Uncedo lokuqala kunye ne-BLS (iNkxaso yoBomi obuSisiseko): yintoni na kwaye ungayenza njani

By UCristiano Antonino On Ngamana 11, 2022

I-Massage ye-Cardiac yindlela yokwelapha eyenza ukuba, kunye nezinye iindlela zobugcisa, i-BLS, emele iNkxaso yoBomi obuSisiseko, iseti yezenzo ezibonelela ngoncedo lokuqala kubantu abaye bahlaselwa yintlungu, njengengozi yemoto, ukubanjwa kwentliziyo okanye umbane.

I-BLS ibandakanya amacandelo amaninzi

ukuvavanywa kwendawo
Uvavanyo lwemeko yolwazi lomfundi
ukucela uncedo ngomnxeba;
ABC (uvavanyo lwepatency yomoya, ubukho bokuphefumula kunye nomsebenzi wentliziyo);
i-cardiopulmonary resuscitation (CPR): equkethe i-massage ye-cardiac kunye nokuphefumula komlomo emlonyeni;
ezinye izenzo ezisisiseko zokuxhasa ubomi.

Ukuvavanya ingqondo

Kwiimeko zonxunguphalo, into yokuqala ekufuneka yenziwe – emva kokuvavanya ukuba indawo leyo ayinabungozi kumqhubi okanye umntu owenzakeleyo – kukuvavanya imeko yokwazi komntu:

zibeke kufutshane nomzimba;
umntu kufuneka ashukunyiswe ngamagxa ngokucokisekileyo (ukuphepha ukulimala ngakumbi);
umntu kufuneka abizwe ngokuvakalayo (khumbula ukuba umntu, ukuba akaziwa, unokuba sisithulu);
ukuba umntu akaphenduli, ngoko uchazwa njengongekho zingqondweni: kule meko akukho xesha lifanele lichithwe kwaye isicelo esikhawulezileyo kufuneka senziwe kwabo basondeleyo kuwe ukuba bafowunele inombolo yomnxeba kaxakeka yonyango u-118 kunye/okanye u-112;

Okwangoku qala ii-ABCs, okt:

khangela ukuba umzila womoya awukho kwizinto eziphazamisa ukuphefumla;
khangela ukuba kukho ukuphefumla;
khangela ukuba umsebenzi wentliziyo ukhona nge-carotid (entanyeni) okanye i-radial (pulse) pulse;
ngokungabikho kokuphefumla kunye nomsebenzi wentliziyo, qalisa ukuvuselela i-cardiopulmonary resuscitation (CPR).

Ukuvuselelwa kweCardiopulmonary (CPR)

Inkqubo ye-CPR kufuneka yenziwe kunye nesigulane esibekwe kwindawo enzima (indawo ethambileyo okanye enikezelayo yenza ukunyanzeliswa okungafuneki ngokupheleleyo).

Ukuba ikhona, sebenzisa i-automatic/semiautomatic defibrillator, ekwazi ukuvavanya utshintsho lwentliziyo kunye nokukwazi ukuhambisa impembelelo yombane ukwenza i-cardioversion (ukubuyisela kwisigqi esiqhelekileyo se-sinus).

Kwelinye icala, musa ukusebenzisa i- manual defibrillator ngaphandle kokuba ungugqirha: oku kunokwenza imeko ibe mbi ngakumbi.

I-massage ye-cardiac: ukuba uyenza nini kwaye ungayenza njani

I-massage ye-cardiac, ngabasebenzi abangekho bezonyango, kufuneka yenziwe ngokungabikho kombane wentliziyo, xa uncedo lungekho kwaye lungekho i-defibrillator ngokuzenzekelayo / semiautomatic.

I-massage yentliziyo inala manyathelo alandelayo:

Umhlanguli uguqa ngecala lesifuba, kunye nomlenze wakhe kwinqanaba legxalaba lexhoba.
Ususa, ukuvula okanye ukusika ukuba kuyimfuneko, iimpahla zexhoba. I-manuver idinga ukudibanisa nesifuba, ukuqinisekisa indawo echanekileyo yezandla.
Beka izandla zakho ngqo kumbindi wesifuba, ngaphezu kwe-sternum, enye phezu komnye
Ukunqanda ukophula iimbambo xa kukho isigulana esinokuthi sibe namathambo aqaqadekileyo (ubudala, i-osteogenesis imperfecta….), yintende yezandla kuphela ekufuneka ichukumise isifuba. Ngokuthe ngqo, indawo ekudityanwa kuyo kufuneka ibe ludumo lwesundu, okt elona candelo lisezantsi lesundu kufutshane nesihlahla, eliqina ngakumbi kwaye liku-axis kunye nelungu. Ukuququzelela olu qhagamshelwano, kunokuba luncedo ukuvala iminwe yakho kwaye uyiphakamise kancinci.
Shifta ubunzima bakho phambili, uhlale emadolweni akho, de amagxa akho abe ngqo phezu kwezandla zakho.
Ukugcina iingalo zithe tye, ngaphandle kokugoba iingqiniba (jonga ifoto ekuqaleni kwenqaku), umhlanguli uyehla enyuka ngokuzimisela, ejikeleza kwi-pelvis. I-thrust akufanele ivele ekugobeni kweengalo, kodwa ukusuka phambili phambili kwi-torso yonke, echaphazela isifuba sexhoba ngenxa yokuqina kweengalo: ukugcina iingalo ezigobileyo yi-Mistake.
Ukuze kusebenze, uxinzelelo lwesifuba kufuneka lubangele ukunyakaza malunga ne-5-6 cm ngoxinzelelo ngalunye. Kubalulekile, kwimpumelelo yomsebenzi, ukuba umhlanguli ukhulule isifuba ngokupheleleyo emva kokunyanzeliswa ngalunye, ukuphepha ngokupheleleyo ukuba intende yezandla iyahlukana nesifuba esibangela umphumo onobungozi obutsha.
Ireyithi echanekileyo yoxinzelelo kufuneka ibe yi-100 ubuncinane ngomzuzu kodwa kungabikho ngaphezulu kwe-120 yokucinezeleka ngomzuzu, okt i-compressions e-3 rhoqo nge-2 imizuzwana.

Kwimeko yokungabikho kokuphefumla ngaxeshanye, emva kokunyanzeliswa kwe-30 ye-massage ye-cardiac, umqhubi - ukuba yedwa - uya kumisa i-massage ukunika i-2 insufflation ngokuphefumla okwenziweyo (umlomo ukuya emlonyeni okanye ngemaski okanye umlomo), oya kuhlala malunga nemizuzwana ye-3. nganye.

Ekupheleni kwe-insufflation yesibini, qalisa ngokukhawuleza nge-massage ye-cardiac. Umlinganiselo wokunyanzeliswa kwentliziyo kwi-insufflations - kwimeko yomnakekeli omnye - ngoko ngu-30: 2. Ukuba kukho ababini abanonophelo, ukuphefumula okwenziweyo kunokwenziwa ngexesha elifanayo njenge-massage yenhliziyo.

Ukuphefumla emlonyeni

Kuzo zonke ii-30 zokunyanzeliswa kwe-massage ye-cardiac, i-2 insufflation kunye ne-artificial respiration kufuneka inikwe (umlinganiselo 30: 2).

Ukuphefumla komlomo ukuya emlonyeni kubandakanya la manyathelo alandelayo:

Lalisa ixhoba kwindawo esezantsi kwesisu (isisu sinyuke).
Intloko yexhoba ijikelwe ngasemva.
Jonga indlela yomoya kwaye ususe nayiphi na imizimba yangaphandle emlonyeni.

Ukuba umonzakalo AKUrhanelwa, phakamisa imihlathi kwaye ugobe intloko ngasemva ukuthintela ulwimi ekuvaleni indlela yokuphefumla.

If Umgudu Umothuko uyakrokrelwa, musa ukwenza naziphi na iintshukumo zerhashalala, njengoko oku kunokwenza imeko ibe mandundu.

Vala iimpumlo zexhoba ngobhontsi nangomnwe wakho ongaphambili. Isilumkiso: ukulibala ukuvala impumlo kuya kwenza wonke umsebenzi ungasebenzi!

Ukuphefumlela ngokuqhelekileyo kwaye uvuthele umoya ngomlomo (okanye ukuba oku akunakwenzeka, ngempumlo) yexhoba, ukujonga ukuba i-ribcage iphakanyisiwe.

Phinda umlinganiselo we-15-20 ukuphefumula ngomzuzu (umoya omnye rhoqo kwi-3 ukuya kwi-4 imizuzwana).

Kubalulekile ukuba intloko ihlale i-hyperextended ngexesha le-insufflation, njengoko indawo ye-airway engafanelekanga ibeka ixhoba kumngcipheko womoya ongena esiswini, esinokubangela ukuba kube lula ukuphindaphinda. Ukuvuthela kwakhona kubangelwa ngamandla okuvuthela: ukuvuthela kakhulu kuthumela umoya esiswini.

Ukuphefumla ukusuka emlonyeni ukuya emlonyeni kuquka ukunyanzela umoya ukuba ungene kwinkqubo yokuphefumla yexhoba usebenzisa isigqubuthelo sobuso okanye umlomo.

Ukuba imaski okanye umlomo awunakusetyenziswa, i-handkerchief yekotoni elula ingasetyenziselwa ukukhusela umhlanguli ekudibaneni ngqo nomlomo wexhoba, ngakumbi ukuba ixhoba linamanxeba ophayo.

Izikhokelo ezitsha ze-2010 zilumkisa umhlanguli wemingcipheko ye-hyperventilation: ukunyuka okugqithisileyo kwengcinezelo ye-intrathoracic, umngcipheko wokunyuka komoya kwisisu, ukunciphisa ukubuya kwe-venous entliziyweni; ngenxa yesi sizathu, ukunyuselwa akufuneki kube namandla kakhulu, kodwa kufuneka kukhuphe isixa somoya esingekho ngaphezulu kwe-500-600 cm³ (isiqingatha selitha, akukho ngaphezu kwesekondi enye).

Umoya ovuthwe ngumhlanguli ngaphambi kokuvuthela kufuneka ube "msulwa" ngokusemandleni, oko kukuthi, kufuneka ube nepesenti ephezulu ye-oksijeni kangangoko kunokwenzeka: ngenxa yesi sizathu, phakathi kwesinye isibetho kunye nesilandelayo, umhlanguli kufuneka aphakamise intloko yakhe ukuze aphefumule. umgama owaneleyo ukuze angawuphefumli umoya okhutshwa lixhoba, onoxinzelelo oluphantsi lweoksijini, okanye umoya wakhe (otyebileyo kwikharbon diokside).

Phinda umjikelo we-30: 2 ngamaxesha angama-5 xa ewonke, ukhangele ekupheleni kweempawu ze-"MO.TO.RE." (Iintshukumo zalo naluphi na uhlobo, Ukuphefumla nokuphefumla), ukuphinda inkqubo ngaphandle kokuyeka, ngaphandle kokudinwa komzimba (kule meko ukuba kunokwenzeka cela utshintsho) okanye ngokufika koncedo.

Ukuba, nangona kunjalo, iimpawu ze-MO.TO.RE. ukubuya (ixhoba lihambisa ingalo, likhwehlela, lihambisa amehlo, lithetha, njl.), kuyimfuneko ukubuyela kwindawo B: ukuba ukuphefumla kukho, ixhoba linokufakwa kwi-PLS (i-Lateral Safety Position), ngaphandle koko. kufuneka kwenziwe kuphela ukungena komoya (10-12 ngomzuzu), ukujonga iimpawu ze-MO.TO.RE. ngomzuzu ngamnye de ukuphefumla okuqhelekileyo kuqaliswe kwakhona ngokupheleleyo (nto leyo malunga ne-10-20 yezenzo ngomzuzu).

Ukuvuselela kufuneka kuhlale kuqala ngokunyanzeliswa, ngaphandle kwimeko yokwenzakala okanye ukuba ixhoba ngumntwana: kule meko, i-5 insufflation isetyenzisiweyo, kwaye ke ukunyanzeliswa-ukunyuka kwamaxabiso ngokuqhelekileyo.

Oku kungenxa yokuba, kwimeko yokwenzakala, kucingelwa ukuba akukho oksijini eyaneleyo kwimiphunga yexhoba ukuqinisekisa ukujikeleza kwegazi ngokufanelekileyo; ngakumbi, njengenyathelo lokhuseleko, ukuba ixhoba ngumntwana, qalisa ngokunyuka, kuba kucingelwa ukuba umntwana, enandipha impilo entle, ukwimeko yokubanjwa kwentliziyo, mhlawumbi ngenxa yokwenzakala okanye umzimba wasemzini. eye yangena kwimizila yomoya.

Ukumisa nini i-CPR

Umhlanguli uya kumisa i-CPR kuphela ukuba:

Iimeko kwindawo ziyatshintsha kwaye ayikhuselekanga. Kwimeko yengozi enkulu, umhlanguli unomsebenzi wokuzisindisa.
le iigulane ufika nogqirha ibhodi okanye imoto yonyango ethunyelwe ngeNombolo yoNgxamiseko.
uncedo olufanelekileyo lufika lusebenza ngakumbi izixhobo.
umntu uphelile kwaye akanamandla (nangona kule meko sivame ukucela utshintsho, olufanele lwenzeke phakathi kwe-30 compressions, ukwenzela ukuba ungaphazamisi umjikelo wokunyuka kwamaxabiso).
isifundo sibuyisela imisebenzi ebalulekileyo.

Ngoko ke, ukuba kukho ukuboshwa kwe-cardiopulmonary, ukuvuselelwa komlomo ngomlomo kufuneka kusetyenziswe.

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Abahlanguli abangengobezonyango (abo bahlala kwii-ambulensi ezili-118) banokuqinisekisa kuphela ukufa, kwaye ke bangaqalisi ukwenza izinto:

kwimeko yengqondo ebonakalayo yangaphandle, i-decerebrate (kwimeko yokwenzakala ngokomzekelo);
xa kunqunyulwa intloko;
kwimeko yokwenzakala okungahambelani ngokupheleleyo nobomi ;
kwimeko yomba otshisiweyo;
kwimeko yesifundo kwi-rigor mortis .

Izilungiso ezintsha

Olona tshintsho lwamva nje (njengoko lunokubonwa kwiincwadana ze-AHA) lubhekiselele ngakumbi kumyalelo kunenkqubo. Okokuqala, kuye kwakho ugxininiso olwandisiweyo kwi-massage ye-cardiac yokuqala, ethathwa njengebaluleke kakhulu kunomoya wokuqala.

Ulandelelwano ke ngoko lutshintshile ukusuka kwi-ABC (indlela yomoya evulekileyo, ukuphefumla kunye nokujikeleza) ukuya kwi-CAB (ukujikeleza, indlela yomoya evulekileyo kunye nokuphefumla):

qalisa ngokucinezelwa kwesifuba se-30 (okufuneka kuqale kwimizuzwana eyi-10 yokuqaphela ibhloko yentliziyo);
qhubeleka kubuchule bokuvula uhola wendlela yomoya kunye nokukhupha umoya.

Oku kulibazisa kuphela ukungena komoya wokuqala malunga nemizuzwana ye-20, engachaphazeli kakubi impumelelo yeCPR.

Ukongezelela, isigaba se-GAS siye sapheliswa (kuvavanyo lwexhoba) ngenxa yokuba i-agonal gasping ingaba khona, ebonwa ngumsindisi zombini njengemvakalelo yokuphefumula kwesikhumba (i-Sento) kunye nokuzwakalayo (Ascolto), kodwa oko ayibangeli ukungena komoya okusebenzayo emiphungeni kuba i-spasmodic, i-shallow, kwaye iphantsi kakhulu.

Utshintsho oluncinci luchaphazela ukuphindaphinda kwesifuba (ukusuka malunga ne-100 / min ukuya ubuncinane kwi-100 / min) kunye nokusetyenziswa koxinzelelo lwe-cricoid ukukhusela i-gastric insufflation: uxinzelelo lwe-cricoid kufuneka lugwenywe njengoko lungasebenzi kwaye lunokubonakalisa luyingozi ngokwenza ngakumbi. kunzima ukufaka izixhobo zokuphefumla eziphambili ezifana ne-endotracheal tubes njl.

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Indawo yokhuseleko lwasemva

Ukuba ukuphefumla kuyabuya, kodwa isigulana sisengekho zingqondweni kwaye akukho kwenzakala kukrokreleka, isigulane kufuneka sibekwe kwindawo esecaleni yokhuseleko.

Oku kubandakanya ukugoba elinye idolo kunye nokuzisa unyawo lomlenze omnye phantsi kwedolo lomlenze ochaseneyo.

Ingalo ejongene nomlenze ogobileyo kufuneka ityibilike emhlabeni de ibe yi-perpendicular to torso. Enye ingalo kufuneka ibekwe esifubeni ukuze isandla sibe kwicala lentamo.

Emva koko, umhlanguli kufuneka eme kwicala elingenalo ingalo eyongezelelweyo ngaphandle, ubeke ingalo yakhe phakathi kwe-arc eyenziwe yimilenze yesigulane kwaye usebenzise enye ingalo ukubamba intloko.

Ukusebenzisa amadolo, qhubela ngobumnene isigulane kwicala lengalo yangaphandle, uhambe kunye nokuhamba kwentloko.

Intloko ke i-hyperextended kwaye ibanjwe kule ndawo ngokubeka isandla sengalo engathinti umhlaba phantsi kwesihlathi.

Injongo yesi sikhundla kukugcina indlela yomoya icocekile kunye nokuthintela ukugqabhuka ngokukhawuleza ukugabha ekuvaleni umgaqo womoya nokungena emiphungeni, ngaloo ndlela sonakalisa ingqibelelo yawo.

Kwimeko yokhuseleko olusecaleni, nayiphi na i-fluid ekhutshwayo iyakhutshwa emzimbeni.

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Uncedo lokuqala kunye ne-BLS kubantwana nakwiintsana

Indlela ye-BLS kubantwana ukusuka kwiinyanga ezili-12 ukuya kwiminyaka eyi-8 iyafana naleyo isetyenziselwa abantu abadala.

Nangona kunjalo, kukho iiyantlukwano, ezithathela ingqalelo umthamo ophantsi wemiphunga wabantwana kunye nesantya sokuphefumla ngokukhawuleza.

Ukongeza, kufuneka kukhunjulwe ukuba ukunyanzeliswa kufuneka kungabi nzulu kakhulu kunabantu abadala.

Siqala nge-5 insufflation, ngaphambi kokuba siqhubele phambili kwi-massage ye-cardiac, enomlinganiselo wokunyanzeliswa kwe-insufflations ye-15: 2. Ngokuxhomekeke kwi-corpulence yomntwana, ukunyanzeliswa kunokwenziwa kunye nemilenze yomibini (kubantu abadala), ilungu elinye kuphela (kubantwana), okanye iminwe emibini nje (isalathisi kunye neminwe ephakathi kwinqanaba lenkqubo ye-xiphoid kwiintsana).

Ekugqibeleni, kufuneka kukhunjulwe ukuba ekubeni izinga lentliziyo eliqhelekileyo kubantwana liphezulu kunabantu abadala, ukuba umntwana unomsebenzi wokujikeleza kunye nentliziyo engaphantsi kwe-60 beats / min, kufuneka kuthathwe isenzo njengoko kwimeko yokubanjwa kwentliziyo.