Part Three
- Cardiopulmonary resuscitation
A) For an injured adult on the street
The Definition :
The process of pumping blood through heart massage while artificially supplying air to the lungs for a person who does not breathe, does not speak, and does not respond, so that no movement is noticed above the level of the chest, and no sound of breathing is heard.
The Reasons :
Total obstruction of the airways - accidents such as drowning - suffocation - exposure to a strong electric shock - some diseases such as asthma - pulmonary edema.
The person in charge:
Nursing team.
Tools :
Hands.
Steps:
An initial assessment of the environment surrounding the injured person and ensuring that it is free of any dangerous factors (electricity, fire, drowning, etc.).
In the first 10 seconds from the beginning of seeing the injured person, the injured person is placed lying on his back, his degree of consciousness is assessed, and he is called in a loud voice with a shrug of the shoulders, “Are you okay??” '.
No response or abnormal breathing.
Never expose the injured person's chest.
Place the palm of one hand (the whole hand) vertically in the middle of the sternum between the nipples.
Start by doing chest compressions at a rate of 30 per minute
A period not exceeding 18 seconds, or less if there are one or two paramedics.
To perform cardiopulmonary resuscitation in a correct and effective manner, the following must be taken into account:
1- Place the injured person on a hard surface.
2- Begin compressions on the injured person's chest within 10 seconds.
3- Press hard, quickly, and to a depth of 5 cm in adults over 18 years old
4- Allow the rib cage to take its natural space after each compression
5- Reduce external influences (as long as they are less than 10 seconds)
6- Give the injured person an effective breath (by opening the airway by tilting the head back, pulling the chin forward, and opening the airway - but in the case of injuries to the cervical vertebrae, stabilize the injured person’s head).
7. Give 2 breaths if there is one or two paramedics present for the seriously injured person, within a period not exceeding three seconds.
8- Five consecutive segments of compressions and breathing are done (for two minutes) and breathing and pulse are re-evaluated.
Basic CPR
B) For a child injured in the street
The Definition :
The process of pumping blood through heart massage while artificially supplying air to the lungs for a person who is not breathing, speaking, or responding, so that no movement is noticed above the level of the chest, and no sound of breathing is heard.
The reasons :
Total blockage of the airways - accidents such as drowning - suffocation - exposure to a strong electric shock - some diseases such as asthma - pulmonary edema.
The person in charge:
Nursing team.
Tools :
Hands.
Action Steps :
An initial assessment of the environment surrounding the injured person and ensuring that it is free of any dangerous factors (electricity, fire, drowning, etc.)
In the first 10 seconds from the beginning of seeing the injured person, the injured person is placed lying on his back, his degree of consciousness is assessed, and he is called out in a loud voice while shaking his legs, “Are you okay??” '.
There is no response or abnormal breathing.
Call for emergency medical assistance by calling the local number.
Make sure there is a clear pulse (no less than 5 seconds and no more than 10 seconds)
The pulse in the brachial artery (the inner side of the arm for easy identification of the presence of a pulse since it is the largest artery in the body) from the side opposite the paramedic.
5. When it is confirmed that there is no confirmed pulse within 10 seconds, perform cardiopulmonary resuscitation as follows:
Never expose the injured person's chest.
Place the index and middle fingers of the hand vertically in the middle of the sternum between the nipples if there is a single paramedic and the thumbs of both hands if there are two paramedics.
Start doing chest compressions at a rate of 30 compressions in a period not exceeding 18 seconds, or less if there is one paramedic, and if there are two paramedics, give 15 compressions (30 compressions, then 2 breaths) and repeat for two minutes at a rate of 100-120 compressions and 10-12 breaths.
To perform cardiopulmonary resuscitation in a correct and effective manner, the following must be taken into account:
Place the injured person on a hard surface.
Begin compressions on the injured person's chest within 10 seconds.
Press hard, quickly, and to a depth of 4 cm in children from one to eight years of age.
Allow the rib cage to take its natural space after each compression
Reduce external influences (should be less than 10 seconds)
Give the injured person an effective breath (by opening the airway by tilting the head back and pulling the chin forward and opening the airway - or in the case of injuries to the cervical vertebrae, immobilize the injured person’s head).
d. Give 2 breaths if there is one or two paramedics present
6- Five consecutive sections of compressions and breathing are performed (for two minutes) and re-evaluation of breathing and pulse.
Note: When following these steps, infection control policies for administering treatment should be taken into account
Advanced cardiopulmonary resuscitation in hospital
The Definition :
1. The process of pumping blood through heart massage while artificially supplying air to the lungs for a person who does not breathe, does not speak, and does not respond, so that no movement is noticed above the level of the chest, and no sound of breathing is heard.
The Reasons :
2. Total obstruction of the airways - accidents such as drowning - suffocation - exposure to a strong electric shock - some diseases such as asthma - pulmonary edema.
The person in charge:
3. The nursing team.
4. Tools:
5. Hands.
Action Steps :
6. Ensure that the surrounding environment is safe for the workers and the patient (within no more than 10 seconds).
7. Adjusting the patient’s position.
8. Ensure the level of consciousness of the injured person (by gently shaking the shoulders and speaking to the patient in a loud voice, “Are you okay?” for a period not exceeding 10 seconds).
9. If the patient answers, this indicates that the heart and lungs are working well. In this case, it is evaluated whether the patient needs other assistance or not.
10. If the patient does not answer, we begin by taking the following steps:
11. Opening the patient’s airway:
12. Opening the airway by installing a laryngeal tube - this is the best way to open the airway, but it is only installed in the hospital due to the lack of capabilities and human resources trained for this in the street.
13. Assessing the patient’s breathing:
14. By looking at the patient’s chest (there is movement in the patient’s chest up and down), the duration of the assessment for breathing is 10 seconds.
15. Assessing the presence of a pulse or not:
16. By checking the pulse with the carotid artery for no more than 10 seconds and no less than 5 seconds from the direction opposite the paramedic.
1. In the absence of breathing and pulse:
2. - Pressure on the sternum a distance above the xiphoid process
3. 2 fingers in the middle of the line between the nipples.
4. - Interlock the fingers of both hands and press them together.
5. The hands should be straight and perpendicular to the chest, the back should be straight, and the force of the pressure should come from the muscles of the pelvis and legs.
6. Giving breathing to the patient through a throat tube or using a tube mask (mouth-to-mouth breathing is not given).
7. The ratio of chest compressions to the rate of breathing for the patient varies depending on whether a throat tube is present or not:
8. In case of a throat tube:
9. - Perform 30 chest compressions for 2 breaths, whether it was one paramedic or two paramedics.
10. In the absence of a throat tube:
11. - Perform 100 chest compressions per minute and at the same time give 8-10 breaths per minute.
12. Perform five divisions of chest compressions and breathing, then re-evaluate breathing and pulse.
13.
14. If the heart returns to work, chest compressions are stopped and the patient is placed on a ventilator according to his condition.
Airway obstruction ( chorus)
Definition of a lump:
Bloating occurs when a solid or liquid object or the back of the tongue blocks the airway, and the victim may quickly stop breathing and lose consciousness. The blockage may be partial or complete, such as (false teeth, food debris, coins, etc.). This may affect the patient's breathing and may lead to loss of consciousness. If immediate intervention is performed, the blockage may be partial or complete.
The Reasons:-
Trying to swallow large pieces of food without chewing them well.
It may result from a muscle spasm.
Use a denture. Artificial teeth make it difficult to feel the size of the bite while chewing and swallowing.
Talking emotionally or laughing while eating.
Walking, playing, or running with objects in the mouth.
Tags:-
Partial airway obstruction:
When the patient suffers from partial airway obstruction, he coughs forcefully in an attempt to dislodge the object blocking the airway, and he may be able to speak.
A whistle may be heard when breathing.
The injured person may hold his throat with one or both hands
If the patient is conscious:
Ask the patient to cough as this helps expel the foreign body.
If the patient cannot respond, the Hemlich-Hetti method is used
The foreign body is expelled from the airway through...
Stand behind the patient and wrap your arms around his waist.
Place the thumb side of your fist in front of the injured person's abdomen, just above the navel
And hold your fist with the other hand.
Press inward and up the abdomen with quick pushes and repeat these pushes
If the patient is a child from the age of puberty, we use abdominal pressures while holding the child on the foot for five pressures
If the patient is a child from one month to one year, the nurse uses compressions
Five dorsal compressions or five chest thrusts, but using the palm of the hand
An unconscious patient
Place the patient on his back so that the airway can be opened.
Bend the patient's head backwards with a slight tilt to one side to facilitate the expulsion of the foreign body.
The fingers are inserted to wipe the patient's mouth from the inside using a hook method.
If the foreign body does not come out, the patient is given one count of exhalation and the chest is observed to rise
Follow Hemlich's steps until the foreign body exits the airway:
Sit on your knees so that they surround the patient's thighs.
Place the palm of one hand over the stomach area.
Place the other hand on the first hand and press on the abdomen with five quick successive thrusts to increase internal pressure to help push the foreign body out.
The steps are repeated until the patient expels the foreign body.
The pulse is checked and if there is no pulse, cardiopulmonary resuscitation procedures begin.
If the injured person loses consciousness, lower him to the ground, supporting his head and neck
Clean the mouth with your finger in the shape of a hook
If there is no response, apply abdominal pressure.
