The meaning of cardiopulmonary resuscitation: When a person’s heart and breathing suddenly stop, basic life support must be established within 4 to 8 minutes to ensure the basic blood and oxygen supply of the body’s vital organs, until the establishment of advanced life support or their own heartbeat and breathing recovery, the specific operation is cardiopulmonary resuscitation.
1.Judging the safety of the environment
2.Judging whether there is consciousness or not
You can tap the patient’s face or shoulder and shout out the name or other name. If there is no response, it means that consciousness has been lost, use the fingers to pinch the person, while immediately shouting for help, call others to help save people, and call the emergency phone 120 or nearby hospitals as soon as possible.
Make the patient lean back on the ground or hard bed, untie the collar and trouser belt.
3.Artificial circulation chest cardiac compressions
The basic technique of artificial circulation is chest cardiac compressions. As soon as the heart is judged to have stopped beating, artificial respiration and chest cardiac compressions should be performed immediately.
The first thing to do is to find the correct location for compressions, the correct location is at the junction of the middle and lower 1/3 of the sternum, the rescuer will overlap the horizontal axis of the palm root of one hand with the long axis of the sternum, fix it and don’t move, put the other hand overlapping on the back of the hand, overlap the palm root of both hands, interlock the fingers, so that the fingers of the following hand are lifted (to avoid damage to the ribs during compressions).
Pressing method: press the upper body leaning forward, wrist, elbow, shoulder joints straight, the hip joint as the axis, vertical downward force, with the upper body weight and shoulder and arm muscle strength to press.
4.Open the airway
Open the airway, clean the mouth, nasal foreign body or secretions, if there are dentures, and clear the airway. (Only after the airway is open, the oxygen provided by artificial respiration can reach the lungs, and the human brain tissue and other important organs can be supplied with oxygen)
Airway opening techniques: supine jaw lift, supine neck lift, jaw support method.
Supine jaw lift method Essentials: Use one hand to press the forehead of the injured patient, so that the head is tilted back, while using the index and middle fingers of the other hand to hold up the chin.
5.Artificial respiration
Artificial respiration is the use of artificial methods to help patients breathe, is one of the basic techniques of cardiopulmonary resuscitation.
Immediately after opening the airway, check whether there is breathing, if not, artificial respiration should be performed immediately. The most common and convenient artificial respiration method is to take mouth-to-mouth and mouth-to-nose artificial respiration.
Mouth-to-mouth artificial respiration should be done by pinching the patient’s nostrils with one hand (to prevent the blowing gas from exiting the nostrils and not entering the lungs by the mouth), taking a deep breath, holding the breath, and tightly wrapping the lips of the comatose person’s mouth with the lips of the mouth (without leaving a gap), taking care not to leak air, and blowing the gas into the person’s mouth to the lungs under the operation of keeping the airway open. After blowing, leave the lips of the mouth and release the fingers that pinch the nose to allow the gas to be exhaled. Observe whether the person’s chest rises and falls, if the chest lifts when blowing, it means that the airway is open and the mouth-to-mouth blowing operation is correct.
After blowing, loosen the mouth and nose. Mouth-to-nose resuscitation is similar to mouth-to-mouth resuscitation and is generally used for infants and young children and people with oral trauma.
2010 International CPR Guidelines
If the patient is found on the ground, confirm that there are no risk factors at the scene that could interfere with treatment.
Determine the patient’s consciousness, (be careful to do light patting and heavy calling!) If unresponsive, call for help immediately and call the emergency number or ask someone else to do so.
Immediately place the patient in the resuscitation position (lying down), touch the carotid artery, and perform chest cardiac compressions immediately if not touched!
Open the airway immediately after 30 compressions and perform mouth-to-mouth artificial respiration.
The ratio of chest compressions to artificial respiration is 30 : 2.
When performing chest compressions alone, the frequency should be at least 100 times per minute.
External defibrillation should be performed early if possible.
Compression method: press the fish interval of one hand against the compression site, hold both hands overlapping, arms taut, shoulders in the middle above the patient’s sternum, press vertically downward, the compression force should be enough to make the sternum sink more than 5 cm, relax after pressing down, but do not leave the chest wall with both hands. Repeat the operation with a frequency greater than 100 times/minute.
Infant and child external chest heart compressions
Positioning: 1 horizontal finger below the vertical intersection of the line of both breasts and the sternum. Infant: one hand palm downward pressure. Infant: ring method, overlapping thumbs downward pressure; or one hand index finger and middle finger together downward pressure. Depth of downward pressure: at least 2.5-3.5 cm for infants and 1.5-2.5 cm for toddlers. Frequency of compressions: at least 100 times per minute.
Cardiopulmonary resuscitation termination indicators
1. The patient has resumed voluntary breathing and heartbeat.
2.The patient is determined to be dead.
3, CPR is performed for more than 30 minutes, check the patient is still unresponsive, no breathing, no pulse, no pupil retraction.
Hands-on cardiopulmonary resuscitation technical operation assessment scoring criteria
Operator preparation: dignified, neat and tidy clothing (clothing, hat and shoes), trim nails
Preparation of materials: 1 hardwood board, gauze
Assessment of the patient.
Determine the patient’s consciousness: call the patient (hey, what’s wrong with you), tap the patient’s shoulder. Confirm that the patient has lost consciousness, immediately call out for help and seek help from others.
Judgment of patient’s respiration: Ear against the patient’s mouth and nose, by seeing, hearing and feeling (see: whether there is any rise and fall of the chest; hear: whether there is any respiratory sound; feel: whether there is any gas escaping) three steps to complete, judgment time is 10 seconds.
Judgment of the patient’s carotid artery pulsation: the tips of the operator’s index and middle fingers touch the middle part of the patient’s trachea (equivalent to the laryngeal node), and open two fingers next to it to the depression of the anterior border of the sternocleidomastoid muscle. The judgment time is 10 seconds.
Key points of operation: de-pillow supine on a rigid plane (not a rigid bed with a rigid plate inserted).
Open airway.
①The rescuer is parallel to the patient’s shoulder level.
②Patient supine position solid plane such as a soft bed, under the chest need to pad the external chest compression plate, unbutton the clothes, no distortion of the limbs, de-pillow.
③ If there are clear respiratory secretions, the airway should be cleaned, remove the movable denture; open the airway by tilting the head and lifting the chin.
Artificial respiration: ① forehead pressure – pinch nose – package mouth blowing. ② loosen the nose – turn the head to look at the thorax. Repeat 2 times.
Extra-thoracic cardiac compressions.
① compression site: the junction of the middle and lower 1/3 of the sternum;
② compression technique: the root of the palm of one hand placed on the compression site, the other hand parallel overlap on the back of this hand, fingers up, both elbow joints straight, using the weight of the upper body vertical downward pressure;
③ Pressing range: make the sternum sink 5CM;
④ Pressing: relaxation time = 1:1.
⑤ Pressing frequency: more than 100 times/min;
(6) Ratio of chest compressions and artificial respiration 30:2.
⑦ Judge the patient’s carotid pulsation and artificial respiration again after 5 cycles of operation for 10 seconds, if they have recovered, perform further life support, if carotid pulsation and artificial respiration have not recovered, continue the above operation for 5 cycles and judge again.
Proficiency: first aid awareness, emergency attitude and humanistic care, rhythmical operation, and proficient action.