Technique for performing indirect heart massage. Heart massage Hand position for heart massage

To resume the function of the cardiac system after stopping its central organ and maintaining blood circulation, an artificial, i.e., indirect heart massage, is performed, which is a set of measures.

The essence of the procedure

This is a resuscitation measure that is effective in the first 3-15 minutes after the cessation of the heartbeat. In the future, irreversible consequences occur, leading to clinical death.

Closed heart massage and direct exposure are not the same thing.

1. In the first situation, there is mechanical pressure on the chest, as a result of which the heart chambers are compressed, which contributes to the entry of blood first into the ventricles, and then into circulatory system. Due to this rhythmic effect on the sternum, the flow of blood does not stop.
2. Direct is made at the time of surgery when opening the chest cavity, and the surgeon squeezes the heart with his hand.

Closed massage is correctly combined with artificial ventilation of the lungs. The depth of pressure is at least 3, maximum 5 cm, which contributes to the release of air in the range of 300-500 ml.

After compression is complete, the same volume returns to the lungs. As a result, active-passive inhalation-exhalation occurs.

Indications for carrying out

Before starting an external heart massage, it is important to assess how necessary it is for the victim. For its implementation, there is only one indication - the cessation of the heartbeat.

The symptoms of this condition are:

• sudden onset of sharp pain in the region of the heart, which has never been before;
• dizziness, loss of consciousness, weakness;
• pale skin with a bluish tint, cold sweat;
• dilated pupils, swelling of the veins of the neck.

This is also indicated by the absence of pulsation on carotid artery, the disappearance of breathing or convulsive breaths.

As soon as such symptoms have arisen, it is necessary to immediately seek help from any person (neighbor, passerby on the street) and call a medical team.

Cardiac arrest is possible due to hemorrhagic or anaphylactic shock, due to lack of oxygen, hypothermia, or other unidentified factors.

First aid algorithm

Before you start resuscitation, you need to immediately call an ambulance. In the future, the algorithm of actions is based on the belief:

• in the absence of heart beats and pulse, for which the carotid arteries are felt with fingers, the left area is listened to with the ear chest;
• in the presence of other indicators of clinical death - there is no reaction to any actions, there is no breathing, fainting, the pupils are dilated and do not respond to light.

The presence of such signs is an indication for a heart massage procedure.

Methodology and sequence of carrying out

After the final conclusion about the absence of a heartbeat, they begin resuscitation.

The execution technique consists of several stages:

1. Place the patient on a hard, flat surface (the floor is optimal). The massage rules do not allow placing the victim on a bed, sofa or other soft place, so there should be no deflection when pressing, otherwise the effectiveness of the procedure will be zero.
2. With a napkin or handkerchief, clean the patient's mouth from foreign objects (remnants of vomit, blood).
3. Tilt back the head of the victim, you can put a roller of things under the neck, which will prevent the tongue from falling. Free the massage area from clothing.
4. Kneel on the left side (or on the right, if the rescuer is left-handed) from the patient, place your palms on the lower third of the sternum and above the xiphoid process by two folded fingers.
5. Determine the location of the hands so that one palm is perpendicular to the axis of the chest, and the second is on the back surface of the lower one, at 90 degrees to it. The fingers of the hands do not touch the body, and on the lower palm they are directed upwards, towards the head.
6. With straight arms, using the strength of the whole body, rhythmic, jerky pressure on the chest is carried out until it deflects by 3-5 cm. At the maximum point, you need to hold your palms for at least 1 second, then stop the pressure, leaving your hands in place. In one minute, the frequency of pressing should not be less than 70, optimally - 100-120. Every 30 compressions, artificial respiration is needed into the victim's mouth: 2 exhalations, which will saturate the lungs with oxygen.

When massaging, pressing should be carried out strictly vertically, along the line connecting the spine and sternum. The compressions are smooth, not harsh.

Duration and signs that determine the effectiveness of massage

The procedure should be done before the resumption of heart rate and breathing, in their absence - before the arrival of an ambulance or for 20-30 minutes. After this period of time, if not positive reaction of the victim, biological death often occurs.

The effectiveness of massage is determined by the following features:

• change in skin color (pallor, grayish or bluish tint decreases);
• constriction of the pupils, their response to light;
• the occurrence of pulsation in the carotid arteries;
• return of respiratory function.

The effect of resuscitation measures depends both on the speed and order of execution, and on the severity of the disease or injury that provoked cardiac arrest.

Baby massage

It happens that an indirect heart massage is required for a child, even a newborn. It must be carried out instantly, to prevent irreversible consequences.

In infants, cardiac and respiratory arrest is possible due to:

• drowning while bathing;
• complicated neurological diseases;
• acute bronchospasm, pneumonia;
• sepsis.

Similar conditions occur in babies as a result of the syndrome sudden death or primary cardiac arrest.

Symptoms upon cessation of respiratory and cardiac work are the same as in an adult, the same technique and sequence of activities, but with separate nuances.

Infants are pressed not with the palm of their hand, but with two folded fingers - middle and index, for children 1-7 years old - with the hand of one hand, for victims over 7 years old - in the same way as for an adult - with 2 palms. When pressed, the fingers are located lower than the line of the nipples, the compression should not be strong, since the chest is quite elastic.

During massage, its deflection is:

• from 1 to 1.5 cm in a newborn child;
• from 2 to 2.5 cm in babies older than 1 month and up to a year;
• 3 to 4 cm in children after 12 months.

In one minute, the number of clicks should correspond to the child's heart rate: up to 1 month - 140 beats, up to a year - 135-125.

Essentials for massage

For the effectiveness of the procedure, it is important to follow the basic rules:

1. When compressing the chest, the next pressure should be after returning it to its normal position.
2. Elbows do not bend.
3. In an adult victim, the deflection of the sternum is at least 3 cm, in newborns - 1.5 cm, in children older than a year - 2 cm. Otherwise, there will be no normal blood circulation and it will not be released into the aorta. Consequently, the blood flow will not be established, and the death of the brain will begin due to oxygen starvation.

The first aid technique prohibits the procedure in the absence of breathing, but the presence of a pulse. In such a situation, only artificial respiration is used.

It is allowed to provide the necessary assistance to a person who is in fainting, since he cannot consent to this or refuse. If the victim is a child, then such measures can be applied if he is alone and there are no people close to him (parents, guardians, accompanying persons) nearby. Otherwise, their consent is required.

It is important to remember that providing emergency care start immediately in all situations. But it is highly not recommended to carry it out if there is a threat to one's own life.

Complications and mistakes during massage

The main negative point in the massage may be a fracture of the ribs. The fact that this happened is evidenced by a characteristic rather loud crunch and drawdown of the chest.

If such a complication occurs, resuscitation should not be interrupted, it is enough to reduce the frequency of pressing on the sternum.

In such a situation, the priority becomes the resumption of the heartbeat, not the broken ribs..

Often, the effectiveness of resuscitation is low due to mistakes made:

• compressions are performed above or below the desired location;
• the position of the patient on a soft, and not on a hard surface;
• there is no control over the state of the victim, and impulsive twitches are taken for a meaningful body movement.

When cleaning the oral cavity before the massage, it is impossible to rinse it with water, as the liquid will fill the lungs and bronchi and will not allow breathing to be restored (the condition of drowned people).

After regaining consciousness, patients often behave inappropriately. This is a normal reaction. It is necessary to prevent their excessive activity and mobility until the ambulance arrives.

Efficiency Forecast

The effectiveness of resuscitation has a different prognosis - from 5 to 95%. Usually 65% ​​of the victims manage to restore cardiac activity, which allows them to save their lives.

Full recovery of all functions is possible in 95% of cases when resuscitation measures have brought an effect in the initial 3-5 minutes after the heartbeat has stopped.

If breathing and heartbeat the victim recovered after 10 minutes or more, then there is a considerable probability that the functioning of the central nervous system, as a result of which he will remain disabled.

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Resuscitation actions are carried out when a person has a lack of pulse and breathing. Resuscitation measures include indirect heart massage and artificial ventilation of the lungs (artificial respiration). Each person should be trained in these skills in order to provide timely assistance to the victim and save his life.

Resuscitation measures must be carried out correctly, in accordance with medical standards and algorithms. Only with proper cardiopulmonary resuscitation is it possible to restore vital functions.

Technique of indirect heart massage and artificial lung ventilation

External (indirect) heart massage is a compression that leads to compression of the heart muscle and pumping blood around the body. The indication for closed heart massage is the absence of a pulse. Moreover, the pulse must be determined only on large arteries (femoral, carotid).

Rules and procedure for conducting indirect (external) heart massage:

• A second hand is superimposed on top of the working one;
• It is necessary to make compressions only with arms straightened at the elbows. In this case, you need to press with your whole body, and not just with your hands. Only in this case will there be sufficient force to compress the heart;
• Only the sternum is pressed through by 3 - 5 centimeters, you can not touch the ribs;
• Compressions should be rhythmic and equal in strength. The frequency of compressions is from 100 to 120 per minute.

CPR can be performed in several ways: mouth to mouth, the most commonly used method, mouth to nose, mouth to mouth and nose, used in young children and with an Ambu bag.

Algorithm for performing artificial respiration:

• Lay the person on a flat surface, put a small roller under the neck. Open your mouth and check for foreign bodies in it;
• Place a handkerchief or gauze over the victim's mouth or nose. This will protect the rescuer from contact with the secretions of the victim and possible infection;
• Pinch the nose of the patient;
• Inhale, put your lips around the open mouth of the patient and press them tightly so that the air does not escape. And exhale in the usual volume;

• Control the correctness of artificial respiration. While inhaling air, pay attention to the person's chest. She must rise;
• Inhale and exhale again into the victim's mouth. It should be noted that the rescuer should not breathe often and deeply. Otherwise, he will feel dizzy and may lose consciousness.

First perform artificial respiration. It is necessary to take 2 breaths in a row, the elapsed time is 10 seconds, and then proceed to indirect massage.

The ratio of artificial respiration (IVL) to chest compressions is 2:15.

Resuscitation of one person

Resuscitation is a labor-intensive and energy-consuming process. Therefore, it is recommended that 2 rescuers carry them out. But this condition is not always feasible. Therefore, in some situations, it is necessary for 1 person to perform rescue procedures. How to act in such conditions?

Technique for performing indirect heart massage and ventilation by one person:

• Lay the victim on his back on a flat surface, put a roller under the neck;
• First, ventilation is performed by mouth-to-mouth or mouth-in. If injections are made through the nose, then you should close your mouth and fix it by the chin. If artificial respiration is carried out through the mouth, then pinch the nose;
• 2 breaths are carried out;
• Then the rescuer immediately proceeds to perform an indirect massage. He must perform all manipulations clearly, quickly and correctly;
• 15 compressions (pressures) are performed on the chest. Then again artificial respiration.

It is difficult for one person to perform cardiopulmonary resuscitation, therefore, in this case, the number of compressions should not be less than 80 - 100 per minute.

The rescuer performs resuscitation until: the appearance of a pulse and breathing, the arrival of the Ambulance, the expiration of 30 minutes.

Carrying out cardiopulmonary resuscitation by two rescuers

If there are two rescuers, then resuscitation is much easier to perform. One person does artificial respiration, and the second indirect massage.

Algorithm for performing indirect (external) heart massage 2rescuers:

• The victim is correctly laid down (on a hard and even surface);
• 1 rescuer is located at the head, and the second puts his hands on the sternum;
• First, you need to make 1 injection and check the correctness of its implementation;
• Then 5 compressions, after which the events are repeated;
• Compressions are counted by ear so that the second person can prepare in time for mechanical ventilation. Resuscitation in this case is carried out continuously.

The speed of compressions in the provision of cardiopulmonary resuscitation by 2 people is 90 - 120 per minute. Rescuers must change so that the effectiveness of resuscitation does not decrease over time. If the rescuer who performs the massage wants to change, then he must warn the second rescuer in advance (for example, during the count: "changed", 2, 3, 4.5).

Features of external heart massage and mechanical ventilation in children

The technique of performing resuscitation for children directly depends on their age.

Signs of the effectiveness of cardiopulmonary resuscitation

It should be remembered that only effective and correct resuscitation can save a person's life. How to determine the effectiveness of rescue procedures? There are several signs that will help assess the correctness of the performance of cardiopulmonary resuscitation.

Signs of the effectiveness of chest compressions include:

• The appearance of a pulse wave on large arteries (carotid femoral) at the time of compression. It can track 2 rescuers;
• The dilated pupil begins to narrow, a reaction to light appears;
• The skin changes color. Cyanosis and pallor are replaced by a pinkish tint;
• Gradual increase in blood pressure;
• There is an independent respiratory activity. If there is no pulse at the same time, then it is necessary to continue to perform only actions without mechanical ventilation.

The main mistakes during resuscitation

For cardiopulmonary resuscitation to be effective, it is necessary to eliminate all errors that can lead to death or serious consequences.

The main mistakes in the implementation of rescue activities include:

• Delay in providing assistance. When a patient has no signs of vital activity, namely pulse and breathing, a few minutes can decide his fate. Therefore, resuscitation should begin immediately;
• Insufficient strength when performing compressions. In this case, a person presses only with his hands, and not with his body. The heart does not contract enough and therefore the blood is not pumped;

• Too much pressure. Especially in small children. This may damage internal organs and separation of the sternum from the costal arches and its fracture;
• Incorrect hand placement and pressure with the whole hand leads to fracture of the ribs and damage to the lungs;
• Long break between compressions. It should not be longer than 10 seconds.

Further rehabilitation of a person

A person who has stopped breathing and cardiac activity even for a short time must be hospitalized. In the hospital, the doctor will determine the severity of the patient's condition, and prescribe the appropriate treatment.

In the hospital, it is mandatory to carry out:

• Laboratory and instrumental examination;
• If necessary, life support in the intensive care unit. If the patient does not breathe on his own, then connect the ventilator;
• infusion therapy and parenteral nutrition if necessary;
• Symptomatic therapy (maintaining the work of the cardiac, respiratory, cerebral, urinary systems).

The duration of rehabilitation depends on many factors.:

• Cause of cardiac and respiratory arrest. The more serious the pathology, the longer the recovery takes;
• Duration of clinical death;
• Patient's age;
• The general condition of his body before development pathological condition(presence of chronic, congenital diseases).

When should chest compressions be used?

An indirect heart massage is performed when the patient has no pulse, that is, clinical death. This is the only and absolute indication. There are many reasons for cardiac arrest (acute coronary insufficiency, anaphylactic, pain, hemorrhagic shock, exposure to low temperatures, and so on).

It should be noted that it is important to provide resuscitation assistance only in the absence of a pulse. If the heart rate is weak and rare, then chest compressions should not be done. Since in this case, this manipulation will only lead to cardiac arrest.

If a person is found on the street, then you need to approach and ask if he needs help. If the person does not respond, then call an ambulance and determine the presence of breathing and pulse. If they are not available, proceed with CPR immediately.

External signs that indicate cardiac arrest:

• Loss of consciousness;
• Paleness and cyanosis of the skin and mucous membranes;
• Dilated pupils do not react to light;
• Swelling of the neck veins.

Good day, dear readers!

It is the last day of May, and despite the great gusts of wind with heavy precipitation that swept through Russia and Ukraine the past days, many of us are already mentally, and maybe physically, on vacation, on vacation, somewhere on water bodies, or even the seas , oceans.

Of course, you can’t forbid living well, and thank God for this, but unfortunately, many of the people, having slightly “pulled” a couple of glasses of beer, or something else stronger, with the thoughts “knee-deep sea” climb into the pond. Many people come out of the water with great emotions, but there are people who either had a cramp in the water, or their heart went haywire, or they just got frightened and the person began to drown. Naturally, alcohol is not the only cause of the above problems in the water, but according to statistics, it still prevails in many cases of drowning.

Other common causes of cardiac arrest include:

• Electric shock;
• ventricular fibrillation;
• asystole;
• Strong, when the body temperature drops below 28 ° C;
• or hemorrhagic shock;
• Lack of oxygen, suffocation.

The heart - the main functions and consequences of its stop

The heart is not only the "motor" of the body, but also a kind of "pump", consisting of four chambers - 2 atria and 2 ventricles. Due to its ability to contract and relax, the blood circulation of the whole organism occurs.

Together with the blood flow, all organs and tissues of the body are supplied with oxygen, nutrients without which they die. In addition, the blood absorbs waste products of its vital activity, which then enter the kidneys, lungs and skin and are excreted from the body.

When the heart stops, blood circulation stops, while the supply of all organs with vital substances, as well as oxygen, without which the cells begin to die rapidly, stops. In addition, carbon dioxide and other waste products of organs cease to be excreted from the body, which provokes poisoning of the body.

For example, brain cells begin to die within 3-4 minutes from the onset of cardiac arrest. Of course, there are exceptions, but these are only isolated cases.

Generally, maximum amount the time allotted to start the heart so that irreversible consequences do not appear is only 7 minutes.

Symptoms of cardiac arrest

Signs of cardiac arrest are:

• No pulse- to check the pulse, you need to attach two fingers (index and middle) to the carotid artery
• Respiratory arrest- to determine, look at the chest, whether it is in a respiratory movement, or bring a mirror to your nose, if it sweats, then there is breathing;
• dilated pupils that do not respond to the glow of a flashlight and other light sources;
• Loss of consciousness if a person does not come to their senses when they are patted on the face or loud sounds(scream and others);
• Change in skin color to a bluish tint.

Heart massage - what is it for?

Heart massage implies squeezing the heart with a certain frequency, which, firstly, contributes to the artificial pumping of blood, and secondly, the activation of its own electrical activity, which together helps to restore the work of the heart.

Depending on the method, there are direct and indirect heart massage.

Direct cardiac massage is based on a direct impact on it - direct access to the heart is provided and its squeezing and unclenching begins with hands.

Based on pressure on the chest in the area where the heart is located. Thus, in fact, the pressure on the heart is produced by the chest.

In most cases, during cardiac arrest, the victim is given an indirect massage, since only a doctor can do a direct heart massage, and then with the help of special equipment.
Today we will consider exactly indirect heart massage, as well as its rules and techniques.

Rules and technique of chest compressions

First of all, in this situation, try not to lose self-control, and remember that from right action, and of course, the further life of a person depends on God's mercy.

If there are other people nearby, ask someone to call an ambulance, in the meantime, begin resuscitation to start the heart.

Indirect heart massage - execution technique

1. Determine the location of the xiphoid process located on the human chest.

2. Determine the place of compression (squeezing), heart massage, which is located at a distance of two transverse fingers above the end of the xiphoid process.

3. Place the base of your palm on the massage site, and take a strictly vertical stance above this place, straightening your arms straight in front of you.

4. Smoothly, strictly vertically above the massage site, apply pressure on the chest, pushing it 3-5 cm, with a frequency (compression) of 101-112 pressures per minute.

• For adults, massage is done with the bases of the palms, with the direction thumb in the direction of the head or legs, while all fingers are raised up, i.e. bodies do not touch;
• For adolescents, indirect heart massage is performed with the palm of one hand;
• For children under 2 years of age, pressing is done with the tufts of the index and middle fingers (palm side of the fingers).

5. Between pressing, for better efficiency of resuscitation of the heart, it is necessary to do artificial lung ventilation (ALV). The ventilation cycle is 2 breaths for every 15 clicks, while the victim's nose must be closed. Just be sure to check if there are various masses in the oral cavity (mucus, blood, vomit) that could block breathing, and if any, remove them with a piece of tissue.

When combined with indirect massage with defibrillation, the interval between pressing should not exceed 5-10 seconds.

If during indirect heart massage and mechanical ventilation, the victim began to feel the pulse, and the pupils react to the light source, then your actions have been effective.

Indirect (closed) heart massage - video

Chest Compression Technique

Circulation can be restored by pressing on the chest. In this case, the heart is squeezed between the sternum and the spine, and blood is pushed out of the heart into the vessels. Rhythmic pressing imitates heart contractions and restores blood flow. This massage is called indirect because the rescuer acts on the heart through the chest.

The victim is laid on his back, always on a hard surface. If he is lying on the bed, he should be placed on the floor.

The clothes on the patient's chest are unbuttoned, freeing the chest. The rescuer stands (in full height or on his knees) to the side of the victim. He places one palm on the lower half of the patient's sternum so that the fingers are perpendicular to it. Place the other hand on top. Raised fingers do not touch the body. The straight arms of the rescuer are located perpendicular to the chest of the victim. Massage is performed with quick pushes, the weight of the whole body, without bending the arms at the elbows. In this case, the patient's sternum should bend by 4-5 cm.

Scheme of actions of the resuscitator

1. Lay the victim face up on a hard surface.
2. Tilt his head back.
3. Give the patient 2 breaths using the mouth-to-mouth or mouth-to-nose method.
4. Check the pulse on the carotid artery. If not, continue resuscitation.
5. Start chest compressions: do 15 chest compressions in a row at 1-second intervals.
6. 2 more breaths of artificial respiration. Do 4 such cycles (30 presses and 2 breaths each).
7. Then check the carotid pulse again. If not, resuscitation continues. Repeat 5 cycles of 30 presses and 2 breaths.

Scheme of actions of two rescuers

1. Lay the victim on their back on a hard surface.
2. Tilt your head back.
3. Stand on the side of the patient: the first rescuer is at the head (he breathes for the patient), the second is opposite the chest (he massages the heart).
4. The first rescuer gives 2 breaths of artificial respiration.
5. The second rescuer checks the pulse on the carotid artery. If not, resuscitation continues.
6. The second rescuer presses the chest five times in a row with an interval of 1 second, massaging the patient's heart.
7. After that, the first rescuer takes 1 breath to the victim.
8. So in turn, the rescuers spend 10 cycles - each cycle includes 5 clicks and 1 breath.
9. Then check the pulse on the carotid artery. If it is not there, resuscitation is continued: repeat 10 cycles of 5 clicks and 1 breath.

see also

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See what "Indirect heart massage" is in other dictionaries:

I Heart massage is a method of resuming and artificially maintaining blood circulation in the body by rhythmic contractions of the heart, which promote the movement of blood from its cavities to the main vessels; used in cases of sudden termination ... ... Medical Encyclopedia

Heart massage- Rice. 1. The place of contact between the arm and the sternum during an indirect heart massage. Rice. 1. The place of contact between the arm and the sternum during an indirect heart massage. Heart massage is a mechanical effect on the heart after it has stopped in order to restore it ... ... First health care- popular encyclopedia

Artificial heart massage (or indirect heart massage) is a set of measures aimed at maintaining blood circulation in a person during cardiac arrest. Contents 1 Chest compression technique 1.1 Scheme of actions of the resuscitator ... Wikipedia

See Indirect cardiac massage... Big Medical Dictionary

Massage- Massage. MASSAGE (French massage, from Arabic masses to touch), mechanical impact by special techniques on the surface of the body or any organ for therapeutic or hygienic purposes. It is carried out by hands, less often by devices (see Vibrotherapy) ... Illustrated Encyclopedic Dictionary

- (French massage from Arabic masses to touch), mechanical impact by special techniques on the surface of the body or any organ for therapeutic or hygienic purposes. Enhances perspiration and sebum secretion, improves blood and lymph circulation, metabolism… Big Encyclopedic Dictionary

• How NMS is carried out
• Recommendations for effective massage
• Closed heart massage for a child 10-12 years old
• Technique and rules for NMS and artificial respiration for infants

The first and main method of rescuing a person who has stopped breathing is chest compressions, or NMS. It can be carried out in order to restore the work of the heart muscle simultaneously with blood circulation, since it requires mechanical action. Only after this is the restoration of the vital activity of the body and the continuous blood flow normalizes.

If a cardiac arrest occurs, then in almost any case it is necessary to do artificial respiration. The patient will need first aid to maintain the vital activity of his body, until he arrives ambulance. To carry out all the activities associated with NMS, significant efforts are required, which involve artificial respiration.

The main signs of cardiac arrest

Cardiac arrest is considered a sudden and complete cessation of cardiac activity, which in certain cases can occur simultaneously with the bioelectrical activity of the myocardium. The main reasons for stopping are:

1. Asystole of the ventricles.
2. Paroxysmal tachycardia.
3. and etc.

Predisposing factors include:

1. Smoking.
2. Age.
3. Alcohol abuse.
4. Genetic.
5. Excessive stress on the heart muscle (for example, playing sports).

Sudden sometimes occurs due to injury or drowning, possibly due to clogged respiratory tract as a result of electric shock.

In the latter case, clinical death inevitably occurs. It should be remembered that the following signs can signal a sudden cardiac arrest:

1. Consciousness is lost.
2. Rare convulsive sighs appear.
3. There is a sharp pallor on the face.
4. In the region of the carotid arteries, the pulse disappears.
5. Breathing stops.
6. Pupils dilate.

An indirect heart massage is performed until the restoration of independent cardiac activity occurs, among the signs of which the following can be distinguished:

1. The person comes to consciousness.
2. A pulse appears.
3. Decreases pallor and blueness.
4. Breathing resumes.
5. Pupils constrict.

Thus, in order to save the life of the victim, it is necessary to carry out resuscitation, taking into account all the circumstances, and at the same time call an ambulance.

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How NMS is carried out

Carrying out NMS, or external heart massage, is performed with artificial ventilation of the lungs.

This is done by alternating between ventilation and massage, regardless of the reasons why the heart stopped. The main thing is to remember the timeliness and correctness of the actions performed related to cardiac resuscitation of a patient whose body has lost its vital functions. This leads to the death of the victim before the arrival of the ambulance.

The body of the victim has signs of cardiac arrest, so he needs an ambulance. It can only be provided by those people who at that moment were near him. First, they kneel near the patient's chest, determine the area on the palm, which should be pressed. The base of the palm can easily be bent with sufficient pressure.

It is necessary to follow the massage technique correctly, rhythmically squeezing the chest and pressing on it with both hands, which causes blood to be squeezed out of the heart muscle, which begins to spread through the vessels. There is a pressing of the heart to the spine. The process of blood circulation in the body of the victim is resumed if about 60-70 pressings with both hands are performed per minute. If there is no cardiac activity, then these manipulations will be enough.

If clinical death occurs, then muscle tone is significantly reduced, so the mobility of the chest increases, which makes it easier to perform actions related to simulating the work of the heart muscle. Whether there is blood circulation is established simultaneously with the observation of the pulse. It is measured at the wrist, neck, or femoral artery.

If the condition is terminal, then the pulse should be felt where the area of ​​the carotid artery is located, since it is not possible to determine it at the level of the wrist. For this purpose, fingers are placed on the larynx, on top of the so-called Adam's apple, after which they are moved along the neck.

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Mandatory steps in the process of heart massage

According to the methodology, the NMS rescuer begins to conduct, standing up from right side from the patient. To detect the xiphoid process, first run a finger along the ribs of a person. Using the index and middle fingers, a tubercle is found on the sternum small size, which should be lower than the level of the nipples, or on it. Then it is necessary, having measured two fingers above the xiphoid process, to place the left hand with the palm down in this place.

The palm of the base is placed on the found place. Next, with the palm on top of the left hand, put right hand on the back of it so that the fingers are pointing up. This position of the hands will allow you to block the hands due to the fingers fastened with a lock. It is important to ensure that the shoulders of the rescuer are located directly above the chest of the patient, placing his palms on his sternum and straightening his elbows.

At the next stage, they already begin to massage, pressing with both hands on the chest. The chest is pressed through no less than 3-5 cm. The rescuer must squeeze the sternum in jerks so that it can be displaced exactly 3-5 cm in the direction of the spine, holding for about half a second (if the victim is an adult). After that, the rescuer should relax his hands, but do not tear them off his chest. We should not forget about artificial respiration, which is done to the patient.

With NMS, it is required to compress the heart, that is, its muscles, where the sternum and spine are located, which is associated with squeezing blood into the arteries. When the pressure stops, the heart fills with blood through the veins. It must be remembered that with proper NMS, only 20-40% of the circulatory norm of a healthy person is provided, which is sufficient to maintain the body's vital functions for an hour before the ambulance arrives. In this regard, you cannot stop actions, but you can interrupt for seconds by continuing actions.

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Particular attention should be paid to the location of the rescuer, who needs to be much higher than the patient's body. He can sit on a chair or kneel near the victim if he is lying on the floor. It is necessary to ensure that the arms are straight during the massage, so you need to press when the strength of the hands is used simultaneously with the severity of the victim's torso. This allows for efficiency to conserve energy, so that NMS can be carried out for a long time.

The fingers should not lie on the chest, as an effective massage is necessary. All forces must be directed to the lower third of the sternum, and not to the area itself chest wall which will reduce the risk of rib fractures.

If the patient is in horizontal position on a hard, level surface, it is easier for the rescuer to apply pressure on the sternum so that the heart muscle can contract. The NMS scheme assumes not only the correct location, but also the right way pressure.

Quickly starting to implement the NMS, forcefully press on the sternum area. It can go to a depth equal to half the height of the entire chest. After pressing, relaxation immediately follows.

It is important to monitor the coincidence of moments associated with pressure and relaxation. It is necessary to squeeze the patient's sternum with such force that it is pressed against the spine by 5-6 cm, at a pace close to normal heart rhythms.

Cardiac massage should be performed for at least 30 minutes. Performing an external heart massage should remember that you can not stop the massage process until 30 clicks have been made. If you often rest, then this will only harm the victim, since resuscitation carried out in these rhythms causes the cessation of the blood circulation process completely.

Having made 30 clicks on the chest area, about two breaths are taken into the patient's mouth, which can be done after 150 times. It is necessary to observe the pressure rate of about 100 times per minute, which is suitable for any patient, with the exception of a newborn.

You should wait for an ambulance or take the necessary actions until the pulse in the carotid artery resumes. If there is no pulse, then the massage should be continued until signs of biological death begin to appear, developing after clinical death has occurred within an hour.