Introduction: The Basic Scheme of Cardiopulmonary Resuscitation

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Today, I watched one of those TV shows that depicts accidents and the way the first responders render help. It is always important to be timely when someone has a critical health condition. It has also been said that hundreds of people die before emergency help arrives, despite the fact that there always are crowds of people around the  accidents. It is ridiculous that no one is able to help these people until emergency help arrives and saves their life.  I have decided to try to remember things I learned from the medical course I took at school as well as using information found on the Internet involving the essentials of CNA training. If we need to help a person who is dying before the emergency help can arrive, we can try the basic scheme of resuscitation that is used for people in a state of apparent death.

The ABC Scheme of Resuscitation

The basic means of resuscitation involve three main stages, also known as ABC.
- During stage one, it is necessary to free the airway (A) from anything that prevents breathing;
- During stage two, it is necessary to start artificial breathing (B);
- During stage three, it is necessary to start the indirect heart massage to renew the circulation (C).

Step 1: Freeing Airways

Before taking any action, the person who conducts resuscitation should examine the mouth and nose of the patient. These could be clogged with vomit that needs to be removed. The airway could also be blocked by the tongue falling back and blocking it. It is necessary to pull the tongue out with the help of a clean cloth or paper towel. Another way to remove the tongue from the airway is by putting one hand under the neck of the patient and the other hand on the patient’s forehead and throwing the head back.

Step 2: Ventilating Lungs

The artificial ventilation of lungs is conducted mouth to mouth, mouth to nose, or with the help of a special respiratory device. The effectiveness of the ventilation procedure is shown by the way the ribcage moves: lungs should become filled with air that is being pushed in and go down when it comes out with each passive exhalation. The ventilation is conducted simultaneously with the indirect heart massage.

Step 3: Massaging the Heart

Before the massage, it is necessary to start with one abrupt strike using one’s fist on the ribcage of the patient above the heart area. Performing this strike can sometimes be effective at getting the heart to start pulsing again. The patient needs to lie on a horizontal surface during this procedure. At the same time, the person who does the resuscitation and performs the strike should be careful in order not to crush ribs. If it does not work, it is necessary to start the massage. The resuscitator should stand at the side of the patient placing one hand perpendicularly to the lower third of the breastbone and the other hand over the first one, but parallel to the breastbone. In this position, hands should make about sixty quick pushes downwards. The massage is effective if there is a pulsation on arteries and the pupils of the eye grow narrow. This massage needs to be performed carefully to save inner organs from traumas.

Still knowing all this, you should not start resuscitation in any case where the patient has a medical condition, such as heart attack or apoplexy. Resuscitation should be used only in very particular cases.

Conditions That Require Resuscitation

There are several main conditions when it is necessary to render such help to people:

- Circulatory and respiratory arrest;
- Preagonic and agonic conditions;
- Apparent death.

It is possible to refuse trying resuscitation only under the condition that biologic death is certified or all these measures are obviously and absolutely unpromising. There are certain visible early symptoms of biologic death: the “cat eye” symptom and cornea dimness and dryness. Late symptoms of biologic death include postmortem rigidity and death spots. It is necessary to remember that irreversible changes in the brain start to happen within three to four minutes after the circulatory arrest. That is why it is so important to begin resuscitation as soon as possible. Emergency calls and diagnostics should be done together with resuscitation.

Diagnostics of Apparent Death

Diagnosis of apparent death is not hard. A sudden loss of consciousness, no pulse on large arteries, growing cyanosis (blue color) of skin, no respiratory movements, and/or wide eye pupils are enough to diagnose this life threatening condition. There is no time to measure blood pressure or listen for  heart beating. Changes in the nervous system can start to happen at any moment after heart ventricles stop to push blood. Thus, the very moment of apparent death is the moment to begin resuscitation.

Now you know what can be done to save someone’s life. Remember that quite often the quality of this life depends on how well you are able to act and how much care you put into each movement of your hands.