Rubatsiro rwekutanga uye BLS (Basic Hupenyu Tsigiro): chii uye kuti ungazviita sei

By Cristiano Antonino On Dai 11, 2022

Cardiac massage inzira yekurapa iyo, pamwe chete nedzimwe hunyanzvi, inogonesa BLS, inomiririra Basic Life Support, seti yezviito zvinopa rubatsiro rwekutanga kune vanhu vakatambura nekushungurudzika, senge tsaona yemotokari, kusungwa kwemoyo kana electrocution.

BLS inosanganisira akati wandei

kuongororwa kwechiitiko
kuongororwa kwemamiriro ekuziva kwemudzidzi
kudana rubatsiro nerunhare;
ABC (kuongororwa kwemhepo patency, kuvapo kwekufema uye basa remwoyo);
cardiopulmonary resuscitation (CPR): inosanganisira cardiac massage uye muromo-ku-muromo kufema;
mamwe maitiro ekutanga ekutsigira hupenyu.

Kuongorora pfungwa

Mumamiriro ezvinhu ekukurumidzira, chinhu chekutanga kuita - mushure mekuongorora kuti nzvimbo yacho haipei imwe njodzi kune anoshanda kana munhu akakuvara - kuongorora mamiriro ekuziva kwemunhu:

zviise pedyo nemuviri;
munhu wacho anofanira kuzununguswa nemapfudzi zvinyoro-nyoro (kudzivisa kuwedzera kukuvadza);
munhu wacho anofanira kushevedzwa nenzwi guru (yeuka kuti munhu wacho, kana asingazivikanwi, angave ari matsi);
kana munhu wacho asingaiti, zvino anotsanangurwa seasingazivi: munyaya iyi hapana nguva inofanira kutambiswa uye chikumbiro chekukurumidza chinofanira kuitwa kune avo vari pedyo newe kuti vafonere nhamba yefoni yehutano yekukurumidzira 118 uye / kana 112;

panguva ino tanga maABC, kureva:

tarisa kana nzira yemhepo isina zvinhu zvinokanganisa kufema;
tarisa kana kufema kuripo;
tarisa kana chiitiko chemoyo chiripo kuburikidza necarotid (mutsipa) kana radial (pulse) pulse;
mukushayikwa kwekufema uye kushanda kwemwoyo, tanga cardiopulmonary resuscitation (CPR).

Cardiopulmonary resuscitation (CPR)

Nzira yeCPR inofanira kuitwa nemurwere akaiswa panzvimbo yakaoma (nzvimbo yakapfava kana inobereka inoita kuti compression iite zvachose).

Kana iripo, shandisa otomatiki/semiautomatic defibrillator, iyo inokwanisa kuongorora kuchinja kwemwoyo uye kukwanisa kuendesa simba remagetsi kuti riite cardioversion (kudzokera kune yakajairika sinus rhythm).

Kune rumwe rutivi, usashandise defibrillator yemaoko kunze kwekunge iwe uri chiremba: izvi zvinogona kuita kuti mamiriro acho anyanye kuipa.

Cardiac massage: nguva yekuzviita uye sei kuzviita

Cardiac massage, nevashandi vasiri vezvokurapa, inofanira kuitwa pasina kushandiswa kwemagetsi emwoyo, kana rubatsiro rusingawaniki uye kana pasina otomatiki / semiautomatic defibrillator.

Cardiac massage ine matanho anotevera:

Mununuri anogwadama parutivi pechipfuva, gumbo rake riri pamwero webendekete reakakuvadzwa.
Anobvisa, kuvhura kana kucheka kana zvichidikanwa, zvipfeko zvemunhu akabatwa. Kufambisa kunoda kubata nechipfuva, kuve nechokwadi chechimiro chakarurama chemaoko.
Isa maoko ako zvakananga pakati pechipfuva, pamusoro pe sternum, imwe pamusoro peimwe
Kuti usatyoke mbabvu kana murwere angangoita brittle bone (akura, osteogenesis imperfecta….), chanza chemaoko chete ndicho chinofanira kubata chipfuva. Kunyanya, nzvimbo yekubata inofanira kunge iri kukwirira kwepalmar, kureva kuti chikamu chezasi chechanza chiri padyo nechanza, icho chakanyanya kuoma uye paakisi negumbo. Kuti ufambise kubata uku, zvingave zvinobatsira kuvharira zvigunwe zvako uye kuzvisimudza zvishoma.
Shandura uremu hwako mberi, uchigara pamabvi ako, kusvikira mapepa ako ari pamusoro pemaoko ako.
Kuchengeta maoko akatwasuka, pasina kupeta magokora (ona mufananidzo uri panotangira chinyorwa), muponesi anokwira nekudzika nekutsunga, achitenderera pachiuno. Kusundidzirwa hakufaniri kubva pakukotama kwemaoko, asi kubva pakufamba mberi kwemuviri wese, izvo zvinokanganisa chifuva chemunhu anenge abatwa nekuda kwekuoma kwemaoko: kuchengeta maoko akakotama Kukanganisa.
Kuti ibudirire, kudzvanywa kwechipfuva kunofanirwa kukonzera kufamba kwe5-6 cm kune imwe neimwe yekumanikidza. Izvo zvakakosha, kuitira kubudirira kwekushanda, kuti muponesi anosunungura chipfuva zvachose mushure mekumanikidzwa kwega kwega, kudzivirira zvachose kuti chanza chemaoko chinobvisa kubva pachifuva chinokonzera kukuvadza rebound effect.
Chiyero chakakodzera chekutsikirira kunofanirwa kuve kanosvika zana paminiti asi isingapfuure zana nemakumi maviri paminiti, kureva katatu masekonzi maviri ega ega.

Muchiitiko chekushaikwa kwekufema panguva imwe chete, mushure mekumanikidzwa kwega kwega makumi matatu ekusimbisa kwemoyo, mutyairi - kana ari ega - anomisa masaja kuti ape 30 insufflation nekufema kwekugadzira (muromo kumuromo kana nemask kana muromo), iyo inotora anenge masekondi matatu. mumwe nomumwe.

Pakupera kwechipiri insufflation, pakarepo tangazve ne cardiac massage. Chiyero chekumanikidzwa kwemoyo kune insufflations - munyaya yemumwe muchengeti - saka 30: 2. Kana pane vatarisiri vaviri, kufema kwekugadzira kunogona kuitwa panguva imwe chete semassage emwoyo.

Muromo-ku-muromo kufema

Pamaseji makumi matatu ega ega ekumameja kwemoyo, 30 insufflation nekufema kwekugadzira kunofanirwa kupihwa (reshiyo 2: 30).

Kufemeruka pamuromo-kune-muromo kunosanganisira matanho anotevera:

Isai munhu anenge akuvara panzvimbo yemusana (mudumbu kumusoro).
Musoro weabatwa wakadzoserwa shure.
Tarisa nzira yemhepo uye bvisa chero miviri yekunze kubva mumuromo.

Kana kurwadziswa KUSINA kufungidzira, simudza shaya wokotamisa musoro kumashure kudzivirira rurimi kuvharira nzira yekufema.

If Musipinha kushungurudzwa kunofungidzirwa, usaite chero kukurumidza kufamba, sezvo izvi zvingaita kuti mamiriro acho awedzere.

Vhara mhino dzemunhu abatwa nechigunwe chako nechigunwe. Yambiro: kukanganwa kuvhara mhino kuchaita kuti kushanda kwese kusashande!

Inhale zvakajairika uye furidzira mweya nemumuromo (kana kana izvi zvisingaite, kuburikidza nemhino) yemunhu anenge abatwa, uchitarisa kuti ribcage yakasimudzwa.

Dzokorora pamwero we15-20 kufema paminiti (kufema kumwe chete 3 kusvika ku4 seconds).

Izvo zvakakosha kuti musoro urambe uine hyperextended panguva insufflations, sezvo nzvimbo isina kururama yemhepo inofumura munhu anenge abatwa panjodzi yemhepo inopinda mudumbu, izvo zvinogona kukonzera kudzoka zvakare. Regurgitation inokonzerwawo nesimba rekuvhuvhuta: kufuridza zvakanyanya kunotumira mweya mudumbu.

Kufemeruka kubva pamuromo uchienda kumuromo kunosanganisira kumanikidza mweya kupinda pakufema kwemunhu anenge abatwa nechirwere ichi achishandisa mask kana kuti muromo.

Kana chifukidziro kana muromo usinga shandiswe, hengechepfu yedonje yakareruka inogona kushandiswa kudzivirira mununuri kuti asasangana nemuromo wemunhu anenge abatwa, kunyanya kana munhu wacho aine maronda ekubuda ropa.

Nhungamiro itsva dze2010 dzinonyevera muponesi wezvipingamupinyi zve hyperventilation: kuwedzera kwakanyanya mu intrathoracic pressure, njodzi yekuputika kwemhepo mudumbu, kuderedza kudzoka kwevenous kumwoyo; nekuda kwechikonzero ichi, insufflation haifanirwe kunge yakanyanya kusimba, asi inofanira kuburitsa huwandu hwemhepo isingapfuuri 500-600 cm³ (hafu yelita, isingapfuure sekondi imwe).

Mhepo inofemerwa nemununuri isati yavhuvhuta inofanira kuva "yakachena" sezvinobvira, kureva kuti inofanira kunge iine chikamu chepamusoro cheokisijeni sezvinobvira: nekuda kwechikonzero ichi, pakati pekurova uye kunotevera, muponesi anofanira kusimudza musoro wake kuti afeme. chinhambwe chakakwana kuitira kuti asafeme mhepo inoburitswa nemunhu anenge abatwa, ine mweya wakaderera weokisijeni, kana mweya wake (uyo wakapfuma mucarbon dioxide).

Dzokorora kutenderera kwe30: 2 kwehuwandu hwekashanu, uchitarisa kumagumo kune zviratidzo zve "MO.TO.RE." (Kufamba kwemhando ipi neipi, Kufema uye Kufema), kudzokorora nzira yacho pasina kumbomira, kunze kwekuneta kwemuviri (munyaya iyi kana zvichibvira kumbira shanduko) kana pakuuya kwerubatsiro.

Kana, zvisinei, zviratidzo zveMO.TO.RE. kudzoka (munhu akabatwa anofambisa ruoko, achikosora, anofambisa maziso ake, anotaura, nezvimwewo), zvakakosha kudzokera kune imwe nzvimbo B: kana kufema kuripo, munhu anenge abatwa anogona kuiswa muPLS (Lateral Safety Position), zvisinei. kufefetera chete kunofanira kuitwa (10-12 paminiti), kutarisa zviratidzo zveMO.TO.RE. miniti yega yega kusvika kufema kwese kwatangwazve zvachose (izvo zvingangoita gumi kusvika makumi maviri paminiti).

Kudzoreredza kunofanirwa kugara kuchitanga nekumanikidzana, kunze kwekunge kuri kukuvadzwa kana kana munhu akabatwa ari mwana: mune izvi zviitiko, 5 insufflations inoshandiswa, uye ipapo kudzvanya-inflation kunochinja kazhinji.

Izvi imhaka yokuti, panyaya yekukuvadzwa, inofungidzirwa kuti hapana oxygen yakakwana mumapapu emunhu anenge abatwa kuti ave nechokwadi chekutenderera kweropa; zvakatonyanya kudaro, senzira yekuzvidzivirira, kana munhu wacho ari mwana, tanga nekudzika, sezvo zvichifungidzirwa kuti mwana, ane hutano hwakanaka, ari mumamiriro ekusungwa kwemwoyo, zvichida nekuda kwekukuvara kana muviri wekune imwe nyika. iyo yapinda mumhepo.

Nguva yekumisa CPR

Muponesi anongomisa CPR kana:

Mamiriro ezvinhu munzvimbo inoshanduka uye inova isina kuchengetedzeka. Muchiitiko chengozi yakakomba, mununuri ane basa rokuzviponesa.
ari amburenzi anosvika nachiremba bhodhi kana kuti motokari yezvokurapa inotumirwa neEmergency Number.
rubatsiro rwakakwana runouya nerunoshanda zvakanyanya midziyo.
munhu wacho apera simba uye haachina simba (kunyange munyaya iyi tinowanzo kukumbira kuchinja, izvo zvinofanira kuitika pakati pemakumi matatu ekumanikidzika, kuitira kuti usazovhiringidza kutenderera-inflation cycle).
musoro wacho unowanazve mabasa anokosha.

Naizvozvo, kana paine kusungwa kwecardiopulmonary, muromo-ku-muromo resuscitation inofanira kushandiswa.

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Vasiri-vanonunura vekurapa (avo vanowanzove pa118 ambulensi) vanogona kungoziva kufa, uye nekudaro kwete kutanga maneuvres:

kana iri yekunze inoonekwa uropi nyaya, decerebrate (pachiitiko chekushungurudzika semuenzaniso);
kana decapitation;
kana kukuvara kusingaenderani zvachose nehupenyu;
muchiitiko chechinhu chakatsva;
kana iri nyaya in rigor mortis .

Zvitsva zvinogadziriswa

Iko kuchangopfuura shanduko (sezvinogona kuonekwa kubva kumabhuku eAHA) inobatanidza zvakawanda kurongeka pane maitiro. Chekutanga, kwave nekuwedzera kusimbiswa kwekutanga cardiac massage, iyo inonzi yakakosha kupfuura yekutanga oxygenation.

Saka kutevedzana kwachinja kubva kuABC (kuvhurika mhepo, kufema uye kutenderera) kuenda kuCAB (kutenderera, kuvhurika nzira uye kufema):

tanga ne 30 chipfuva compressions (iyo inofanira kutanga mukati memasekonzi gumi ekuzivikanwa kwemoyo block);
enderera kunzira yekuvhura nzira uye wozofefetera.

Izvi zvinongononotsa kufefetedza kwekutanga nemasekonzi makumi maviri, izvo zvisingakanganisi kubudirira kweCPR.

Mukuwedzera, chikamu cheGAS chakabviswa (mukuongorora kwemunhu akabatwa) nokuti agonal gasping inogona kunge iripo, iyo inonzwisiswa nemuponesi zvose sekunzwa kwekufema paganda (Sento) uye zvinonzwika (Ascolto), asi izvo haikonzeri kufefetedza kwemapapu kunoshanda nekuti ine spasmodic, shallow, uye yakaderera frequency.

Shanduko diki dzine chekuita nekuwanda kwekumanikidza kwechipfuva (kubva pa100 / min kusvika pa100 / min) uye kushandiswa kwecricoid kumanikidza kudzivirira gastric insufflation: cricoid pressure inofanirwa kudziviswa sezvo isingashande uye inogona kuratidza kukuvadza nekuita kuti iwedzere. zvakaoma kupinza midziyo yekufema yepamusoro senge endotracheal chubhu nezvimwe.

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Lateral kuchengetedza nzvimbo

Kana kufema kuchidzoka, asi murwere anenge achiri asina chaanoziva uye pasina kukuvadzwa kunofungidzirwa, murwere anofanira kuiswa panzvimbo yakachengeteka.

Izvi zvinosanganisira kukotama ibvi rimwe chete uye kuunza tsoka yegumbo rimwechete pasi pebvi regumbo rakatarisana.

Ruoko rwakatarisana negumbo rakakotama runofanira kutsvedzerwa pasi kusvika rwaita perpendicular kune torso. Rumwe ruoko runofanira kuiswa pachipfuva kuitira kuti ruoko rwuve padivi pemutsipa.

Zvadaro, muponesi anofanira kumira kune rumwe rutivi rusina ruoko rwakatambanudzirwa kunze, isa ruoko rwake pakati pearc yakagadzirwa nemakumbo emurwere uye kushandisa rumwe ruoko kuti abate musoro.

Uchishandisa mabvi, zvinyoronyoro fambisa murwere parutivi rwekunze kweruoko, uchiperekedza kufamba kwemusoro.

Musoro unobva wawedzerwa hyperextended wobatwa panzvimbo iyi nekuisa ruoko rweruoko rwusiri kubata pasi pasi pedama.

Chinangwa chechinzvimbo ichi ndechekuchengetedza nzira yemhepo yakachena uye kudzivirira kuputika kamwe kamwe kurutsa kubva pakuvhara nzira yekufema uye kupinda mumapapu, nokudaro zvichikuvadza kuvimbika kwavo.

Mune lateral kuchengetedza nzvimbo, chero mvura inobudiswa inodzingwa kubva mumuviri.

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Rubatsiro rwekutanga uye BLS muvana nevacheche

Nzira yeBLS muvana kubva pamwedzi 12 kusvika kumakore masere yakafanana neyo inoshandiswa kuvanhu vakuru.

Zvisinei, pane misiyano, iyo inofunga nezvehuwandu hwemapapu evana uye kukurumidza kufema kwavo.

Mukuwedzera, inofanira kuyeukwa kuti kumanikidzika kunofanira kunge kwakadzika kudarika kune vanhu vakuru.

Tinotanga ne 5 insufflations, tisati taenderera mberi kune cardiac massage, iyo ine chiyero chekumanikidza kune insufflations ye15: 2. Zvichienderana corpulence yemwana, compressions inogona kuitwa nemakumbo maviri (muvanhu vakuru), imwe nhengo chete (muvana), kana kunyange zvigunwe zviviri chete (index uye zvigunwe zvepakati pamwero we xiphoid process muvacheche).

Pakupedzisira, inofanira kuyeukwa kuti sezvo chiyero chemwoyo chinowanzo muvana chakakwirira kudarika vanhu vakuru, kana mwana ane basa rekutenderera nemwoyo wepasi pe60 beats / min, chiito chinofanira kutorwa sechiitiko chekusungwa kwemwoyo.