When and how to do artificial respiration and chest compressions correctly. How to do artificial respiration and cardiac massage? How exactly to do artificial respiration

Early signs circulatory arrests that appear first are: disappearance of pulse on carotid artery, lack of consciousness, convulsions. Late signs circulatory arrests that appear first are: dilation of the pupils in the absence of their reaction to light, disappearance of breathing or convulsive breathing (2-6 inhalations and exhalations per minute), the appearance of an earthy-gray color of the skin (primarily the nasolabial triangle).

This condition is reversible, with it it is possible full recovery all functions of the body, if the brain cells do not occur irreversible changes. The patient's body remains viable for 4-6 minutes. Timely resuscitation measures can remove the patient from this condition or prevent it.

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

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

A correctly and timely blow can bring a person back to life in a matter of seconds: his heartbeat is restored, his consciousness returns. However, if this does not happen, then begin chest compressions and artificial respiration, which are carried out until signs of revival of the victim appear: a good pulsation is felt on the carotid artery, the pupils gradually narrow, the skin upper lip turns pink.

Indirect cardiac massage and its implementation

Indirect cardiac massage is performed in the following sequence (Fig. 1):

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

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

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

Rice. 1. Artificial respiration and indirect massage hearts: a - inhalation; b - exhale

4. After short pressure on the sternum, you need to quickly release it so that the artificial compression of the heart is replaced by its relaxation. While the heart is relaxing, you should not touch the victim’s chest with your hands.

5. The optimal rate of chest compressions for an adult is pressure per minute. Children under 8 years old are massaged with one hand, and infants - with two fingers (index and middle) with a frequency of additional pressure per minute.

In table 1. The requirements for performing indirect cardiac massage are given depending on the age of the victim.

Table 1. Indirect cardiac massage

Depth per click

1 finger below the nipple line

2 fingers from the sternum

2 fingers from the sternum

1/5 - 2 rescuers 2/15 - 1 rescuer

A possible complication in the form of a rib fracture during chest compressions, which is determined by a characteristic crunch during compression of the sternum, should not stop the massage process.

Artificial respiration and its implementation

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

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

2. The rescuer stands on the side of the victim, puts one hand on his forehead, and the other under the back of the head and turns the victim’s head (at the same time, the mouth, as a rule, opens).

3. The rescuer does deep breath, slightly holds the exhalation and, bending over the victim, completely seals the area of ​​his mouth with his lips. In this case, the victim’s nostrils must be pinched with a large and index fingers hands lying on the forehead, or cover with your cheek (air leakage through the nose or corners of the victim’s mouth negates all the efforts of the rescuer).

4. After sealing, the rescuer exhales quickly, blowing air into Airways and the victim's lungs. In this case, the victim’s inhalation should last about a second and reach 1 - 1.5 liters in volume in order to cause sufficient stimulation of the respiratory center.

5. After the end of exhalation, the rescuer unbends and releases the victim’s mouth. To do this, turn the victim’s head to the side without straightening it and raise the opposite shoulder so that the mouth is lower than the chest. The victim’s exhalation should last about two seconds, or at least twice as long as the inhalation.

6. In the pause before the next breath, the rescuer needs to take 1-2 small regular inhalations and exhalations for himself. After this, the cycle repeats from the beginning. The frequency of such cycles is in min.

When hit large quantity air in the stomach causes it to swell, making it difficult to revive. Therefore, it is advisable to periodically empty the stomach of air by pressing on the victim’s epigastric region.

Artificial respiration “mouth to nose” is almost no different from what has been described. To seal with your fingers, you need to press lower lip the victim to the top.

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

If two people provide assistance, then one of them does indirect cardiac massage, and the other does artificial respiration. At the same time, their actions must be coordinated. Do not press on the chest while inhaling air. These measures are carried out alternately: 4-5 compressions on the chest (as you exhale), then one blow of air into the lungs (inhalation). If assistance is provided by one person, which is extremely tiring, then the sequence of manipulations changes slightly - after every two quick injections of air into the lungs, 15 pressures are applied to the chest. In any case, it is necessary that artificial respiration and chest compressions are carried out continuously for the required time.

Carrying out artificial respiration and chest compressions

How to do it correctly: indirect cardiac massage and mechanical ventilation

When restoring breathing and cardiac activity of a victim who is in unconscious, be sure to lay him on his 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.

Rules and techniques for performing artificial respiration and chest compressions

If resuscitation is carried out by two people, then one of them performs cardiac massage, the other performs artificial respiration in the mode of one insufflation every five presses on the chest wall.

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

1. The person is laid on a hard surface, top part the torso is freed from clothing.

2. To carry out closed massage heart resuscitator kneels on the side of the victim.

3. The palm, with its base extended as far as possible, is placed in the middle of the chest, two to three centimeters above the sternal end (where the ribs meet).

4. Where is pressure applied to the chest during closed cardiac massage? The point of maximum pressure should be in the center, not on the left, because the heart, contrary to popular belief, is located in the middle.

5. Thumb hands should be facing the person's chin or stomach. The second palm is placed crosswise on top. The fingers should not touch the patient; the palm should be placed with the base and be extended as much as possible.

6. Pressure on the heart area is done with straight arms, the elbows do not bend. Pressure should be applied with your entire weight, not just your hands. The shocks should be so strong that the chest of an adult falls by 5 centimeters.

7. With what frequency of pressure is indirect cardiac massage performed? Press on the sternum at least 60 times per minute. You need to focus on the elasticity of the sternum specific person, exactly how it returns to the opposite position. For example, in an elderly person the frequency of clicks may be no more than 40–50, and in children it can reach 120 or higher.

8. How many breaths and presses should you take during artificial respiration?

Every 15 pressures, the person providing assistance blows air into the victim’s lungs twice in a row and again performs a cardiac massage.

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

How to do artificial respiration and chest compressions

Poisoning with certain substances can cause respiratory and cardiac arrest. In such a situation, the victim needs help immediately. But there may be no doctors nearby, and an ambulance may not arrive in 5 minutes. Every person should know and be able to put into practice at least the basic resuscitation measures. These include artificial respiration and external cardiac massage. Most people probably know what it is, but do not always know how to correctly perform these actions in practice.

Let's find out in this article what kind of poisoning can cause clinical death, what kind of human resuscitation techniques exist, and how to properly perform artificial respiration and chest compressions.

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

Death as a result 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:

• drugs from the group of cardiac glycosides;
• “Obzidan”, “Isoptin”;
• barium and potassium salts;
• some antidepressants;
• organophosphorus compounds;
• quinine;
• hellebore water;
• adrenergic blockers;
• calcium antagonists;
• fluorine.

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

• drugs, sleeping pills, inert gases (nitrogen, helium);
• intoxication with substances based on organophosphorus compounds used to control insects;
• curare-like drugs;
• strychnine, carbon monoxide, ethylene glycol;
• benzene;
• hydrogen sulfide;
• nitrites;
• potassium cyanide, hydrocyanic acid;
• "Diphenhydramine";
• alcohol.

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. Release 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.

1. The person is laid on a hard surface, the upper body is freed from clothing.
2. To perform closed cardiac massage, the resuscitator kneels on the side of the victim.
3. The palm, with its base extended as far as possible, is placed in the middle of the chest, two to three centimeters above the sternal end (where the ribs meet).
4. Where is pressure applied to the chest during closed cardiac massage? The point of maximum pressure should be in the center, not on the left, because the heart, contrary to popular belief, is located in the middle.
5. The thumb should be facing the person's chin or stomach. The second palm is placed crosswise on top. The fingers should not touch the patient; the palm should be placed with the base and be extended as much as possible.
6. Pressure on the heart area is done with straight arms, the elbows do not bend. Pressure should be applied with your entire weight, not just your hands. The shocks should be so strong that the chest of an adult falls by 5 centimeters.
7. With what frequency of pressure is indirect cardiac massage performed? Press on the sternum at least 60 times per minute. You need to focus on the elasticity of the sternum of a particular person, precisely on how it returns to its opposite position. For example, in an elderly person the frequency of clicks may be no more than 40–50, and in children it can reach 120 or higher.
8. How many breaths and presses should you take during artificial respiration? When alternating chest compressions with artificial ventilation, 2 breaths are taken for 30 pushes.

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.

Age up to 1 year

2 fingers from the sternum

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?

1. The victim must be given horizontal position with his head thrown back. You can put a cushion or your hand under your neck. If there is a suspicion of a fracture cervical region spine, then you can’t throw your head back.
2. The lower jaw needs to be pushed forward and downward. Free your mouth from saliva and vomit.
3. Holding the injured person’s open jaw with one hand, with the other you need to tightly pinch his nose, inhale deeply and exhale as much as possible into his mouth.
4. The frequency of air injections per minute during artificial respiration is 10–12.

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 kids small face, an adult can perform artificial respiration by immediately covering both the mouth and nose of the child. 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.

At correct execution artificial respiration, you can notice the movement of the chest up and down during passive inspiration.

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 more likely bringing a person back to life. Their correct implementation will help not only bring you back to life, but also provide vital oxygen. important organs, prevent their death and disability of the victim.

Before performing artificial respiration, it is necessary to restore patency of the airways (clear oral cavity from foreign substances), insert a tongue depressor or use a pin, place a cushion under the neck. Otherwise, all your efforts are in vain and instead of providing help, you can not only harm, but also kill the victim.

Indirect cardiac massage and artificial respiration - rules and techniques for its implementation

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.

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.

Physiological basis of blood circulation

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 big circle blood circulation occurs reverse process. But besides this, they come from the blood into the tissues. nutrients. And the tissues “give back” the products of their metabolism, which are excreted by the kidneys, skin and lungs.

Main signs of cardiac arrest

Cardiac arrest is the sudden and complete cessation of cardiac activity, which certain cases may occur simultaneously with bioelectric activity 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 current circumstances, and at the same time call an ambulance.

Consequences of circulatory arrest

In case of circulatory arrest, tissue exchange and gas exchange stops. Metabolic products accumulate in the cells, and in the blood - carbon dioxide. 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.

Restoration of blood circulation

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 promotes recovery independent work organ. 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:

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 once 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 the level of mercury. 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. Pressure is applied to the sternum per minute in the form of quick pushes.

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, the massage is performed with one hand, and for newborns and children up to one year old - with the fingertips.

The effectiveness of cardiac massage is assessed by the appearance of pulsation in the carotid, femoral and radial arteries, increased blood pressure domm rt. Art., constriction of the pupils, the appearance of their reaction to light, restoration of breathing.

When and why is cardiac massage performed?

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. Most reliable way to determine this - bring 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 colour faces.

The essence and algorithm of performing indirect cardiac massage

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 most simple 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 it is lost muscle tone, 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 cardiac cavities extending from the heart muscle blood vessels. 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 by 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 children adolescence 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, in jerks, using weight own body 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 pushes 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. The inhalation rate is once every 1 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 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

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 ambulance, if it is 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 lower jaw near the chin. Gently push your forehead back and pull your jaw upward. Keep your mouth slightly open so that your teeth are almost touching. Don't put your fingers on soft fabrics under the 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.

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. Do 15 presses based on 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, make 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. Frequency of massage pressure 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 due to the syndrome sudden death. 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.

Artificial respiration

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:

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 bottom and upper jaw so that 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 events 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 precisely 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 functions, you must immediately apply artificial ventilation lungs and indirect cardiac massage.

How to determine if resuscitation is being performed correctly

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.

What is unacceptable during external cardiac massage

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 quickly and thoroughly preparatory procedures, in particular, freeing the oral cavity from foreign objects, tilting the head to the position necessary for artificial respiration, freeing the chest from clothing, 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 indirect cardiac massage 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.

In the life of every person, a situation may arise when it is necessary to provide first aid to the victim or even perform artificial respiration. Of course, in such a situation, navigating and doing everything right is not only very important, but also very difficult. Despite the fact that everyone is taught the basics of first aid at school, not every person will be able to even approximately remember what and how to do a few years after leaving school.

Most of us by the phrase “artificial respiration” mean resuscitation measures such as mouth-to-mouth breathing and chest compressions or cardiopulmonary resuscitation, so let’s look at them. Sometimes these simple actions help save a person’s life, so you need to know how and what to do.

In what situations is it necessary to perform indirect cardiac massage?

Indirect heart massage is performed to restore its function and normalize blood circulation. Therefore, the indication for its implementation is cardiac arrest. If we see a victim, the first thing we need to do is make sure of our own safety., because the injured person may be under the influence of poisonous gas, which will also threaten the rescuer. After this, it is necessary to check the victim’s heart function. If the heart has stopped, then you need to try to resume its work using mechanical action.

How can you determine whether the heart has stopped? There are several signs that can tell us about this:

• cessation of breathing
• pallor skin,
• lack of pulse,
• absence of heartbeat,
• no blood pressure.

These are direct indications for cardiopulmonary resuscitation. If no more than 5-6 minutes have passed since the cessation of cardiac activity, then properly performed resuscitation can lead to the restoration of the functions of the human body. If you start resuscitation after 10 minutes, it may be impossible to completely restore the functioning of the cerebral cortex. After a 15-minute cardiac arrest, it is sometimes possible to resume the body’s activity, but not thinking, since the cerebral cortex suffers too much. And after 20 minutes without a heartbeat, it is usually not possible to resume even autonomic functions.

But these numbers greatly depend on the temperature around the victim’s body. In the cold, brain vitality lasts longer. In the heat, sometimes a person cannot be saved even after 1-2 minutes.

How to Perform Cardiopulmonary Resuscitation

As we have already said, any resuscitation measures must begin with ensuring your own safety and checking the presence of consciousness and heartbeat in the victim. It is very simple to check for breathing; to do this, you need to place your palm on the victim’s forehead, and with two fingers of the other hand, lift his chin and push the lower jaw forward and up. After this, you need to lean towards the victim and try to hear breathing or feel the movement of air on your skin. At the same time, it is advisable to call an ambulance or ask someone about it.

After this, we check the pulse. On the arm, the way they test it in the clinic, we most likely won’t hear anything, so we immediately proceed to check on the carotid artery. To do this, place the pads of 4 fingers on the surface of the neck on the side of the Adam's apple. Here you can usually feel the pulse beating; if there is none, we proceed to chest compressions.

To implement indirect cardiac massage, we place the base of the palm in the middle of the person’s chest and take the hands into the lock, while keeping the elbows straight. Then we perform 30 presses and two mouth-to-mouth breaths. In this case, the victim should lie on a flat, hard surface, and the frequency of pressing should be approximately 100 times per minute. The depth of pressure is usually 5-6 cm. Such pressure allows you to compress the chambers of the heart and push blood through the vessels.

After performing compression, it is necessary to check the airway and breathe air into the victim’s mouth, while closing the nostrils.

How to properly perform artificial respiration?

Direct artificial respiration is exhaling air from your lungs into the lungs of another person. Usually it is done simultaneously with chest compressions and this is called cardiopulmonary resuscitation. It is very important to carry out artificial respiration correctly so that air enters the respiratory tract of the injured person, otherwise all efforts may be in vain.

To inhale, you need to place one of your palms on the victim’s forehead, and with the other hand you need to lift his chin, move his jaw forward and up and check the patency of the victim’s airway. To do this, you need to pinch the victim's nose and breathe air into the mouth for a second. If everything is normal, then his chest will rise, as if inhaling. After this, you need to let the air come out and inhale again.

If you are driving a car, then it most likely has a special device for artificial respiration in the car first aid kit. It will greatly facilitate resuscitation, but still, it is a difficult matter. To maintain strength during chest compressions, you must try to keep them straight and not bend your elbows.

If you see that during resuscitation the victim's arterial bleeding, then be sure to try to stop him. It is advisable to call someone for help, since doing everything on your own is quite difficult.

How long is it necessary to carry out resuscitation measures (Video)

While everything is more or less clear about how to carry out resuscitation, not everyone knows the answer to the question of how long it should take. If resuscitation does not seem to be successful, when can it be stopped? The correct answer is never. It is necessary to carry out resuscitation measures until the ambulance arrives or until the doctors say that they are taking responsibility or, in best case scenario until the victim shows signs of life. Signs of life include spontaneous breathing, coughing, pulse or movement.

If you notice breathing, but the person has not yet regained consciousness, you can stop resuscitation and place the victim in a stable position on his side. This will help prevent the tongue from sticking, as well as the penetration of vomit into the respiratory tract. Now you can calmly examine the victim for presence and wait for the doctors, observing the condition of the victim.

CPR can be stopped if the person doing it is too tired to continue. It is possible to refuse resuscitation measures if the victim is clearly not viable. If the victim has severe injuries that are incompatible with life or noticeable cadaveric spots, resuscitation does not make sense. In addition, resuscitation should not be performed if the absence of a heartbeat is due to incurable disease, for example, oncological.

Clinical death occurs with circulatory arrest. This can happen during drowning and in a number of other cases when the airways are compressed or blocked.

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

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

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

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

A correctly and timely blow can bring a person back to life in a matter of seconds: his heartbeat is restored, his consciousness returns. However, if this does not happen, then begin chest compressions and artificial respiration, which are carried out until signs of revival of the victim appear: a good pulsation is felt in the carotid artery, the pupils gradually narrow, and the skin of the upper lip turns pink.

Indirect cardiac massage and its implementation

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

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

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

3. The rescuer becomes as stable as possible and so that it is possible to press on the sternum with his hands straightened at the elbow joints, then quickly leans forward, transferring the weight of the body to his hands, and thereby bends the sternum by about 4-5 cm. In this case, it is necessary to watch ensure that the pressure is applied not to the heart area, but to the sternum. The average force of pressure on the sternum is about 50 kg, so the massage should be carried out not only using the strength of the arms, but also the mass of the torso.

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

4. After short pressure on the sternum, you need to quickly release it so that the artificial compression of the heart is replaced by its relaxation. While the heart is relaxing, you should not touch the victim’s chest with your hands.

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

In table 1. The requirements for performing indirect cardiac massage are given depending on the age of the victim.

Table 1. Indirect cardiac massage

A possible complication in the form of a rib fracture during chest compressions, which is determined by a characteristic crunch during compression of the sternum, should not stop the massage process.

Artificial respiration and its implementation

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

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

2. The rescuer stands on the side of the victim, puts one hand on his forehead, and the other under the back of the head and turns the victim’s head (at the same time, the mouth, as a rule, opens).

3. The rescuer takes a deep breath, slightly holds the exhalation and, bending over to the victim, completely seals the area of ​​his mouth with his lips. In this case, the victim’s nostrils must be pinched with the thumb and forefinger of the hand lying on the forehead, or covered with one’s cheek (air leakage through the nose or corners of the victim’s mouth negates all the efforts of the rescuer).

4. After sealing, the rescuer exhales quickly, blowing air into the victim's airways and lungs. In this case, the victim’s inhalation should last about a second and reach 1 - 1.5 liters in volume in order to cause sufficient stimulation of the respiratory center.

5. After the end of exhalation, the rescuer unbends and releases the victim’s mouth. To do this, turn the victim’s head to the side without straightening it and raise the opposite shoulder so that the mouth is lower than the chest. The victim’s exhalation should last about two seconds, or at least twice as long as the inhalation.

6. In the pause before the next breath, the rescuer needs to take 1-2 small regular inhalations and exhalations for himself. After this, the cycle repeats from the beginning. The frequency of such cycles is 12-15 per minute.

When a large amount of air enters the stomach, it swells, making it difficult to revive. Therefore, it is advisable to periodically empty the stomach of air by pressing on the victim’s epigastric region.

Artificial respiration “mouth to nose” is almost no different from what has been described. To seal, you need to press the victim’s lower lip to the upper lip with your fingers.

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

If two people provide assistance, then one of them does indirect cardiac massage, and the other does artificial respiration. At the same time, their actions must be coordinated. Do not press on the chest while inhaling air. These measures are carried out alternately: 4-5 compressions on the chest (as you exhale), then one blow of air into the lungs (inhalation). If assistance is provided by one person, which is extremely tiring, then the sequence of manipulations changes slightly - after every two quick injections of air into the lungs, 15 pressures are applied to the chest. In any case, it is necessary that artificial respiration and chest compressions are carried out continuously for the required time.

Situations when a person may require artificial respiration and cardiac massage do not happen as rarely as we imagine. This can be depression or arrest of the heart and breathing in accidents such as poisoning, drowning, foreign objects entering the respiratory tract, as well as in traumatic brain injuries, strokes, etc. Providing assistance to the victim should be carried out only with full confidence in one’s own competence, because incorrect actions often lead to disability and even death of the victim.

How to perform artificial respiration and provide other first aid in emergency situations, are taught in special courses operating under the Ministry of Emergency Situations, in tourist clubs, and in driving schools. However, not everyone is able to apply the knowledge gained in courses in practice, much less determine in which cases it is necessary to perform cardiac massage and artificial respiration, and when it is better to abstain. You need to start resuscitation measures only if you are firmly convinced of their feasibility and know how to properly perform artificial respiration and external cardiac massage.

Sequence of resuscitation measures

Before starting the procedure of artificial respiration or indirect external cardiac massage, you must remember the sequence of rules and step by step instructions their implementation.

1. First you need to check whether the unconscious person is showing signs of life. To do this, put your ear to the victim's chest or feel the pulse. The easiest way is to place 2 closed fingers under the victim’s cheekbones; if there is pulsation, it means the heart is working.
2. Sometimes the victim’s breathing is so weak that it is impossible to detect it by ear; in this case, you can observe his chest; if it moves up and down, it means breathing is functioning. If movements are not visible, you can put a mirror on the victim’s nose or mouth; if it fogs up, it means there is breathing.
3. It is important - if it turns out that the heart of an unconscious person is working and, although weakly, - respiratory function This means that he does not need artificial ventilation and external cardiac massage. This point must be strictly observed for situations where the victim may be in a state of heart attack or stroke, because in these cases any unnecessary movements can lead to irreversible consequences and death.

If there are no signs of life (most often the respiratory function is impaired), resuscitation measures should be started as soon as possible.

Basic methods of providing first aid to an unconscious victim

The most frequently used, effective and relatively uncomplicated actions:

• mouth-to-nose artificial respiration procedure;
• mouth-to-mouth artificial respiration procedure;
• external cardiac massage.

Despite the relative simplicity of the activities, they can only be carried out by mastering special implementation skills. Technique for artificial ventilation of the lungs, and, if necessary, cardiac massage, performed in extreme conditions, requires from the resuscitator physical strength, precision of movements and some courage.

For example, it will be quite difficult for an unprepared, fragile girl to perform artificial respiration, and especially to perform cardiac resuscitation on a large man. However, mastering the knowledge of how to properly perform artificial respiration and how to perform cardiac massage allows a resuscitator of any size to carry out competent procedures to save the life of the victim.

The procedure for preparing for resuscitation actions

When a person is unconscious, he should be brought back to his senses in a certain sequence, having previously clarified the need for each of the procedures.

1. First, clear the airways (throat, nasal passages, mouth) of foreign objects, if any. Sometimes the victim’s mouth may be filled with vomit; it must be removed using gauze wrapped around the hand of the resuscitator. To facilitate the procedure, the victim’s body should be turned to one side.
2. If heartbeat is detected, but breathing does not work; only artificial respiration from mouth to mouth or mouth to nose is required.
3. If both the heartbeat and respiratory function are inactive, artificial respiration alone cannot be done, and indirect cardiac massage will have to be done.

List of rules for performing artificial respiration

Artificial respiration techniques include 2 methods of mechanical ventilation (artificial pulmonary ventilation): these are methods of pumping air from the mouth into the mouth and from the mouth into the nose. The first method of performing artificial respiration is used when it is possible to open the victim’s mouth, and the second - when it is impossible to open his mouth due to spasm.

Features of the mouth-to-mouth ventilation technique

A serious danger for a person performing artificial respiration using the mouth-to-mouth technique may be the possibility of discharge from the victim’s chest. toxic substances(especially in case of cyanide poisoning), infected air and other toxic and dangerous gases. If such a possibility exists, the mechanical ventilation procedure should be abandoned! In this situation, you will have to make do with indirect cardiac massage, because mechanical pressure on the chest also contributes to the absorption and release of about 0.5 liters of air. What actions are performed during artificial respiration?

1. The patient is placed on a hard horizontal surface and the head is thrown back, placing a bolster, a twisted pillow or a hand under the neck. If there is a possibility of a neck fracture (for example, in an accident), throwing your head back is prohibited.
2. Pull the patient's lower jaw down, open the oral cavity and free it from vomit and saliva.
3. Hold the patient's chin with one hand, and tightly pinch his nose with the other, take a deep breath through the mouth and exhale air into the victim's mouth. In this case, your mouth must be pressed firmly against the patient’s mouth so that air passes into his respiratory tract without escaping (for this purpose, the nasal passages are pinched).
4. Artificial respiration is performed at a rate of 10-12 breaths per minute.
5. To ensure the safety of the resuscitator, ventilation is performed through gauze; control of the pressure density is mandatory.

The artificial respiration technique involves gentle air injections. The patient needs to be provided with a powerful but slow (over one to one and a half seconds) supply of air for recovery motor function diaphragm and smooth filling of the lungs with air.

Basic rules of the “mouth to nose” technique

If it is impossible to open the victim’s jaw, artificial respiration from the mouth to the nose is used. The procedure for this method is also carried out in several stages:

• first, the victim is laid horizontally and, if there are no contraindications, the head is thrown back;
• then check the nasal passages for patency and, if necessary, clean them;
• if possible, extend the jaw;
• do their best full breath, cover the patient’s mouth and exhale air into the victim’s nasal passages.
• count 4 seconds from the first exhalation and take the next inhalation and exhalation.

How to perform artificial respiration on young children

Performing the mechanical ventilation procedure for children is somewhat different from the previously described actions, especially if you need to perform artificial respiration for a child under 1 year old. Face and respiratory organs in such children they are so small that adults can ventilate them simultaneously through the mouth and through the nose. This procedure is called “mouth to mouth and nose” and is performed similarly:

• first the baby's airways are cleared;
• then the baby’s mouth is opened;
• The resuscitator takes a deep breath and exhales slowly but powerfully, covering both the child’s mouth and nose with his lips at the same time.

The approximate number of air blows for children is 18-24 times per minute.

Checking the correctness of mechanical ventilation

When carrying out resuscitation efforts, it is necessary to constantly monitor the correctness of their implementation, otherwise all efforts will be in vain or will further harm the victim. Methods for monitoring the correctness of mechanical ventilation are the same for adults and children:

• if, while blowing air into the victim’s mouth or nose, a rise and fall of his chest is observed, it means that passive inhalation is working and the mechanical ventilation procedure is carried out correctly;
• if the chest movements are too sluggish, it is necessary to check the tightness of the compression when exhaling;
• if artificial injection of air moves not the chest, but abdominal cavity, this means that air does not enter the respiratory tract, but into the esophagus. In this situation, it is necessary to turn the victim’s head to the side and, pressing on the stomach, allow air to burp.

It is necessary to check the effectiveness of mechanical ventilation every minute; it is advisable that the resuscitator has an assistant who would monitor the correctness of actions.

Rules for performing indirect cardiac massage

The procedure for chest compressions requires somewhat more effort and caution than mechanical ventilation.

1. The patient should be placed on a hard surface and the chest should be freed from clothing.
2. The person resuscitating must kneel to the side.
3. You need to straighten your palm as much as possible and place its base on the middle of the victim’s chest, about 2-3 cm above the end of the sternum (where the right and left ribs “meet”).
4. Pressure on the chest should be applied centrally, because This is where the heart is located. Moreover, thumbs Massaging hands should be directed towards the stomach or chin of the victim.
5. The other hand should be placed on the lower one - crosswise. The fingers of both palms should be kept pointing upward.
6. The resuscitator's arms must be straightened when applying pressure, and the center of gravity of the entire weight of the resuscitator must be transferred to them so that the shocks are strong enough.
7. For the convenience of the resuscitator, before starting the massage, he needs to take a deep breath, and then, as he exhales, make several quick presses with crossed palms on the patient’s chest. The frequency of shocks should be at least 60 times per minute, while the victim’s chest should drop by about 5 cm. Elderly victims can be resuscitated with a frequency of 40-50 shocks per minute; for children, cardiac massage is done faster.
8. If resuscitation measures include both external cardiac massage and artificial ventilation, then they need to be alternated in the following sequence: 2 breaths - 30 pushes - 2 breaths - 30 pushes and so on.

Excessive zeal of the resuscitator sometimes leads to broken ribs of the victim. Therefore, when performing a cardiac massage, one should take into account the individual’s own strengths and characteristics. If this is a person with thin bones, a woman or a child, efforts should be moderated.

How to give a heart massage to a child

As has already become clear, cardiac massage in children requires special care, since the children’s skeleton is very fragile, and the heart is so small that it is enough to massage with two fingers, and not with the palms. In this case, the child’s chest should move in the range of 1.5-2 cm, and the frequency of compressions should be 100 times per minute.

For clarity, you can compare the measures for resuscitation of victims depending on age using the table.

Important: cardiac massage must be carried out on a hard surface so that the victim’s body is not absorbed into soft ground or other non-solid surfaces.

Monitoring the correct execution - if all actions are performed correctly, the victim develops a pulse, cyanosis (blue discoloration of the skin) disappears, respiratory function is restored, and the pupils return to normal sizes.

How long does it take to resuscitate a person?

Resuscitation measures should be carried out for the victim for at least 10 minutes or exactly as long as it takes for signs of life to appear in the person, and ideally until the doctors arrive. If the heartbeat continues and respiratory function is still impaired, mechanical ventilation must be continued for quite a long time, up to an hour and a half. The likelihood of a person returning to life in most cases depends on the timeliness and correctness of resuscitation actions, however, there are situations when this cannot be done.

Symptoms of biological death

If, despite all efforts to provide first aid, they remain ineffective for half an hour, the victim’s body begins to become covered with cadaveric spots, the pupils when pressed on eyeballs take on the appearance of vertical slits (cat pupil syndrome), and signs of rigor also appear, which means further actions are meaningless. Symptoms mentioned talk about the onset of biological death of the patient.

No matter how much we would like to do everything in our power to bring a sick person back to life, even qualified doctors are not always able to stop the inevitable passage of time and give life to a patient doomed to death. This is, unfortunately, life, and you just have to come to terms with it.

There are so many situations in life that a person can influence and change the outcome in better side. But sometimes people simply lack basic skills to help victims. Therefore, it never hurts to learn how to act when a random passerby or family member stops breathing. Any person can provide first aid to a patient, observing basic rules and following clear instructions. Violation respiratory process may be caused by a foreign body entering the mouth or trachea or a stuck tongue.

In what cases is ventilation performed?

The procedure for rescuing a person should begin by identifying the source of the problem. Ventilation should be done in the following cases:

1. If the heartbeat stops. To restore breathing, it is necessary to perform an indirect cardiac massage.
2. The retraction of the tongue has occurred (man is without creation). While lying down, the muscles of the tongue and pharynx relax, which can cause the root of the tongue to move and close the entrance to the trachea. In the same time breathing movements are present, but the noise cannot be heard. In this case, it would be appropriate to tilt the head back, which will clear the entrance and allow air to enter the trachea. In order for the mouth to open, there must be a helping hand under the person’s neck and pressure on the forehead with the other hand.
3. If a foreign body (this can be a particle of water, food, dirt, as well as blood and other objects) has entered the organs that provide air passage. Symptoms of this problem include weak breathing movements, bluish knees and lips, rapid pulse(110 or more beats per minute), noisy convulsive inhalation, exhalation with the sound of hoarseness.

Having determined the cause of stopping (difficulty) breathing, providing first aid to the victim is mandatory. But for this you need to create comfortable conditions to the victim.

Methods of ventilation

The procedure for restoring breathing should be carried out until positive result. First you need to remove the victim’s clothes, which may be compressing the chest area, then you should ensure that your mouth is open and your clenched teeth are unclenched.

There are three ways to perform ventilation:

1. For use this method the victim should lie with his back up, one arm under his head, the other extended along the body, his face turned to the side. The person performing artificial respiration should position himself so that the patient's thighs are between his knees. The palms are on the victim’s back, and the fingers clasp him from the sides. Leaning forward, the man leans on outstretched arms and leans back, exhaling and inhaling.
2. To apply the second method, the victim is placed with his back to the surface and a bundle of clothes is placed in the area of ​​the shoulder blades, this allows the patient’s head to be thrown back. The mouth should be cleaned and the tongue extended. During the procedure, the tongue is slightly pulled down towards the chin. To exhale, you need to take the victim’s hands at the elbows and press them to the side of the chest. To inhale, raise your arms and throw them behind your head.
3. The mouth-to-mouth method is the most common and effective method resume the victim's breathing. Before starting the procedure, the person should be on his back with his head thrown back (chin and neck should be in line). The victim's mouth should be cleared of mucus. Air enters through the mouth of the person providing assistance, while the victim’s nose must be pinched. It is necessary to make 10-12 blows per minute.

Before providing first aid to the victim, you need to call an ambulance. By the time she arrives, you may have saved someone's life.