Family first aid is divided into two steps
All kinds of heart diseases can lead to cardiac arrest, especially coronary heart disease. Other causes include electric shock, poisoning, drowning, trauma and other emergencies. Patients often show sudden loss of consciousness, which may be accompanied by local or systemic convulsions. Intermittent, sighing, or short, spasmodic breathing, followed by cessation of breathing. Skin is pale or purplish, pupil is loose big, can appear defecate incontinence.
The key to avoid biological death is to carry out cardiopulmonary resuscitation and defibrillation as soon as possible after cardiac arrest. The key of family first aid is to provide primary life support, that is, hand cardiopulmonary resuscitation.
First, judge whether the patient has lost consciousness
When the patient's consciousness is suddenly unclear, the first step is to judge the patient's response. You can pat the patient's shoulders, lean over your ears and shout 'what's the matter with you?' if the patient is a baby, you can pat the sole of his foot. If there is no response, it is initially judged as loss of consciousness. Call for help immediately.
Step 2: call for help + cardiopulmonary resuscitation
If the patient is over eight years old, he / she should be regarded as an adult, call 120 for rescue first, and then carry out CPR; if the child is between one and eight years old, he / she should immediately carry out CPR for two minutes, then call 120, and then return to CPR quickly; if the baby is under one year old, he / she should immediately carry out CPR for two minutes, and then carry the child while walking for resuscitation 。 When there are other people around, you can arrange them to call 120 for rescue, and at the same time instruct them to come back to help rescue after asking for help.
Cardiopulmonary resuscitation measures
The main measures of CPR include open airway, artificial respiration and artificial chest compression.
1. First, place the patient in the correct position and lie on the back on a hard plane. If you want to rescue the patient in bed, you should put a hard board on the back of the patient. The rescuer is located on one side of the patient, legs are the same width as the shoulder, and kneels (or stands) beside the shoulder and chest.
2. Untie the clothes of the patient and expose the front chest.
3. Open the mouth, if there is any foreign body, turn the patient's head to one side, hook it out with fingers, and take out the denture if it is loose.
4. Open the airway by raising the head and jaw: the rescuer put one hand on the patient's forehead to press hard, so that the head is tilted back, and the index finger and middle finger of the other hand raise the jaw, so that the line between the jaw angle and the earlobe is perpendicular to the ground. One to eight year olds had a 60 degree angle between the mandibular angle and the line of the earlobe and the ground, while infants had a 30 degree angle.
5. Judge whether there is breathing. Place the cheek about 3cm close to the patient's mouth and nose. Use the eyes to observe whether the chest is undulating, whether there is breathing sound in the ears, and whether there is breathing air flow in the cheek. The judgment time is 5-10S. No artificial respiration is prepared.
6. Artificial respiration is commonly used for adults and children. Mouth to nose breathing can be used for those who can not open their mouth and are injured in the mouth; mouth to nose breathing can be used for infants who are small in mouth and nose.
7. Check the pulse, adults and children touch the carotid artery, infants touch the brachial artery, and use 5-10 seconds to judge whether there is a pulse, and immediately press the heart outside the chest if there is no pulse.
8. Chest compression for heart disease
① position: the pressing position of adults and children is 1 / 2 of the lower part of the sternum, and that of infants is the middle part of the chest close to the lower level of the line of the nipple.
② method: adults and children can press by overlapping the palmar roots of both hands. The transverse axis of the palmar roots is the same as the long axis of the sternum. Children can also press by single palmar roots. Infants can press by the fingertips of middle finger and ring finger.
③ method and depth: when pressing, lean your upper body forward, straighten your arms perpendicular to the sternum, take the hip joint as the fulcrum, use the upper body weight and the palm root to press the sternum down 4-5cm (3-4cm for children, 2-3cm for infants, all about 1 / 3-1 / 2 of the front and back diameter of the thorax). After pressing, relax, but don't leave the chest. The pressing time is the same as the relaxing time.
④ pressing frequency and blowing ratio: press at the frequency of 100 times / minute, the rhythm should be uniform, and blow twice after every 30 times as a cycle.
⑤ when pressing, observe the patient's reaction and face color, complete 5 cycles of pressing and blowing in about 2 minutes, then check the pulse and observe the circulation signs in 5-10 seconds, and check once every 2 minutes after the period. If the patient has only pulse but no breath, artificial respiration should be performed at the frequency of 12 times per minute.
Cardiopulmonary resuscitation is an effective manifestation of cardiopulmonary resuscitation if the following conditions occur in the patients with heart disease: the complexion changes from pale, blue and purple to ruddy; the pulse and breath recover during the recheck; the pupil changes from big to small, and the light reflex recovers; the limbs twitch, the eyeball moves, and moans.
Precautions for heart disease
I. essential sphygmomanometer at home
We should prepare a sphygmomanometer which is convenient to measure by ourselves. Its function is to judge the blood pressure and guide the medication during the heart attack. In addition, you should take nitroglycerin with you, and prepare aspirin and heartache.
There are heart patients at home. We should take precautions against myocardial infarction as a major event. In case of emergency, what preparations should be made? Our reporter interviewed Professor Meng Qingyi, deputy director of emergency department of PLA General Hospital. He proposed the following necessary items:
First of all, we should prepare a sphygmomanometer which is convenient for self measurement. Its function is to judge the blood pressure and guide the medication when the heart attack occurs. Meng Qingyi said that the measurement of blood pressure during a heart attack is often ignored by the public. Many people take nitroglycerin once they feel uncomfortable in the heart. However, nitroglycerin is a kind of vasodilator, which can reduce blood pressure to a certain extent. If the patient's blood pressure is low at this time, it is likely to be worse.
Secondly, several drugs need to be prepared: 1. Nitroglycerin or quick acting Jiuxin Pill, which is best placed in a 24-hour first-aid box; 2. Xiaoxintong, because nitroglycerin is easy to deliquesce and lose efficacy, prepare some Xiaoxintong, which is well prepared, in addition, Xiaoxintong's antihypertensive effect is not as strong as nitroglycerin, and its efficacy is relatively mild, which is suitable for myocardial infarction patients with low blood pressure; 3. ASI The function of aspirin is to make patients chew and take it when myocardial infarction breaks out, which is conducive to dissolving thrombus and unblocking blocked blood vessels.
Finally, if conditions permit, the home can prepare oxygen production devices, such as small oxygen cylinders, oxylide, etc., which can play a certain role in the first aid of myocardial infarction.
2. Lie down when you are ill
If your heart is not comfortable, you must lie on your back, even in the street. Don't hold on. In addition to nitroglycerin, take 300 milligrams of aspirin.
'if your heart doesn't feel comfortable, you must lie down on your back. Even in the street, you must do the same. Don't hold on. Professor Meng Qingyi, emergency department of PLA General Hospital, stressed. He said sadly, this is all blood lessons. Once there was an old man with coronary heart disease who felt severe chest pain when riding on the street. He stopped for a rest and felt a little better. He rode on the car and went on walking. As a result, he fell to the ground not far away and never woke up again.
Why do you have to lie down? Meng Qingyi explained that when you are sitting or standing, your heart needs to pump blood to a higher head. If you lie down, your heart will save energy and reduce many burdens.
Meng Qingyi said that if you are alone at home when you are ill, lie down immediately, measure your blood pressure, then take nitroglycerin or heartache, and chew 300 mg aspirin. The reason why aspirin is chewed is to make it absorbed from under the tongue, so as to play a faster role. In addition, call 120 or 999 emergency call at the same time of self rescue. If you are on the street, you should also lie on your back and take medicine, and then ask passers-by to call for help.
It is said that coughing can help in case of heart attack. Meng Qingyi said that there is a "cough recovery" theory in medicine, but it only aims at specific arrhythmias, such as ventricular tachycardia, extreme bradycardia, etc., which need to be carried out under the guidance of doctors. However, in general patients with myocardial infarction, if coughing, it will increase oxygen consumption and increase the burden on the heart, so it should not be advocated.
3. My heart stops beating. I need help in 4 minutes
If the patient 'doesn't respond to the call and doesn't wake up', it can basically be judged that the heartbeat stops. At this time, cardiopulmonary resuscitation should be started immediately.
Time is life, which is the truth in first aid of heart disease. There are 500000 new myocardial infarction every year in China, and about one person dies every 15 seconds. If recovery measures are taken in time, many people can save their lives. Professor Meng Qingyi pointed out that generally speaking, the later the recovery starts, the lower the recovery success rate. If the recovery starts after 4-5 minutes of cardiac arrest, the chances of survival are very few; if the recovery is delayed to 7-8 minutes, the chances of survival are even lower. This is the source of the "gold 4 minutes" statement.
How to judge the patient's cardiac arrest? Generally speaking, if the patient is ill after exercise or has a history of heart disease before, the first thing to consider is a heart attack. If the patient 'can't call, can't wake up', it can be basically judged that the heartbeat has stopped. At this time, cardiopulmonary resuscitation should be started immediately. If more than two people are present, one person should perform CPR immediately, and the other person should call the emergency number at the same time; if only one person is present, resuscitation should be performed first, and then call.
Cardiopulmonary resuscitation should first open the airway, the patient should be placed flat on the hard bed, the ground can also be, the head should not be higher than the chest, in order to facilitate the flow of blood into the brain prone to hypoxia. The rescuer pushes the patient's forehead with one hand and raises the patient's jaw with the other hand to keep the airway unblocked. When a person rescues, only external chest compression can be done. The compression part is located in the middle of the double nipple line. The frequency of compression is 100 times per minute, each time the sternum sinks 3-5cm. If there are two people present, they can also cooperate with artificial respiration, that is, hold the nose of the patient with one hand and slowly blow air into the mouth of the patient.
"Once the heart stops beating, there is a great risk of death. Therefore, cardiopulmonary resuscitation must be done immediately and continuously until the medical staff arrives. 'Meng Qingyi stressed.