Cardiopulmonary resuscitation: rules for the new protocol

The sad figures of medical statistics show that in our country every year about a quarter of a million people die due to a sudden stop of blood circulation. The indicators could be much higher, but some cases of cardiac and cerebral death can be prevented due to the fact that there are people nearby who know the rules of cardiopulmonary resuscitation (CPR).

CPR technique: a new standard

Cardiopulmonary resuscitation is a complex of urgent measures to stop the terminal condition and maintain life. Of the three stages of CPR, the first — basic — does not require the use of medicines or special equipment, when using medicines or devices, the resuscitation stage is called extended. The third stage of CPR is performed in the intensive care unit.
The main modern postulates of the CPL were adopted in 1968 by Peter Safar and have been changed more than once since then in order to make measures for the restoration and maintenance of vital functions more effective. Thus, the rules of cardiopulmonary resuscitation of the first stage have changed after numerous studies have shown that the use of continuous chest compressions is crucial for the survival of victims, and the interruption of indirect heart massage for artificial respiration can increase the risk of death.

In 2010, a new CPR protocol from the American Heart Disease Association (HDA) was published. According to the recommendations of experts in the field of emergency care, the classical Safar method has given way to modern methods. For adult patients, when performing CPR, non-specialists are recommended to focus on indirect heart massage or limit themselves to it only.

It should be clarified that cardiopulmonary resuscitation of children has its own specifics and other requirements.

According to the new standard of the rules of cardiopulmonary resuscitation for adults, if anyone witnessed a sudden cardiac arrest in relatives, acquaintances, colleagues or strangers, it is necessary:

  • if the victim does not show signs of life, loudly call for help and call an ambulance;
  • make sure that there is no threat to your own life and health (exposed electrical wire, hanging object, danger of explosion, etc.);
  • assess the condition of the victim and the situation to make sure that the person is unconscious, there is no independent breathing and pulsation on the main vessels (if it is not possible to find a pulse on the carotid artery, it is recommended not to waste time determining this sign);
  • turn the victim face up and carefully release the airways, using the Safar method (known as the “triple reception”) with simultaneous movement of the hands: one, pressing on the forehead, gives the back of the head back, and the other — at first, if there is no spinal injury, placed under the back of the neck, lifts it, and then placed under the chin, moves the lower jaw up;
  • with the hands straightened in the elbow joints (one is placed with the palm on the lower chest area in the center, the other on top, fingers intertwined) rhythmically press on the central chest area of the victim so that the sternum drops by 5-6 cm, at a speed of about 2 movements per second;
  • alternate 30 taps and two exhalations (1 second each, with an interval of less than 10 seconds) into the victim’s mouth, blocking the nasal passages and carefully monitoring his condition. This can be done if CPR is performed on an adult by two people. If there are no assistants, indirect heart massage is considered more important than artificial respiration.

To maintain the necessary rhythm of chest presses, there are top lists of songs with a suitable rhythm. In Germany, for example, the Bee Gees’ Stayin’ Alive is considered the official CPR tune and is exempt from a fine for copyright infringement when broadcast in medical educational institutions.
Other songs fit just as well. In order not to lose the rhythm, remember Yellow Submarine from The Beatles, Like a Prayer of Madonna, “Macarena” from Los Del Rio. In general, everything with a rhythm of 100-120 beats per minute.

CPR should be performed:

  • before the arrival of the ambulance team;
  • until the appearance of steady and rhythmic breathing (without convulsive breaths);
  • if signs of life do not appear, perform compression for at least 30 minutes.

In 2020, the results of research by Chinese scientists were published, who, after analyzing statistics, came to the conclusion that thanks to timely CPR, spontaneous blood circulation can be restored in 29.7% of episodes of cardiac death.

Prevention of infections with CPR

In the illustrations to the CPR rules, it was previously possible to see a picture where a handkerchief was applied to the mouth and nose area of the resuscitated person to reduce the risk of infections for both CPR participants during mouth-to-mouth or mouth-to-nose artificial respiration. Today the recommendations have changed.
If the victim is a stranger or there is a threat of infection, including COVID—19, in accordance with the new instructions of the World Health Organization, it is recommended:

  • use personal protective equipment during CPR (masks, glasses, gloves, etc.);
  • do not approach the victim’s face, trying to check for breathing, pupil reactions, and so on, in order to reduce the risk of possible infection;
  • limit the compression effect on the chest of the victim without artificial ventilation;
  • thoroughly treat your hands with antiseptic and wash them with water after resuscitation.

If, for any reason, CPR cannot be performed in case of sudden clinical death, there is a threat to one’s own life, physical weakness, panic, a strong fear of infection, one should try to call others and be sure to call an ambulance, tell them what condition the person is in and exactly where he is. Then you should wait for the arrival of specialists near the scene of the accident, this can help doctors find the victim faster and clarify the causes of his condition.
For a quick and correct reaction and self-confidence, we recommend taking first aid courses: there are trainings for cardiopulmonary resuscitation.

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