Basic emergency resuscitation/SŠ (nurse)

Cardiopulmonary resuscitation (CPR) is indicated for loss of consciousness when normal breathing is not present.

Basic emergency resuscitation procedure

 * 1) Remember your own safety!
 * 2) Assess the situation, quality of consciousness (addressing, shaking); in case of polytraumathis bleeding condition.
 * 3) Call for help from the neighborhood, the person in question calls 155 immediately.
 * 4) Open the airway by tilting the head.
 * 5) Check for breathing (hear, see, feel), detect possible gasping, must not last more than 10 seconds
 * 6) Call EMS (155, 112).
 * 7) Is AED in range? If YES, use it.
 * 8) 30 chest compressions, frequency 100-120 per minute, depth 5-6 cm.
 * 9) 2 breaths – move the jaw forward, plug the nose (in the case of a feeling of the possibility of transmission of an infectious disease or inefficient breathing, we prefer compressions).

General

 * Chest massage is preferred over artificial respiration when contagion is assumed during artificial respiration.
 * We emphasize starting CPR as quickly as possible with as little interruption as possible and using an AED.



A – airway → patency of airways

 * This step involves clearing the airway.
 * Manual examination of the oral cavity.
 * Head tilt.

When suffocating a conscious patient, we use the following procedure:
 * 1) Prompt to cough.
 * 2) 5× punch between the shoulder blades (Gordon punch).
 * 3) Heimlich palpation in adults.
 * 4) In case of loss of consciousness, we start CPR.

B – breathing → breathing

 * Securing the airway should not delay cardiac massage.
 * The volume we inhale into an adult is approx. 500 ml of air (7-9 ml/kg), we use our own normal breath.

C – circulation → circulation
https://www.youtube.com/watch?v=hZqwjYPQPbM&feature=youtu.be
 * 1) We kneel from the side next to the affected person, who is placed on a firm mat (ideally the ground).
 * 2) Place the joined hands on the center of the chest - between the breasts. The upper limbs must be bent at the elbows!
 * 3) We compress the chest approx. 5-6 cm deep.
 * 4) * Frequency of compressions is 100-120 compressions per minute.
 * 5) * Compression:relaxation = 1:1.


 * With an effective heart massage, we are able to ensure 30% of the minute cardiac output.

Stop CPR

 * When breathing and pulse are restored.
 * Based on the doctor's decision.
 * Transfer of the affected person to the rescue service.
 * Exhaustion of the savior's physical strength.
 * Reason not to start:
 * Certain signs of death.
 * Real risk of endangering the rescuer.
 * Terminal phase of the disease.

AED - Automated External Defibrillator
Use:
 * 1) Remember your own safety!
 * 2) Assess the situation, the quality of consciousness (addressing, shaking); in the case of polytrauma, the condition bleeding.
 * 3) Call for help from the neighborhood.
 * 4) Open the airway by tilting the head.
 * 5) Check breathing (hear, see, feel), it must not last more than 10 seconds.
 * 6) Call EMS (155, 112).
 * 7) Is the AED in range? If YES, use it.
 * 8) Turn on the defibrillator.
 * 9) Place the electrodes on the chest and let the device perform the analysis.
 * 10) If SHOCK RECOMMENDED sounds (the device analyzes EKG):
 * 11) * Check if anyone is touching.
 * 12) * Press the Shock button, followed by delivery of 1-3 shocks.
 * 13) * 2 minutes of CPR 30:2 follows without circulation control.
 * 14) * The device analyzes the time, after 2 minutes it proceeds to the next ECG analysis and possibly recommends another shock.
 * 15) * The procedure continues to repeat until the ECG changes or emergency services arrive and proceed to ALS.


 * If SHOCK NOT RECOMMENDED is heard, we continue CPR 30:2 for 2 minutes, then repeat the rhythm analysis; we keep repeating the cycle until the RZS arrives or until consciousness is restored.


 * Possibility of a virtual trainer at http://www.sntplus.cz/products/defibrillator.php

https://www.youtube.com/watch?v=cwG64FYV9Sg&feature=youtu.be

Procedure for basic emergency resuscitation in children
We distinguish children up to 1 year and from 1 year to puberty.
 * 1) Remember your own safety!
 * 2) Assess the situation, quality of consciousness (addressing, shaking); in case of polytraumathis bleeding condition.
 * 3) Call for help from the neighborhood.
 * 4) Open the airway by tilting the head.
 * 5) Check breathing (hear, see, feel), it must not last more than 10 seconds.
 * 6) Start CPR 5 breaths.
 * 7) CPR for 1 minute, 30:2, two rescuers or one experienced medical professional trained in children's CPR 15:2, newborns 3:1 compress the chest by 1/3 of the height (up to 5 cm).
 * 8) Call EMS (155, 112).
 * 9) Is AED in range? If YES, use it. The use of children's electrodes, if any, anteroposterior bonding of the electrodes, the keys to reducing the shock energy to 4 J/kg (50–75 J in children 1–8 years).
 * 10) 30 chest compressions, frequency 100 per minute. We perform compression with one hand or two fingers in the middle of the chest.
 * 11) 2 breaths, plug the nose (small children breathe through the nose and mouth at the same time).
 * The most common cause of circulatory arrest in children is suffocation, so we take into account the number of breaths before compression.
 * It is advantageous to use capnometry.
 * After resumption of circulation, ventilation with 100% oxygen is not desirable, SaO2 must be maintained between 94-98%.

Summary of Resuscitation Differences
Note: Two rescuers or one experienced paramedic trained in pediatric CPR use a ratio of 15:2 (for children from 1 year to puberty).

Related Articles

 * Advanced emergency resuscitation/SŠ (nurse)
 * FIRST AID KIT
 * Basic CPR

Externí odkazy

 * Společnost urgentní medicíny a medicíny katastrof
 * Česká resuscitační rada
 * Záchranná služba: nezávislý web o záchranné službě