The concept of CPR at the scene
This refers to the technique of cardiopulmonary resuscitation, or basic life support, first administered by the initial witness to a patient in cardiac arrest.
Significance of CPR
If resuscitated within 4 min, 50% of the patients may be saved;
If resuscitation is initiated within 4-6 minutes, 10% of patients can be saved;
The survival rate for those who are resuscitated for more than 6 min is 4%;
For more than 10 min, the survival rate is almost zero.
Steps of CPR
A(Assessment+Airway)—- Determine whether there is cardiac arrest and respiratory tract patency
Determine the presence of cardiac and respiratory arrest: consciousness, touch the carotid artery, listen to the heart sounds, and observe whether there is heaving of the chest.
Call for help.
Position: The correct position for resuscitation is to place the patient in a supine position.
Clear the airway: remove foreign bodies from the mouth, nose and throat.
B (Breath)D artificial respiration
Mouth-to-mouth blowing: tilt the head and lift the jaw to open the airway. The rescuer pinches the patient’s nostrils with one hand, takes a deep breath, opens the mouth and presses it against the patient’s mouth (to completely wrap the patient’s mouth), and blows the gas into the patient’s mouth with force, the amount of gas blown into the patient’s mouth is based on the elevation of the thorax, generally 700 to 1000 ml for adults, then relaxes the nostrils and inhales fresh air for the next artificial respiration.
C (circulation)DD artificial circulation
Artificial circulation and artificial respiration must be performed simultaneously, and the ratio of compressions/ventilation is 15:2 for two-person resuscitation and 30:2 for single-person resuscitation.
Chest compressions for older children (>8 years old) and adults: place the patient on a hard board, cross the root of one palm over the back of the other hand, and press vertically on the lower part of the sternum (at the junction of the two nipples and the chest). The depth of compression is 1/3 to 1/2 of the thickness of the chest, and the frequency is 100 times/min. The ratio of compression to relaxation is 1:1.
For children aged 1 to 8 years, one hand can be used to fix the child’s head for ventilation; the root of the palm of the other hand is placed on the lower part of the sternum (one finger below the line of the two nipples), and the long axis of the root of the palm is consistent with the long axis of the sternum.
The 2008 CPR Guidelines suggest that if there are not enough resuscitators, single person chest compressions can be taken and wait for 120 rescue to arrive!