The technique of a complex of cardiopulmonary resuscitation
Reanimation of a person in a state of clinical death is most effective when carrying out an indirect heart massage alternates with inspiratory ventilation. The optimal ratio is 15 pressures on the thorax for 2 breaths of ALV.
One person can carry out resuscitation for no more than 10 – 15 minutes, and the reanimation should be continued for at least 20 – 30 minutes. The optimal number of resuscitation participants is three. It is in this quantity that they will not interfere with each other, and at the same time there will be no shortage of hands. At the same time, one person carries ALV, the second – an indirect cardiac massage, the third – pushes the victim's stomach with his fist.
Strong pressure on the navel region will make it difficult for the blood to pass through the abdominal aorta, which practically excludes blood supply to the lower limbs and pelvic organs. This will reduce the circulation three times and achieve more complete blood supply to the brain and vital organs.
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| Gently shake the shoulders and shout. | Gently tip the head back and lift the chin to open the airway. |
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| Look, listen and feel for normal breathing. | Place the heel of one hand in the centre of the chest, then the other hand on top. |
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| Arms straight and shoulders above your hands, depress the chest 4 to 5 cm. | Nip the nose and seal your mouth around the casualty's mouth. |
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| Slowly breathe just enough air to make the chest rise | Using a protective barrier during CPR |
Fig. 11.1. A complex of cardiopulmonary resuscitation
Participants in intensive care should move according to the scheme: indirect heart massage –ALV– pressure on the stomach – indirect cardiac massage.
The technique of a complex of cardiopulmonary resuscitation is shown on fig. 11.1.
Processing the practical skills of a complex of cardiopulmonary resuscitation on the «Maxim III-01E» simulator
The «Maxim III-01E» simulator is used to train practical skills in performing a complex of cardiopulmonary resuscitation.
The simulator allows:
1. Do the following:
– indirect heart massage;
– artificial ventilation of the lungs by methods «from mouth to mouth» and «from mouth to nose» (ALV);
– simulate the condition of the victim (pulse, pupils, etc.)
2. To control:
– the correct position of the head and the condition of the waist belt;
– the correctness of the indirect heart massage;
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– sufficiency of air flow during ventilation;
– the correctness of the test modes of resuscitation of the victim by one or two rescuers;
– pupil's condition in the victim.
The simulator is equipped with an electronic control panel, which determines the correctness of the head position, the condition of the waist belt, the adequacy of the blown air, the compression force, the correct position of the hands with indirect heart massage, the correctness of resuscitation by one or two rescuers; the state of the pupils of the victim, the appearance of a pulse.
To learn the skills of cardiopulmonary resuscitation on the simulator before starting work, you must turn on the power switch located on the back of the electronic console. At the same time, the green signal «network on» is activated on the console, as well as red signals indicating that the belt of the victim is buttoned and the head is not thrown back (analogous signals appear on the wallboard). Then the operating mode of the simulator is selected and appropriate actions are taken.
Modes of work of the simulator «Maxim III-01E»:
The simulator can be used in five modes:
1. Training is used to develop individual elements of resuscitation;
2. Test resuscitation mode by one rescuer (2 – 15);
3. Resuscitation mode by two rescuers (1 – 5);
Modes proposed by the European Council for Resuscitation (ERC):
4. Cardiopulmonary resuscitation (2 – 30);
5. Cardiopulmonary resuscitation (30 – 2).
After a properly conducted resuscitation complex, the simulator automatically «comes to life»: a pulse appears on the carotid artery and the pupils of the victim narrow.
I The training mode.
It used for testing individual elements of resuscitation. Procedure:
1. Ensure the correct tilting of the head of the simulator (at a tipping angle of 15° – 20°, the green signal «Correct position» is activated).
2. Unfasten the belt (the green signal «Belt is unbuttoned» is turned on).
3. The hands of the rescuer, when practicing the skills of indirect heart massage, should be above the end of the xiphoid process of the sternum, approximately at a distance of 2 diameters of the fingers of the hand. In case of an incorrect position, the red signal «Hand position» is turned on, and the actions of the rescuers will be considered incorrect.
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4. Conduct an indirect cardiac massage according to the rules of the first medical aid. With an applied force of 25 ± 2 kg and a punching depth of 3 – 5 cm, the green signal «Hand position» is activated.
5. With an effort greater than 32 kg (sternal displacement more than 5 cm), 2 red signals «Rib fracture» are activated.
6. Conduct according to the rules of first aid medical ventilation ALV. With a sufficiently intense airflow into the lungs (air speed of at least 2 l/s and a volume of at least 400– 500 cm3), a green signal «Normal air volume» is activated.
7. Control the carotid artery of the simulator, the presence of a pulse can be enabled by turning on the «Pulse» button.
8. Check the condition of the pupils of the «Victim’s» eye, pulling the eyelid upward. In this case, the pupils of the eyes will be expanded «The victim» is in a state of clinical death. When the «Pulse» button is turned on, the pupils' eyes of the simulator become normal. The «Victim» functions are restored. In addition, every pressing, when performing indirect heart massage, is accompanied by a narrowing of the pupils of the «Victim’s» eye.
9. On the demonstration board, all light signaling about the actions of the rescuers is identical to the signaling on the electronic panel.
Attention!
After completing all the training activities, you must press the «Reset» button, and the green «Reset» signal is turned on.
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