It is necessary to know the heart and understand the importance of respiration and blood circulation to human function. The heart is divided into left and right atria and left and right ventricles. Blood containing carbon dioxide is pumped from the upper and lower vena cava by the right atrium and transported from the whole body through the right ventricle. Blood containing oxygen is sent from the pulmonary artery to the alveoli through dialysis, and then sent to the left atrium through the pulmonary vein, and then pumped into the left ventricle and transported to the whole body through the aorta to maintain the vitality of cells and organs. Among them, the heart and brain cells need oxygen especially.
The principle and importance of CPR
The principle of CPR:
The air contains 8% nitrogen and 2% oxygen, including trace amounts of other gases. According to laboratory analysis, nitrogen still accounts for about 8%, but oxygen is reduced to 16% and carbon dioxide accounts for 4%. This analysis makes us know that the amount of oxygen in the exhaled gas through normal breathing is still enough to meet our normal requirements.
Artificial respiration is used to blow air into the lung cavity, and then it is combined with extra-cardiac oxygen to promote blood to exchange oxygen from the lung and recycle it to the brain and the whole body to maintain the survival of brain cells and organs.
Importance of CPR:
When the human body stops breathing and heartbeat, the heart, brain and organs and tissues will gradually become necrotic due to lack of oxygen supply. In clinic, we can find that the skin color of the patient's lips, nails and face is gradually becoming dark purple from the original normal color, and the pupil of the eye is gradually expanding. Of course, the fluctuation of the chest and the beating of the carotid artery can tell us the message of life more definitely. Within four minutes, the original oxygen in the lungs and blood can still be supplied. Therefore, when CPR is done quickly and reliably within four minutes, the brain cells will be completely recovered without being damaged. Between four and six minutes, depending on the situation, the brain cells may be damaged. If it is delayed for more than six minutes, it will definitely cause necrosis of brain cells due to lack of oxygen.
suitable timing and steps of CPR
suitable timing of CPR:
For all cases of respiratory arrest and cardiac arrest caused by drowning, heart disease, hypertension, car accident, electric shock, drug poisoning, gas poisoning and foreign body blocking the respiratory tract, cardiopulmonary resuscitation can be used to protect brain cells and organs from necrosis before going to the hospital.
Cardiopulmonary Resuscitation
I. Cardiopulmonary Resuscitation
(I) Within 1 minute and 3 seconds after cardiac arrest, the cardiac stress is the highest. At this time, the 5-15 W Sr electric energy generated by boxing the precordial area can excite the myocardium and generate electrical complex waves, which will promote the heart to jump again.
1. Methods Hold the hollow fist loosely with the right hand, and beat the precordial region, that is, the lower sternum, vertically downward with the thenar muscle side facing the patient's chest wall at a height of 2-3cm from the chest wall. Beat 1-2 times, each time for 1-2 seconds, with moderate strength. Observe the changes of ECG. If there is no change, immediately switch to chest compressions and artificial respiration.
2. Precautions
(1) Beating should not be repeated, and the maximum number of beats should not exceed two.
(2) It is not advisable to use too much force when pounding. Children are forbidden to prevent rib fracture.
1) Manually open the airway
1. Lift the neck on the back to remove the pillow. The operator is located at the patient's side, and one hand is placed on the patient's forehead to press back, so that the head leans back, and the other hand holds the neck and lifts the neck upward.
2. The chin-lifting method is located on the patient's side. One hand is placed on the patient's forehead to press the head back, and the fingers of the other hand (except the thumb) are placed on the mandible outside the chin to lift the chin. Be careful not to compress the submandibular soft tissue, so as not to compress the airway.
3. The chin-supporting method is located on the side of the patient's head, with his elbows on the same horizontal plane of the patient's back. He holds the mandibular angle on both sides of the patient with both hands and pulls it upward, so that the chin is forward and his head is backward. At the same time, his lower lip can be pulled down with both thumbs to make his mouth smooth.
1. Patients * * * Patients lie on their backs on hard beds or on the ground, with their heads and hearts at the same level to ensure cerebral blood flow. If possible, the lower limbs should be raised to increase the blood volume.
2. The performer * * * is close to the patient's chest side. In order to ensure that the pressure acts vertically on the patient's sternum, the performer should stand on the ground or footstool, or kneel * * * according to the specific situation of the rescue site.
3. The pressing position is in the lower 1/3 of the sternum. The location is determined by the following methods: the operator uses one hand close to the patient's foot ... >; >
Question 2: Does CPR not include pinching people? The so-called unarmed CPR refers to mouth-to-mouth resuscitation and chest compressions. Pinching people is just a kind of pain to coma patients, and it can also be considered as a kind of pain reflex, which can only explain the consciousness, not a method of cardiopulmonary resuscitation.
Question 3: What are the three aspects of cardiopulmonary resuscitation (CPR) technology? 1. Basic life support, whether professional first responders or the first non-professional first responders, is often implemented on the spot and immediately. Due to the popularity of the public, it is required to start within 4 minutes. Without any first-aid auxiliary facilities, only one hand and one mouth are used for life rescue, that is, cardiopulmonary resuscitation, including chest compressions, to establish effective artificial circulation; Open the airway and carry out first aid artificial respiration; And as soon as possible, defibrillation will be used to restore ventricular fibrillation and promote the heart to return to spontaneous beating.
2. Advanced Life Support (BLS), which is generally carried out by professional first responders, requires to establish and maintain effective ventilation and blood circulation, establish effective venous access, conduct ECG monitoring, identify and treat arrhythmia, maintain cardiopulmonary function and treat primary diseases within 8 minutes on the basis of BLS. BLS is the foundation of the following stages. If there is no timely and effective cardiopulmonary resuscitation on the spot, the patient will have no chance for follow-up treatment.
3. Post-CPR treatment is carried out by professionals, usually in hospital, mainly for brain resuscitation and treatment of primary diseases and complications of cardiac arrest. The functions and coagulation status of heart, lung, liver, kidney and digestive organs should be closely monitored.
Question 4: What does a perfect cardiopulmonary resuscitation include? Cardiopulmonary resuscitation (CPR). Cardiopulmonary resuscitation (CPR), also known as basic lifesupport,BLS), is one of the first-aid measures that must be taken within 4-6 minutes for cardiac arrest caused by various reasons. The purpose is to save brain cells from necrosis under hypoxia as soon as possible (brain damage begins in more than four minutes, and irreversible brain damage occurs in more than ten minutes), so the sooner the rescue opportunity, the better. Cardiopulmonary resuscitation (CPR) is suitable for coma caused by heart attack, drowning, asphyxia or other accidents, with respiratory and cardiac arrest.
standard procedures of cardiopulmonary resuscitation
1. The procedures (referred to as A, B and C) and operations of single-person cardiopulmonary resuscitation are as follows:
A.(asses *** ent+airway) From judging whether consciousness exists to judging whether spontaneous breathing exists, that is, the following items (1) to (5).
B.(breathing) Blow air from mouth to mouth, that is, item (6) below.
C.(circulation) Judge whether the pulse disappears or not and chest compressions, namely the following items (7) and (8).
(1) judge whether the patient has consciousness and reaction after cardiopulmonary resuscitation, pat the patient on the shoulder and shout loudly: "hello! What's the matter with you? " (2) Start the EMS system (pre-hospital emergency medical service system). If the patient does not respond, call the emergency number 12 immediately and start the EMS system in time. If there is only one rescuer at the scene, you should call for help loudly and seek help from others at the same time. The 25 International Guide to Cardiopulmonary Resuscitation and Cardiovascular First Aid suggests that if patients are found to be unresponsive, they should immediately call and start EMS；. However, for drowning, trauma, drug poisoning and children under 8 years old, CPR with bare hands should be performed for one minute before calling the emergency number for help.
(3) Put the patient in the resuscitation position * * * If the patient is prone or lying on the side, kneel on one side of the patient's body quickly, fix the back of his neck with one hand, and fix his axil (suitable for cervical vertebra injury) or hip (suitable for thoracic or lumbar vertebra injury) with the other hand, and turn the patient over as a whole to become supine position, that is, the head, neck, shoulders, waist and hip must be on the same axis. The patient should lie on his back on a solid plane, not a soft bed or sofa; The head should not be higher than the chest, so as not to reduce cerebral blood perfusion and affect the effect of CPR.
(4) After cardiac arrest by opening the airway, the muscle tension of the whole body decreases, including that of the pharynx, which leads to tongue falling back and airway obstruction. If the jaw of lower cardiopulmonary resuscitation is pushed forward, the tongue can leave the throat; At the same time, the backward extension of the head can open the airway. If you find foreign bodies in your mouth, such as food, vomit, teeth with blood clots, sediment, dentures, etc., you should clean them up as soon as possible, otherwise it can also cause airway obstruction. No matter what method is chosen to open the airway, the line between the earlobe and the mandibular angle should be perpendicular to the plane of the patient lying on his back before the airway can be opened. In the whole process of CPR, the airway should always be open. The commonly used methods of opening the airway are as follows: 1. Pressing the forehead and lifting the chin. If the patient has no cervical spine injury, this method can be the first choice. Stand or kneel on one side of the patient's body, and press down with one hand hypothenar on the forehead of the patient; At the same time, the other hand and the middle finger are put together, and the bony part placed on the chin is lifted upward, so that the chin and jaw are lifted upward, the head leans back, and the airway can be opened. 2. If cervical spine injury has occurred or is suspected, using this method can avoid aggravating cervical spine injury, but it is not convenient for mouth-to-mouth blowing. Stand or kneel at the top of the patient's head, with the elbow supported on the patient's supine plane. Put your hands on both sides of the patient's head, respectively. Fix the mandibular angles on both sides of the patient's cardiopulmonary resuscitation with your hands and your middle finger, and fix the temporal bones on both sides with your thenar. Pull up the mandibular angles on both sides so that your head leans back and the airway can be opened. 3. Stand or kneel on the side of the patient's body by pressing the forehead and holding the jaw, and press the patient's forehead with one hand; At the same time, the thumb, food and middle finger of the other hand are respectively placed at the mandibular angles on both sides and lifted upwards, so that the head leans back and the airway can be opened. In practice, this method is superior to other methods, which is not only reliable in effect, but also labor-saving, will not cause or aggravate cervical spine injury, and is convenient for mouth-to-mouth blowing. (
5) After judging whether the airway is open, immediately put one ear close to the patient's nose and mouth, and judge whether the patient is breathing by seeing, hearing and feeling. The judgment time should not exceed 1 seconds, and it should be based on seeing. At first glance, observe whether the patient's chest has ups and downs with his eyes. Second Listening > >
Question 5: What are the seven sessions of cardiopulmonary resuscitation? Your "seven sessions" probably include seven steps: discovery, checking consciousness, breathing, calling for help and cardiopulmonary resuscitation.
Step 1: Call for help and dial 12. Accurately report the address and tell the medical staff the contact information, indicating that someone fainted.
step 2: evaluate the environment. Don't save people blindly when someone faints and the environment is unsafe and can't guarantee their lives.
Step 3: Check your consciousness. Shout "What's wrong with you?" in his ears first. . If there is no response, you can pat his shoulder or pinch his ear.
step 4: check whether you are breathing. Mainly depends on whether his chest has ups and downs, and the time is controlled within 1 seconds. Or check his pulse (not required by non-professionals), and the carotid artery is 1~2 cm next to the trachea.
step 5: chest compressions. By increasing the pressure in the chest cavity or directly pressing the heart to drive blood flow, effective chest compression can produce 6~8mmHg arterial pressure. Let the patient lie flat on the flat ground first, and the pressing process can't be interrupted. Generally, another person presses for 2 minutes to avoid fatigue. The palmar root is pressed in contact with the lower sternum, with a depth of 5-6 cm, a frequency of 1-12 times/min and a pressing time of 3 times.
step 6: unblock the respiratory tract. Before opening the airway, check whether there are foreign bodies in the mouth and clean them up. There are two methods to open the airway: lifting the chin (not suitable for patients with cervical diseases) and chin-supporting method.
step 7: artificial respiration. Hold the patient's nose with one hand, completely wrap the patient's mouth with your mouth, and blow slowly, each time lasting more than 1 second. You can't take a deep breath and do it again, which may blow the patient's lungs. After blowing one breath, immediately release the hand holding the nose and let the patient complete the exhalation process independently. * * * Blow twice.
then repeat the steps from step 5 to step 7.
Question 6: What is the first aid for cardiopulmonary resuscitation? Hand-held cardiopulmonary resuscitation is an important first aid method including mouth-to-mouth resuscitation and chest compressions. It is suitable for patients with cardiac arrest and breathing. For non-professionals, if someone falls to the ground for unknown reasons, can't wake up, and is not breathing, cardiopulmonary resuscitation can be started (because non-professionals don't need to master pulse examination); For professional emergency personnel, if the pulse of the patient does not touch the pulse of the aorta within 1 seconds (check the pulse and observe whether there is respiratory fluctuation in the chest), then start cardiopulmonary resuscitation. In a word, the indication of cardiopulmonary resuscitation is cardiac arrest.
Question 7: The whole method of cardiopulmonary resuscitation should only be used when the wounded are in any situation. The indication of cardiopulmonary resuscitation is cardiac arrest, that is, the wounded are unconscious, have no breathing and have no pulse. However, for non-professionals, it is only necessary to start cardiopulmonary resuscitation when the injured person or patient loses consciousness and is not breathing, and the judgment of pulse does not require mastering.
question 8: what is the content of primary life-saving CPR? The correct order is that CPR in basic life support generally includes only three steps: chest compressions C, airway opening A and artificial respiration B.. And this is exactly their correct operation sequence at present. Note that it is to press first and then do other operations, instead of pressing at the end as before.
question 9: judging whether the patient is conscious by performing on-site cardiopulmonary resuscitation. When performing cardiopulmonary resuscitation, the method of judging the patient's consciousness is "patting and shouting". The rescuer patted the patient's shoulders with both hands and shouted in the patient's ears, "Are you okay? Are you all right? " (or you can call the name directly if you know the name). If the patient does not respond, it is considered that he has lost consciousness.
question 1: briefly describe the operation flow of cardiopulmonary resuscitation.