ORGANIZATION OF resuscitation care.
The need for resuscitation can WHO niknut in any place and in any environment. In this case, a person’s life will depend on how much the person assisting him knows the methods of resuscitation (external cardiac massage and artificial respiration). EU natural to that full resuscitation may spend only a medical professional.
TASKS OF REANIMATION.
The main problem with the resuscitation of the patient, finding Gosia in a state of clinical death – the fight against gipok sion and fading stimulation of the body’s functions. According to the degree of urgency, resuscitation measures can be divided into two groups:
- maintaining artificial Foot respiratory and cardiopulmonary bypass and
- about maintenance intensive therapy, the restored directed to Leniye spontaneous circulation and respiration, normalization of the CNS, liver, kidney metabolism.
Of great importance is the organization of a special cabinet in the clinic, pharmacy, any medical Poon kT, where it is necessary to have a resuscitation kit.
This set should include:
- sterile bandages and napkins;
- syringes in special styles;
- hemostatic tourniquets;
- duct for breathing mouth to mouth;
- hand bag respirator;
- adrenaline in ampoules – 0.1% solution,
- calcium chloride in ampoules – 10% solution,
- promedol or morphine,
- prednisone for internal administration,
- nitroglycerin in tablets;
- solutions for intravenous infusion – polyglucin, hemodez and gelatin;
- venipuncture needles;
- sterile system for intravenous infusion.
Of great importance for the timely provision of Rean mation aid was the creation in our country ReA nimatsionnoy service ambulance system. Special nye ambulances are equipped with everything necessary for a wasp schestvleniya intensive care, up to operations (tracheostomy, cannulation of veins, arteries and the heart, cardiac massage, and others.).
All major hospitals set up special ReA nimatsionnye department. These offices have a separate staff of doctors and highly-resuscitation nurses, sophisticated equipment for reanima tion, diagnostic equipment. The resuscitation otde Lenia most severe patients received from other divisions, for example after surgery, and delivered ma tires ambulance. There resuscitation by dividing the therapeutic profile, which treated patients with myocardial infarction, acute heart Nedo sufficiency, severe respiratory diseases, surgical – for postoperative pain GOVERNMENTAL, poison control centers – for poisoning treatment Nij, casualty department – for patients with severe injuries and traumatic shock.
RESUME ON STOPPING BREATHING.
The need for artificial respiration or correct it, ventilation occurs when ac CONST due to occlusion of the airways inorod GOVERNMENTAL bodies, drowning, electrocution, poisoning of different toxic substances or les drugs on, brain haemorrhage, herbs cally shock.
Artificial respiration is etsya only treatment with distances at which the spontaneous respiration of the patient can not provide up sufficient oxygen saturation.
Acute respiratory failure may be originated pull the secondarily due to impaired circulation.
Acute respiratory failure and its extreme ste stump – stop breathing – whatever reason leads to a decrease in the oxygen content in the body (hypoxia) and excessive accumulation in the blood and tissues of carbon dioxide (hypercapnia). As a result of hypoxia and hypercapnia in the body develop severe violated key’s function of all organs, which can be eliminated only if timely started resuscitation – mechanical ventilation. There are various methods of artificial venti lyatsii light (artificial respiration). Nowadays, Sylvester and Schaefer are extremely rarely used. They are less effectiveness tive than CPR, based on the received tsipe injection into the lungs, and are used in patients with damaged niyami face. Methods and Sylvester Schaefer protivopo cauldrons chest trauma. The Sylvester method cannot be used for obstruction of the airways due to drowning.
Artificial respiration by blowing air can be done in several ways. The most pro stand of them – artificial ventilation of the lungs of the ACT soba mouth to mouth or mouth to nose. The equipment developed hand you for artificial respiration in the form of a rubber elasticity Gogo bag with a mask. These bags, respirators should be in any medical institution on common point of FAPs. In the hospital, special complicated devices, the so-called respirators, are used for artificial ventilation of the lungs. Port tive respirator equipped ambulances Pomo soup, rescue stations on the beaches.
The technique of artificial ventilation of the lungs by mouth or mouth to nose.
For carrying out artificial respiration is necessary to put the patient on his back, unbutton Steciw clothing and ensure a free airway sculpt If in the mouth or throat there is content, it is necessary to quickly remove your finger, napkin, handkerchief, or by any of Sosa. For this purpose can be used rubber -hand syringe, pre-cutting its thin tip. For the airway head suffered Sheha should be given back. We must remember that excessive Noah retraction of the head can lead to narrowing of the respiratory -negative ways. For a more complete opening of the airways, it is necessary to extend the lower jaw forward. If near at hand there is a type of air ducts, it should enter into the throat prevented for Niya the tongue. The absence of air water during rescue breathing follows blowing to keep his head in the retracted position by hand, moving the lower jaw forward.
In carrying out mouth-to-mouth of catching hold of the victim in a certain position. Conducting resuscitation, taking a deep breath and tightly pressing his mouth to the patient’s mouth, exhales air into his lungs. In this case, a hand located at the forehead of the victim must pinch his nose. Exhale wasp fected passively, due to the elastic forces of the chest. The number of breaths per minute should be at least 16-20. Injection should be carried out quickly and sharply (in children less sharply), so that the duration of inspiration was 2 times less than the expiration time.
Ensure that the air you breathe is not when led to excessive stretching of the stomach. In this case there is a danger of food masses of zhelud ka and entering them into the bronchi. Of course, mouth-to-mouth breathing creates significant hygienic inconvenience. You can avoid direct contact with the patient’s mouth by blowing air through a gauze, scarf or any other loose material. In this IU Tode ventilation can use air water. When using the method mouth breathing nasal air blowing is carried through the nose. In this case, the victim’s mouth should be closed hand, which at the same time shift the jaw up to the pre warnings related to the tongue. Artificial ventilation with hand-held respirators . BHA Chal necessary to ensure airway patency as previously described and enter the duct. A mask is tightly applied to the patient’s nose and mouth. Contractive May bag, produce breath, exhale through the bag valve at the same time duration to milk ha in 2 times more than the duration of inspiration.
In all ways of ICs artificially ventilation is necessary to evaluate Vat its effectiveness for chest rise.
In no case nel Gia start ordeal governmental breath, relieving respiratory tion path (mouth and throat) from inorod GOVERNMENTAL bodies, mucus wee schevyh masses.
Continuous Valve tion of light by means of these methods is not possible, it serves only to provide first Pomo soup and assistance during transport. Therefore, while continuing intensive care – cardiac massage and artificial of breath, should make every effort to call an ambulance or to transport the patient to a medical establi denie to provide skilled care.
Mechanical ventilation using spe cially devices.
During prolonged artificial veins tilyatsii lung necessarily resorting to intubation of the trachea, injecting it with the help of a laryngoscope endotracheal tube. Endotracheal intubation is the best way of maintaining the free cross res GOVERNMENTAL paths. Thus no danger depressions Yazi ka and entering the lungs of vomit. Through the endotracheal tube it is possible to produce both artificial respiration – the mouth into the tube, and ventilation with the help of modern devices – respirators. These devices allow for artificial ventilation of the lungs for many days and even months. If necessary, artificial respiration for 3-4 days or more produce a tracheostomy.
Tracheostomy is an emergency operation consisting in the introduction of a special tube into the trachea through an incision on the front surface of the neck. Tracheostomy is applicable nyatsya also asphyxia caused by diphtheria and false croup, foreign bodies larynx harmed deniem larynx.
In the absence of a tracheostomy tube in Emerg GOVERNMENTAL cases, it may be used any tube (hot lyshko from kettle coil, a metal tube).
RESUSCITATION AT THE STOP OF BLOOD CIRCULATION.
Termination of activity of the heart can occur under the influence of a wide variety of reasons (drowning, suffocation, gassing, causing an electric the ball and lightning, stroke, myocardial infarction and other heart disease, heat stroke, blood loss, a strong direct blow to the heart, burns, freezing of, etc.) and in any environment -. in the hospital, zubovra chebnom the office, at home, on the street production. In any of these cases, at the disposal of the person conducting the intensive care unit, there are only 3-4 minutes for setting diag Noz and restore blood supply to the brain. Various chayut two kinds of cessation of heart function – asystole (complete cessation figure Nosta heart) and fibrillyatsiyuzheludochkov , when certain muscle fibers of the heart are reduced chaotic, uncoordinated. In both the first and second cases, the heart stops “pumping” blood and blood flow through the vessels stops.
The main symptoms of heart failure that allow you to quickly make a diagnosis are:
- loss of consciousness;
- lack of pulse, including on the carotid and femoral arteries;
- Ser absence dechnyh tones;
- respiratory arrest;
- pallor or blueness of the skin and mucous membranes;
- dilated pupils;
- cramps that may appear at the time of loss of consciousness and be the first noticeable surrounding symptom of cardiac arrest.
These symptoms are so convincing evidence of cardiac arrest and the fact that you can not lose a second in the additional examination (blood pressure measurement, the determination of the heart rate), or search for a doctor, and you should immediately begin intensive care – cardiac massage and artificial respiratory NIJ. It should be remembered that cardiac massage should always be carried out simultaneously with artificial respiratory Niemi, which resulted in the circulating blood is endowed zhaetsya oxygen. Otherwise, resuscitation is meaningless. Currently used two types of massage serd ca – open or line that is used only during the operations on the organs of the chest cavity, and closed fifth outer conducted through unopened thorax.