Kardiopulmonalno oživljanje

Kardiopulmonalno oživljanje (CPR), nujni postopek zagotavljanja umetnega dihanja in krvnega obtoka, ko se ustavi normalno dihanje in prekrvavitev, običajno kot posledica travme, kot je srčni infarkt ali blizu utopitve. CPR kupi čas za žrtev travme z oskrbo možganov in drugih vitalnih organov, ki vzdržujejo življenje, dokler na prizorišče ne pride popolnoma opremljeno osebje nujne medicinske pomoči.

Medtem ko je za običajni CPR potrebno usposabljanje, lahko sodobno obliko, imenovano samo za roke ", opravijo posamezniki, ki niso bili formalno usposobljeni. Po mnenju Ameriškega združenja za srce (AHA) za samostojen CPR, ki se priporoča samo za uporabo pri odraslih, ki so se nenadoma zrušili, so potrebni samo "dva koraka, da rešite življenje." Najprej oseba, ki deluje (reševalec), ukrene, da pokliče osebje nujne medicinske pomoči na kraj dogodka. Drugič, reševalec začne močno in hitro potiskati v sredino prsnega koša žrtve, tako da z vsakim pritiskom potisne prsni koš 4–5 cm (1,5–2 palca). Stisk v prsih naj se nadaljuje neprekinjeno, s hitrostjo 100 stiskalnic na minuto, dokler ne pride medicinsko osebje. CPR samo za roke, ki se izvaja pri odraslih, ki so se nenadoma zrušili, je prav tako učinkovit kot običajni CPR; vendarAHA priporoča, da se pri otrocih in dojenčkih uporablja samo običajni CPR.

Prvi korak običajnega CPR je vzpostavitev nezavesti. Če je žrtev v nezavesti, reševalec pokliče pomoč in se nato pripravi na administracijo CPR. Zaporedje korakov je mogoče povzeti kot ABC-ji CPR-a - ki se nanašajo na dihalne poti, B na dihanje in C na kroženje.

Reševalec odpre žrtvino dihalno pot tako, da ga položi na hrbet, nagne glavo nazaj in dvigne brado. Nato mora reševalec preveriti, ali ima znake dihanja.

Če žrtev ne diha, mora reševalec opraviti reanimacijo iz ust v usta. V tem postopku naredi nepredušno zalivanje z usti nad umorom žrtve, hkrati pa zapre nosnice žrtve. Reševalec dvakrat vdihne v usta žrtve, zaradi česar se prsni koš vsakič vidno dvigne in mu omogoči naravno iztekanje. Umetno dihanje se izvaja s hitrostjo približno 12-krat na minuto.

The rescuer next looks for signs of circulation; the recommended method is to check for a pulse in the carotid artery of the neck. If a pulse is not felt after 10 seconds of careful searching, the rescuer proceeds to deliver chest compressions. The rescuer places the heels of his hands, overlapping, on the lower half of the victim’s breastbone, or sternum. With his elbows locked, arms straight, and shoulders directly over the victim, the rescuer uses his upper body to apply a perpendicularly directed force onto the victim’s sternum. The chest is depressed approximately 4–5 cm (1.5–2 inches) at a brisk rate of about 100 compressions per minute. At the end of each compression, pressure is released and the chest allowed to rebound completely, though the rescuer’s hands are not removed. After 30 compressions, the rescuer delivers two full breaths, then another 30 compressions, and so on. CPR continues uninterrupted until spontaneous breathing and circulation are restored or until professional medical assistance is obtained. The procedure is modified somewhat for infants and children and under special circumstances (such as multiple injuries).

Before the introduction of modern CPR techniques, attempts to revive victims of cardiac or respiratory arrest were sporadic and rarely successful. In 1958 Peter Safar and James Elam, anesthesiologists at Johns Hopkins Hospital in Baltimore, Maryland, described an emergency ventilation technique that involved tipping the victim’s head back and pulling the jaw forward in order to clear the air passage and then blowing air into the victim’s lungs through a mouth-to-mouth connection. Safar’s technique was the basis of what became the first two letters (for airway and breathing) in the ABCs of CPR. The basis of the third letter (for circulation) was provided by electrical engineer William B. Kouwenhoven and colleagues, also at Johns Hopkins, who in 1960 described the “closed-chest cardiac massage,” a method of restoring circulation in a heart-attack victim by pushing down rhythmically on the sternum. The combination of Kouwenhoven’s technique with Safar’s ventilation technique evolved into the basic method of CPR. In the mid-1990s a group of researchers at the University of Arizona Sarver Heart Center discovered that continual chest presses kept blood circulating in adult victims of cardiac arrest better than conventional CPR techniques. They found that mouth-to-mouth breaths required too much time, resulting in slowed or stopped circulation before compressions were resumed. In 2008 the researchers’ “hands-only” method for adult victims, which uses only continuous chest presses, was adopted by the AHA.