one Confirm whether the rescuer has lost consciousness, heartbeat and breathing arrest. It is characterized by dilated pupils and loss of light reflex. The femoral artery and carotid artery could not be touched by pulse. Heart sounds disappeared; Cyanosis (Figure 1).
2. Position: Lay the rescuer flat on a flat hard ground or put a hard board behind him (Figure 2).
3. Keep the respiratory tract unobstructed: First check the respiratory tract (Figure 3), remove secretions, vomit and foreign bodies from the respiratory tract. If there is a prosthetic denture, it should be removed. To open the airway, one hand is placed on the forehead so that the head is tilted back, and the index and middle fingers of the other hand are placed on the mandible near the chin (jaw) to lift the chin forward and pull the neck (FIG. 4).
Figure 1 Assessment of patient consciousness
Figure 2 Seek help and position yourself
Figure 3 Examination of patient respiration
4. Artificial respiration and chest compressions
(1) Artificial respiration: mouth-to-mouth breathing, mouth-to-nose breathing, and mouth-to-nose breathing (infants) can be used. This procedure was performed while the airways were maintained patent and the carotid arteries were checked for pulsation (Figure 5). The operator presses the patient’s forehead with his left hand and pinches the lower end of the alar of the nose with his thumb and index finger. With the index and middle fingers of the other hand, lift the patient’s lower jaw, take a deep breath, open the mouth to completely cover the patient’s mouth, and blow deep and fast into the patient’s mouth, until the patient’s chest is lifted up. At the same time, the patient’s mouth should be open, and the hand that pinches the nose should also be relaxed, so that the patient can ventilate from the nose. observe the recovery of the patient’s chest, and have air flow out of the patient’s body. The frequency of blowing is 12-20 times/min, but it should be proportional to the heart compression (Figure 6). In single person operation, 15 cardiac compressions and 2 air blows were performed (15:2). Chest compression should be stopped during air blowing, as excessive air blowing can cause alveolar rupture.
Figure 4 Maintaining airway patency
Figure 5 Examination of carotid pulsation
Figure 6 Performing artificial respiration
(2) External chest cardiac compression: perform artificial heart compression while artificial breathing.
(i) The compression site was at the junction of the upper 2/3 and lower 1/3 of the sternum, or 4 to 5 cm above the xiphoid process (FIG. 7).
Figure 7 Determining the correct press position
(ii) Compression method: the root of the palm of the rescuer’s hand is placed tightly on the pressing site, and the other palm is placed on the back of the hand. The two hands are parallel overlapping and the fingers are crossed and held together to lift the fingers off the chest wall; The rescuer’s arms should be stretched straight, the middle point of both shoulders should be perpendicular to the pressing site, and the weight of the upper body and the muscle strength of the shoulders and arms should be used to press down vertically, so that the sternum will sag 4 to 5 cm (5 to 13 years old 3 cm, infant 2 cm); Pressing should be carried out smoothly and regularly without interruption; The time ratio of downward pressure and upward relaxation is 1:1. Press to the lowest point, there should be an obvious pause, can not impact type thrust or jump type press; When relaxing, the root of the palm should not leave the sternal fixation point, but it should be as relaxed as possible, so that the sternum is not under any pressure; A compression rate of 100 was preferred (Figs. 8 and 9). At the same time of chest compression, artificial respiration should be performed, but do not interrupt cardiopulmonary resuscitation frequently in order to observe the pulse and heart rate, and the rest time of compression should not exceed 10 seconds, so as not to interfere with the success of resuscitation.
Figure 8 Performing chest compressions
Figure 9 Correct posture for external cardiac compression
(3) The main indicators of effective compression: ① palpation of arterial pulse during compression, brachial artery systolic pressure > 60 mmHg; ② The color of the patient’s face, lips, nails and skin turned ruddy again. ③ The dilated pupil shrank again. ④ The alveolar breath sounds or spontaneous breathing could be heard during air blowing, and the breathing improved. ⑤ Consciousness gradually recovered, coma became shallower, reflex and struggle could occur. ⑥ Increased urine output.
Post time: Jan-14-2025