Acute cardiovascular collapse and cardiac arrest

Acute cardiovascular collapse and cardiac arrestIn terminal States, i.e., predalone, agony and clinical death, only the immediate resuscitation aimed primarily at restoring breathing and circulation, can return to the life of the patient. Initial resuscitation is sometimes referred to as cardio-pulmonary resuscitation: they include mechanical ventilation and cardiac massage. Cardiac arrest is extremely important to immediately start resuscitation, as the period of reversibility upon the occurrence of clinical death lasts no longer than 4-5 minutes It is extremely important development of all health professionals and the population of the practical skills of primary resuscitation. Only then appeared on the scene people before the arrival of the medical worker to start resuscitation. Moreover, it is important for every health care worker to learn resuscitation techniques. Cardiac massage is aimed at restoring blood flow in the broken heart. Restoring the pumping of the heart and thus blood circulation during the massage takes place in the shock compression of the heart between the front and rear surface of the chest. Indications for cardiac massage are the absence of pulse on peripheral and carotid arteries, dilated pupils, absence or type of agonal breathing, rapid blanching of skin, unconsciousness. In the hospital, you should not wait until the electrical activity of the heart if the patient is in the monitor observation. Electrical complexes on the ECG and even weakened heart sounds can be saved, while the peripheral circulation has ceased. The patient should be laid on a hard surface, on the floor, ground, solid shield. Heart massage on a soft bed ineffective. Animator is so that his hands perpendicular dropped in a straight position on the patient's chest. If the patient lie on the floor or on the ground, the rescuer kneels down, if the patient lies on a bed with a shield - stands for any base. Otherwise, the recovery will not be able to use the power of gravity of the upper half of his body will be forced to work only with hands, quickly get tired and not be able to achieve effective cardiac massage. Hands have one on the other hands down. Proximally the lower part of the palm is placed on the lower third of the sternum (above the ventricles), slightly raising his fingers. Straight arms make jerky pressure on the lower third of the sternum, shifting her 5 - see should Not put pressure on the edges to avoid fracture Shocks do with the frequency of 60 in 1 minute, not allowing a break! in the massage more than 5 C. at the same time start the PE ratio of the massage bumps and artificial breath depends on the number of assisting. If the rescuer is alone, it makes 12-15 massage shocks, then quickly changes position and makes 2 quickly following one another artificial breath possibly greater depth, then again do cardiac massage (12-15 tremors), and so on, until when) Yes second rescuer. If resuscitation is carried out by two people, the rhythm of the other: after every 5-6 jolt of massage is carried out breath. Within the first 30-60 resuscitation should establish the effectiveness of cardiac massage, as evidenced by simultaneous with massage strokes pulsation of carotid and peripheral arteries, when measuring the HELL is the disappearance of such pulsations at a systolic pressure below 60 mm RT. Art. , pupillary constriction, the result of the skin of the patient and other signs of recovery in the peripheral circulation. Evidence of the high efficiency of the cardiac massage is to restore consciousness and breathing. Effective cardiac massage and artificial ventilation help to sustain the life of the patient without cardiac activity for quite a long time to arrival of ambulance crews and deliver the patient to the hospital, not allowing the development of irreversible changes in the body, primarily in the cerebral cortex. You should not discontinue cardiac massage and artificial ventilation, if not managed quickly to restore cardiac activity and spontaneous breathing, although long-term cardiac massage - heavy physical work, quickly tiring resuscitation. Therefore, it is desirable to perform cardiac massage alternately by 2-3 medical professionals that provides optimal conditions for the effectiveness of massage as necessary to conduct long-term (there are special devices for automatic external cardiac massage). If the closed massage of heart cannot quickly restore peripheral circulation, it must be immediately clarified the reasons for its ineffectiveness, which is easiest to do using electrocardiography. Common cause of failure cardiac massage is ventricular fibrillation, successfully fight which can only be applying electrical defibrillation. Another reason for the ineffectiveness of closed cardiac massage is the loss of heart muscle tone. In such cases, intracardiac administration of drugs that eliminate atony of the myocardium. Needle length of 10-12 cm, attached to the syringe, the dotted line in the heart of the third or fourth intercostal space, 2 cm from the edge of the sternum. The direction of vcol needle strictly vertical. You should establish that the needle is in the cavity of the heart (in the syringe should be easy to enter the blood) and there is no danger to introduce the drug into the thickness of the myocardium. Only after intracardiac injected with 0.3 - 1 ml of 0.1% solution of epinephrine or norepinephrine, dissolved in 10-15 ml of isotonic solution of sodium chloride, and 5-10 ml of 10% solution of chloride or calcium gluconate. Open cardiac massage is indicated for severe chest trauma and multiple fractures of ribs, sometimes with atony of the myocardium, if intracardiac introduction of the above drugs have led to the recovery of peripheral blood circulation. Make a left anterolateral thoracotomy in the fourth or fifth intercostal space. Heart contracts between the Palmar surface of both hands or with the palm and the Palmar surface of 1 finger of one hand. It is necessary to avoid compression of the heart ends of the fingers, as this is injured myocardium. Cessation of cardiac massage and other resuscitation measures can be justified if the patient is in a state of clinical death, it is not possible to achieve with cardiac massage restore peripheral circulation for 20-30 minutes If properly implemented cardiac massage and artificial ventilation pulsation of carotid and peripheral arteries is missing, the pupils remain dilated, breathing and cardiac activity is not restored, the skin of the patient remain sharply pale or cyanotic, can be ascertained biological death and resuscitation stop. Comments on this article yet. Be the first one! Write a comment.



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