pieces. And one or more of these small pieces, when inhaled, will again fall into the respiratory tract.

But, no matter what the victim chokes on, the first thing to do is turn him over on his stomach and throw him over the back of a chair, chair, if he is an adult, or over his own thigh, if he is a child. Then you need to hit him several times with an open palm on the back between the shoulder blades. It is impossible to strike with a fist or with the edge of the palm.

If a small child chokes on a ball or pea, you need to quickly turn him upside down and tap on his back several times at the level of the shoulder blades with an open palm. In this case, the "Pinocchio effect" will work. It will look the same as in the fairy tale about Pinocchio, when money was shaken out of him. If, after several blows with the palm of the hand, the foreign body does not fall to the floor, then another method should be used.

But if a child chokes on a coin-shaped object, for example, a button, then another method should be used, since the one described above will not justify itself in this case, since the “piggy bank effect” is triggered. If you had a piggy bank as a child, remember how you tried to shake coins out of it. There is enough noise and ringing, but the coins don’t want to fall out of the piggy bank, because they can’t stand on their own edge and roll flat on themselves. In the same way, a flat and coin-shaped foreign body blocks the airways. We must force him to change position. To do this, use the method of concussion of the chest. As a result of the concussion, the foreign body will either turn around its axis and open the passage for air, or move down the trachea and end up in one of the bronchi. This will give the victim the opportunity to breathe at least one lung.

There are several ways to concussion chest. The most common and effective of them is short, frequent blows with an open palm on the back in the interscapular region.

There is another way, which in Russia is called the "method of the American police." I must say right away that I do not know why it is called that. In America, this technique is called the Heimlich method. This method has two versions.

First option

It is necessary to stand behind the choking person, take him by the shoulders and move him away from himself on outstretched arms. Then, sharply with force, hit him with his back against his own chest. Such a blow can be repeated several times. This option has one drawback. The chest, on which the victim must be hit, should be flat, masculine.

Second option

When using this option, you must also stand behind the victim. But in this case, it is necessary to clasp it with your hands so that the hands folded into the lock are below the xiphoid process of the victim. Then, with a sharp movement, it is necessary to strongly press on the diaphragm and at the same time hit the victim on his chest.

Both of these methods can be used if the victim is conscious. But at the same time, one must be prepared for the fact that the victim will develop a state of clinical death. Therefore, immediately after the impact, you can not unclench your hands, so that in the event of a cardiac arrest, do not let the victim fall.

The same method in relation to young children should be performed as follows:

1. Put the baby on a hard surface on his back, tilt his head back, raise his chin; 2. Place two fingers of one hand on the child's upper abdomen, between the xiphoid process and the navel, and quickly push inward and upward. The movement must be strong enough to remove the foreign object; 3. If the first time is not enough, then take up to four times.

Help for older children

If blows to the back do not help, then put the child on your lap, placing one of your hands on his stomach. Squeeze this hand into a fist, resting with the inner side where the thumb is located in the middle of his abdomen, and with the other hand hold the child behind his back. Quickly press your fist on your stomach a little up and as deep as possible. The movement must be strong to push out the stuck object. Repeat pressing up to four times.

If the choking person has fallen into a coma, you must immediately turn him over on his right side and hit his back several times with his palm. But, unfortunately, as a rule, these actions do not bring success.

See you next time!

They were removed from the lungs under local anesthesia with the help of special tools. During the nut picking season, Kyiv specialists perform this procedure weekly on two or three babies who accidentally inhaled the nucleoli

Relatives brought a basket of young nuts from the dacha, - says the mother of two-year-old Andryusha Svetlana. - I cleaned the nucleoli from the film. Andryusha from time to time ran up to me and asked: “Mom, give me!” Once again, putting a nut in his mouth, the son choked. I tapped him on the back, he cleared his throat and resumed his game. Who would have thought that at that moment the pieces got into his bronchial tubes?

The next day Andryusha went to kindergarten. Educators noticed that from time to time the baby coughs. But he had no other symptoms of a cold. And suddenly

As usual, I came for my son, and I was met by a worried teacher: “Andryusha suddenly had a fever, he has a severe cough and wheezing in his chest,” Svetlana continues. The doctors diagnosed him with left-sided pneumonia. But the x-ray did not confirm this diagnosis, although breathing in the left lung was practically not audible. For almost a month Andryusha was treated for pneumonia, but there was no improvement. Then we were sent for a special examination - bronchoscopy.

Before this procedure, the doctors asked Svetlana in detail about how her child fell ill. Among the usual questions about the temperature and nature of the cough was an unusual one: “Maybe Andryusha choked shortly before the illness?”

That's when I remembered the day when we ate nuts, - says Svetlana.

In the autumn, during the season of collecting nuts, small children come to our department two or three times a week, whose airways accidentally got nucleoli, - says Yevgeny Simonets, surgeon at the pediatric thoracic surgery department of Kyiv Clinical Hospital N 17. - On the x-ray, the pieces of the nut in the bronchi are not visible. That's why we ask parents if their child has choked or coughed while eating. Having clogged the lumen of the bronchus, pieces of walnut do not allow the lung to breathe in full, sputum collects there, which causes bronchitis or pneumonia. Only examination with a bronchoscope equipped with a miniature video camera helps to detect a foreign object in the bronchi. By the way, in addition to nuts, children inhale popcorn, pieces of straw, chewing gum, small parts of toys, coins. Our department even has a collection of retrieved items.

From fruits to small children it is better to make mashed potatoes

The doctors gave me pieces of the nut that were in my son's lungs - Oksana shows tiny fragments of the nucleolus. “I decided to keep them as a reminder of what happened. Now I don't let my son chew while playing. He knows what to eat while sitting quietly at the table.

We talked with Oksana on the eve of Andryusha's discharge from the hospital. When the nuts were removed from the child's lungs, the inflammatory process quickly stopped.

After bronchoscopy, the doctors prescribed a weekly course of treatment, Oksana continues. - Now I decided not to allow my son to eat his favorite nuts, chips, seeds, dryers. He, like other children, loves to chew them for a walk. In the hospital, I was also convinced that children should not buy chewing gum. They also often get into the bronchi. During our stay at the clinic, I saw kids who inhaled popcorn. There was even a case when black peppercorns were taken out of the lungs of a child!

It's hard to imagine that food can be so dangerous. But children under four years of age do not chew food well, and they have not yet developed a swallowing reflex.

Toddlers often swallow while inhaling, so pieces of food enter the respiratory tract with air, explains Evgeny Simonets. - And this happens mainly during the game or when the child is distracted. So if he often chokes while eating, you need to grind large pieces of food. Over time, the child will learn to eat properly. By the way, more than once it happened that the kids inhaled pieces of badly chewed apples. Fruit can be mashed so that unexpected situations do not arise.

Before this trouble, Andryusha had already eaten unblended food, says Oksana. - But now I try to chop the potatoes in the soup as much as possible, cut the meat into small pieces, grind the rough fruits. So it’s easier for my son to eat, and I’m calmer.

If the child coughs while eating and his skin begins to turn blue, something may have entered the lungs.

Sometimes during the game, children take small parts into their mouths - so as not to lose them, - says Yevgeny Simonets. - But, having played too much, they forget about them and swallow them. Foreign objects do not necessarily enter the lungs. They also get stuck in the esophagus, which has natural constrictions. In our practice, there was a case when a screw got into the airways of a child. It was impossible to extract it with a bronchoscope - it wedged into the wall of the bronchus. I had to do a major operation - a thoracotomy.

Do fish bones have to be removed from the esophagus? - I ask Evgeny Nikolaevich.

Yes, we have such patients too. Fish bones are very dangerous. Once in the esophagus or respiratory tract, they, as a rule, pierce the walls of the organ with a point. And when breathing or swallowing, they gradually move out, injuring the tissues even more. There is a girl in our department who has been wandering around hospitals since June. The fish bone stuck in the airways, inflammation began. They treated both bronchitis and pneumonia. When the patient was referred to us, the fish bone had already resolved, but the mucus accumulated in the lungs could only be removed with a bronchoscope.

How dangerous is chewing gum in the lungs?

If chewing gum closes the gaps in the bronchi, the child may suffocate. Getting into the bronchi themselves, the gum becomes viscous, loose. It has to be taken out in several stages, piece by piece.

What symptoms indicate that a foreign object has entered the lungs of a child?

The baby is salivating profusely, it is difficult for him to swallow, he may refuse to eat, which means that there is, for example, a fish bone in the esophagus. If the child suddenly coughed or choked and his skin began to turn blue, perhaps something got into the lungs. In any case, you need to contact the experts. Then the treatment will take no more than a day.

It happens that a woman who is in a clinic with a baby does not tell her husband what caused the disease. Afraid of reproach: “I didn’t keep track of the child!”

Some men do not understand that this can happen to an adult, - says Evgeny Simonets. - The main thing is to know where to turn to get qualified help. And then there will be no complications, no health consequences.