Proper CPR procedure and performance criteria

Cardiopulmonary resuscitation (CPR) is a system of actions necessary to save a person's life in the event of respiratory and circulatory arrest. The complex includes several options for assistance available not only to an experienced resuscitator, but also to an ordinary person. For safety and ease of use, the actions are divided into groups.

The use of complex methods that require special training without knowledge of human physiology can lead to dangerous consequences, so it is advisable to adhere to the basic resuscitation complex.

Groups of measures of cardiopulmonary resuscitation

In medicine, it is customary to divide the complex into two groups. The main criterion for the division of activities is the training of the person providing assistance, and the availability of auxiliary medical devices.

1. Basic actions are measures taken immediately after a patient's heartbeat and breathing stop.
2. The actions of the expanded complex are carried out upon the arrival of an ambulance and within the walls of a medical institution. To take measures of the extended complex, it is necessary to conduct a complete examination of the patient and identify the causes of clinical death. The technique includes surgical intervention and the use of specialized drugs.

To designate a sequence of actions, it is customary to use the abbreviation CABED. CABED is a set of measures for the new standards established in 2011.

• "C" - heart massage to restore blood circulation;
• "A" - ensuring the patency of the respiratory tract;
• "B" - resumption of breathing;
• "D" - analysis of the general neurological status (presence of consciousness);
• "E" - recovery of life-threatening disorders.

The correct sequence of actions during resuscitation allows you to save a person's life.

When is CPR performed?

Resuscitation is carried out in cases associated with the onset of clinical death. When the work of the heart and respiratory system stops, the victim has a serious danger of developing oxygen starvation of the brain. However, oxygen starvation does not occur instantly, which allows you to provide the necessary assistance to the patient.

1. Loss of consciousness. The symptom is observed 10 seconds after the cardiac arrest. In order to make sure that there is no consciousness, you should stretch the victim's earlobes or try to attract attention by shaking his shoulders.
2. Stopping breathing. To determine the cessation of breathing, you can put your palm on the victim’s chest or use a mirror surface brought to the person’s nose.
3. Heart failure. It is determined by probing the carotid artery (on the neck).

In the case of manifestations of signs of clinical death, you should quickly move to the provision of assistance.

The period from loss of consciousness to the first 5-6 minutes after the onset of clinical death is considered the most optimal for resuscitation. When providing assistance and returning the patient to life, 10 minutes after the onset of clinical death, there is a high probability of violations of the human nervous system, after 15 minutes - critical damage to mental processes.

Contraindications for resuscitation measures

It is believed that it is pointless to carry out a set of resuscitation measures in the event of the development of destructive processes.

• decrease in body temperature after death;
• the formation of spots on the surface of the skin;
• drying of the cornea of ​​​​the eye;
• clouding of the cornea of ​​the eye;
• symptom of "cat's eye";
• rigor mortis or induration.

It should be noted that the change in body temperature of the victim is directly related to the ambient temperature. So, at an average temperature, the rate of decrease in body temperature is 1 degree per hour, however, at low temperatures, the rate of cooling increases significantly.

A set of resuscitation measures

The basic set of measures includes measures available to the savior without undergoing training courses.

1. Precordial stroke.
2. Indirect cardiac massage.
3. Artificial respiration.

For an extended method of care, appropriate equipment and medicines are used.

precordial beat

Used as a defibrillator-like technique. A precordial strike is performed in case of cardiac arrest for no more than 30 seconds.

• you should place the victim on a solid surface and make sure that there is a heartbeat;
• if there is no pulse, the rescuer needs to press 2 fingers into the region of the xiphoid process (the center of the human chest);
• then strike with the edge of the other hand (palm in a fist) above the attached fingers;
• in the absence of a pulse, it is necessary to proceed to an indirect massage of the cardiac organ.

Indirect cardiac massage

The principle of indirect cardiac stimulation is to compress the chest of the victim and resume the work of the cardiac organ.

• first of all, the victim should be laid on a hard, stable surface on his back;
• the hands of the person conducting resuscitation should be in the lower part of the chest (relative to the width of the chest - in the middle);
• the position of the hands is one palm on top of the other, the hands are at a distance of 3-4 centimeters above the xiphoid process;
• pressing is carried out with the help of the palms, the fingers do not touch the person’s chest;
• the lowering of the ribs of the victim when pressing on the chest should not exceed 5 centimeters.

If the mass of the rescuer is large and the pressure is too strong, rib fractures may occur.

The features of an indirect heart massage include the following factors:

1. Pressing lasts no more than 0.5 seconds.
2. The interval between two clicks is no more than 1 second.
3. The number of clicks per minute is 60.

These criteria are suitable for adult chest compressions. Due to the difference in the mass of an adult and a child, the method of resuscitation is different.

• before starting, you need to take 5 mouth-to-mouth breaths;
• then the ratio of pressures and breaths is 15:2;
• for newborns, pressure with 1 finger is allowed;
• for infants - 2 fingers;
• for young children - 1 palm.

Even with successful resuscitation, the child should call an ambulance.

After the appearance of signs of the resumption of blood circulation, it is recommended that the victim be turned to one side because of the danger of suffocation when the tongue sinks or the vomit comes out.

Artificial lung ventilation

Mechanical ventilation is also known as the Safar method.

1. It is necessary to put the victim in a horizontal position.
2. Tilt back the person's head.
3. One hand should hold the head with the palm on the forehead, the other under the neck.
4. The patient should open his mouth and try to take a test breath, if it does not work out, push the victim's lower jaw forward and down.
5. If there are foreign objects in the oral cavity that impede breathing, they must be removed.
6. If, after removing the obstruction, breathing has not resumed, it is necessary to immediately begin artificial ventilation of the lungs.

In some cases, breathing resumes on its own after clearing the airways, but if this does not happen, it is important to adhere to the further technique.

• having closed the victim's nostrils, the rescuer makes several exhalations into the victim's mouth;
• if the exhalation is correct, then the patient's chest rises, after which the expansion decreases;
• during the procedure, it is the chest that should rise, and not the epigastric region (a sign means blockage of the airways);
• one exhalation must be at least 1 liter;
• with an interval of 5 seconds, 12 "exhalations" should be carried out.

How can you tell if the resuscitation was successful?

If the procedure for resuming breathing and circulation was carried out successfully, the following symptoms are observed:

1. Resumption of carotid pulse between chest compressions.
2. Pupils constrict, there is a reaction to light.
3. Breathing is restored.
4. The victim regained consciousness.

After the appearance of signs of a successful event, it remains necessary to call an ambulance and turn the patient on his side.

Extended resuscitation measures

Advanced resuscitation methods include:

• defibrillation;
• the use of medicines;
• direct cardiac massage.

The difference between direct heart massage and the basic resuscitation method described above is that the doctor must open the patient's chest before performing the impact.

The listed methods of extended resuscitation are unacceptable in the absence of medical training of the rescuer.

Complications and errors during resuscitation

The most common reasons for unsuccessful resuscitation are:

1. Late start of resuscitation.
2. Insufficient ventilation of the lungs.
3. Insufficient pressure with chest compressions.
4. Soft surface on which the victim is located.
5. Incorrect position of the hands with an indirect heart massage.

• fracture of the thoracic ribs;
• lung injury due to shrapnel damage;
• liver damage;
• heart damage.

When implementing a set of measures, one should be attentive to the force exerted by pressure during an indirect heart massage. Excessive application of force can cause serious injury to the victim.