1. Introduction
Most vital emergency and cardiac arrests occur outside hospitals, resulting in some delay in providing medical staff, which is vital in obtaining favorable results with those measures.
One factor that determines a clear increase in survival in such situations is the early activation of the hospital emergency systems and rapid application of basic life support maneuvers by the people who help the victims.
Various studies have shown that time is a factor essential in improving survival, and it is estimated that the best results are obtained when basic CPR is started within 4 minutes, once caused the cardiac arrest situation and within 8 minutes, in the case of Advanced CPR.
Another determinant of increased survival is the quality of resuscitation applied, obtaining better results if they are applied according to the recommendations already established.
Finally, the cause of cardiac arrest also acts as a determinant of survival. In adults, the most common causes are usually due to coronary disease and, within them, a specific rhythm (ventricular fibrillation) is identified as a trigger of cardiac arrest. In this situation presents the best survival, because specific treatment by electrical defibrillation, implemented early, will determine its resolution in a high percentage of cases.
is for this that the immediate activation of an emergency system that can carry out diagnosis and treatment of this situation, is a fundamental premise in basic cardiopulmonary resuscitation.
2. Basics
Life Support "Joint maneuvers for the prevention of cardiopulmonary arrest or treatment by cardiopulmonary resuscitation understood as a set of standard maneuvers sequential implementation, aimed at the replacement and restoration of ventilatory and circulatory functions without instrumental contribution.
cardiac arrest
"situation, potentially reversible, loss of spontaneous circulatory and ventilatory functions.
This situation leads to the cessation of blood flow and, therefore, lack of oxygenation of vital organs, primarily in the brain, which can cause death of the victim.
3. Diagnosis of the situation
This exhibition aims to show simply and graphically the mechanisms we have to, in principle, be able to recognize a cardiac arrest situation and then start resuscitation.
start with making the diagnosis of the situation through comprehensive initial assessment, determining the existence of consciousness, spontaneous breathing and pulse.
Determining the status of consciousness
We will use verbal and tactile stimulation of the victim, calling him by name, if known, shaking shoulders or tap on the face or chest.
Determination of spontaneous ventilation
assistance should proceed to open the airway, since in an unconscious person's tongue tends to fall toward the back wall of the pharynx and obstruct the airway. This is solved by applying any of the following maneuvers:
front chin maneuver: is making a whiplash, using the palm of one hand on the forehead of the victim and pulling with the fingers of other hand of the bony chin. This maneuver is easier and more user-application Extended The jaw thrust is performed when there is suspected neck injuries in trauma patients. Consists of jaw thrust, keeping fixed the cervical spine to hold the head with his other hand. We get so elevate the jaw and hence, clear the airway.
currently not recommended to perform maneuvers such as the triple (in its modified or not) and frentecuello, since it has been shown in some studies that there is a higher incidence of ischemic spinal cord injury in trauma patients who are were applied.
After the opening of the airway, and having cleared the oral cavity bodies strange, you should check whether or not ventilatory flow, using the rescuer of sight, hearing and touch. Approaching the face to the mouth and nose of the victim, facing the breast of it, the rescuer tried to hear and feel the air flow in your face, while checks for chest movement
A. Look at the chest of the victim.
B. Feel the air flow in the face.
C.
hear breath sounds on the verification of ventilation, will determine the existence of central pulse.
4. Application maneuvers Basic Life Support Ventilation
buzz
Consists of inflation of the lungs of the victim with the air exhaled by the rescuer, which contains about 16% oxygen.
For application, the rescuer should first of all, to open the airway by any of the maneuvers described. Then seal with his lips the mouth of the victim's nostrils closed it using your cheek or by applying a clamp formed with the index finger and thumb of the hand placed on the forehead.
should proceed to fill the lungs of the victim with an amount of air that oscillate between 800 and 1,200 ml., (Now considered sufficient a volume of 400 to 600 ml.) which is slightly higher inhaled breathing normally
Ventilation must be done gradually to avoid causing air to pass through the digestive tract. The duration of inflation will be about the 1 1 / 2 sec. to 2 sec., heck after blowing out air from the lungs of the victim. External cardiac massage
external cardiac massage is the maneuver used for the replacement of circulatory function, and is at compressions of the chest wall in an attempt to make the change of chest compressions to facilitate the expulsion of blood from the heart and reach out to different organs, primarily the brain and myocardium.
The first step in its implementation is the location of point massage, located in the lower third of the sternum, to which we will follow the victim's rib cage until you locate the xiphoid process (tip of sternum
From here, we measured 2 finger widths above the sternum, then placing the heel of your other hand.
To prevent the support of the palms on the chest wall, intertwine fingers as shown in Figure 9, keeping your arms extended and perpendicular to chest of the victim. Performing compressions carrying the weight of the rescuer, we'll get down about 5 cm., and strive maintain a compression / decompression of 1:1.
is recommended that, when performing compressions, the counted aloud, in order to maintain a correct ratio compression / decompression and a rate of 80 to 100 compressions per minute.
5. Other .
lateral safety position
This position allows the prevention of airway obstruction by the tongue falling back and the aspiration of gastric contents found the victim unconscious in supine position. Is taken by rolling the victim to the rescuer to the extent possible while preserving the axis cabezatronco and avoid injury, in the movement, the arms or legs.
unblocking maneuver the air: Heimlich maneuver
We must remember that the best mechanism for unblocking the airway is the cough reflex, so, if it exists, should not be interfering with blows back or similar actions.
When the obstruction of the airway, it produces a reflection of putting their hands to the throat. If no spontaneous cough, the rescuer approaches the victim and, after informing of their intentions, will step behind her and put a fist in the epigastric region, so that the thumb is directed inwards, with the other hand placed on the wrist.
In this position, apply sudden abdominal thrusts directed inward and upward, repeating until you get the expulsion of foreign body.
In the case of airway obstruction, while the victim unconscious, the rescuer is positioned to straddle it, placing your hands in the same way that the implementation of cardiac massage, but placing them in the epigastric region, and made 5 compressions abrupt directed inwards and the head of the victim, then checking if the foreign body that has produced obstruction come to the oral cavity, which will remove it with your fingers.
In the case of not getting the unblocking a first attempt, it will proceed with 2 breaths and be repeated to achieve compression.
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