How often should artificial respiration be performed? Rules for artificial respiration. Cardiac massage and artificial respiration techniques

Often the life and health of an injured person depends on how correctly first aid is provided to him.

According to statistics, in case of cardiac and respiratory arrest, it is first aid that increases the chance of survival by 10 times. After all, oxygen starvation of the brain for 5-6 minutes. leads to irreversible death of brain cells.

Not everyone knows how resuscitation measures are carried out if the heart has stopped and there is no breathing. And in life, this knowledge can save a person’s life.

Causes and signs of cardiac and respiratory arrest

The reasons that led to cardiac and respiratory arrest may be:

Before starting resuscitation measures, you should assess the risks for the victim and volunteer helpers - is there a threat of building collapse, explosion, fire, electric shock, gas contamination of the room. If there is no threat, then you can save the victim.

First of all, it is necessary to assess the patient’s condition:

The person should be called out and questions asked. If he is conscious, then it is worth asking about his condition and well-being. In a situation where the victim is unconscious or fainting, it is necessary to conduct an external examination and assess his condition.

The main sign of absence of heartbeat is the absence of pupillary reaction to light rays. IN in good condition The pupil contracts when exposed to light and dilates when the light intensity decreases. Advanced indicates dysfunction nervous system and myocardium. However, disruption of pupil reactions occurs gradually. Complete absence the reflex occurs 30-60 s after complete cardiac arrest. Some medications, narcotic substances, and toxins can also affect the width of the pupils.

The functioning of the heart can be checked by the presence of blood impulses in the large arteries. It is not always possible to find the victim’s pulse. The easiest way to do this is on the carotid artery, located on the side of the neck.

The presence of breathing is judged by the noise of air escaping from the lungs. If breathing is weak or absent, then characteristic sounds may not be heard. It is not always possible to have a fogging mirror at hand, which can be used to determine whether there is breathing. Movement of the chest may also not be noticeable. Leaning towards the victim’s mouth, note the change in sensations on the skin.

A change in the shade of the skin and mucous membrane from natural pink to gray or bluish indicates circulatory problems. However, in case of poisoning with certain toxic substances pink of the skin is preserved.

The appearance of cadaveric spots and waxy pallor indicates the inappropriateness of resuscitation efforts. This is also evidenced by injuries and damage incompatible with life. Resuscitation measures should not be carried out in case of a penetrating wound to the chest or broken ribs, so as not to pierce the lungs or heart with bone fragments.

After the victim’s condition has been assessed, resuscitation should be started immediately, since after the cessation of breathing and heartbeat, only 4-5 minutes are allotted to restore vital functions. If it is possible to revive after 7-10 minutes, then the death of some brain cells leads to mental and neurological disorders.

Insufficiently prompt assistance can lead to permanent disability or death of the victim.

Algorithm for resuscitation

Before starting pre-medical resuscitation measures, it is recommended to call an ambulance.

If the patient has a pulse, but is in a deep unconscious state, he will need to be laid on a flat, hard surface, the collar and belt should be loosened, the head turned to the side to prevent aspiration in case of vomiting, if necessary, the airway should be cleared and oral cavity from accumulated mucus and vomiting.

It is worth noting that after cardiac arrest, breathing can continue for another 5-10 minutes. This is the so-called “agonal” breathing, which is characterized by visible movements of the neck and chest, but low productivity. The agony is reversible, and with properly performed resuscitation measures the patient can be brought back to life.

If the victim does not show any signs of life, then the rescuer must perform the following steps step by step:

When resuscitating the patient, the patient’s condition is periodically checked - the appearance and frequency of the pulse, the light response of the pupil, breathing. If the pulse is palpable, but there is no spontaneous breathing, the procedure must be continued.

Only when breathing appears can resuscitation be stopped. If there is no change in condition, resuscitation continues until the ambulance arrives. Only a doctor can give permission to complete the revival.

Method of performing respiratory resuscitation

Restoration of respiratory function is carried out using two methods:

Both methods do not differ in technique. Before resuscitation begins, the victim's airway is restored. For this purpose, the mouth and nasal cavity are cleaned of foreign objects, mucus, and vomit.

If dentures are present, they are removed. The tongue is pulled out and held to prevent blockage of the airway. Then they begin the actual resuscitation.

Mouth-to-mouth method

The victim is held by the head, placing 1 hand on the patient’s forehead, the other pressing the chin.

They squeeze the patient’s nose with their fingers, the resuscitator takes the deepest possible breath, presses his mouth tightly against the patient’s mouth and exhales air into his lungs. If the manipulation is carried out correctly, the chest will rise noticeably.

Method of performing respiratory resuscitation using the mouth-to-mouth method

If movement is observed only in the abdominal area, then the air has entered the wrong direction - into the trachea, but into the esophagus. In this situation, it is important to ensure that air gets into the lungs. 1 artificial breath is performed within 1 s, strongly and evenly exhaling air into the victim’s respiratory tract with a frequency of 10 “breaths” per 1 min.

Mouth-to-nose technique

The mouth-to-nose resuscitation technique is completely identical to the previous method, except that the person performing the resuscitation exhales into the patient’s nose, tightly closing the victim’s mouth.

After artificial inhalation, the air should be allowed to leave the patient's lungs.

Method of performing respiratory resuscitation using the “mouth to nose” method

Respiratory resuscitation is carried out using a special mask from the first aid kit or by covering the mouth or nose with a piece of gauze or cloth, or a handkerchief, but if they are not there, then there is no need to waste time looking for these items - it is worth carrying out rescue measures immediately.

Cardiac resuscitation technique

To begin with, it is recommended to free the chest area from clothing. The person providing assistance is located to the left of the person being resuscitated. Perform mechanical defibrillation or pericardial shock. Sometimes this measure restarts a stopped heart.

If there is no reaction, then perform an indirect cardiac massage. To do this, you need to find the end of the costal arch and place bottom part place the palms of your left hand on the lower third of the sternum, and place your right hand on top, straightening your fingers and lifting them up (butterfly position). The push is carried out with the arms straightened at the elbow joint, pressing with the entire body weight.

Stages of performing indirect cardiac massage

The sternum is pressed to a depth of at least 3-4 cm. Sharp hand pushes are performed with a frequency of 60-70 pressures per minute. – 1 press on the sternum in 2 seconds. The movements are performed rhythmically, alternating a push and a pause. Their duration is the same.

After 3 min. The effectiveness of the activity should be checked. The fact that cardiac activity has been restored is indicated by palpation of the pulse in the area of the carotid or femoral artery, as well as a change in complexion.

Carrying out simultaneous cardiac and respiratory resuscitation requires a clear alternation - 2 breaths per 15 pressures on the heart area. It is better if two people provide assistance, but if necessary, the procedure can be performed by one person.

Features of resuscitation in children and the elderly

In children and older patients, the bones are more fragile than in young people, so the force of pressing on the chest should be commensurate with these features. The depth of chest compression in elderly patients should not exceed 3 cm.

How to perform indirect cardiac massage on a baby, child, or adult?

In children, depending on the age and size of the chest, massage is performed:

Newborns and infants are placed on the forearm, placing the palm under the baby's back and holding the head above the chest, slightly tilted back. The fingers are placed on the lower third of the sternum.

You can also use another method in infants - the chest is covered with the palms, and the thumb is placed in the lower third of the xiphoid process. The frequency of kicks varies among children of different ages:

Age (months/years)	Number of pressures in 1 minute.	Deflection depth (cm)
≤ 5	140	˂ 1.5
6-11	130-135	2-2,5
12/1	120-125	3-4
24/2	110-115	3-4
36/3	100-110	3-4
48/4	100-105	3-4
60/5	100	3-4
72/6	90-95	3-4
84/7	85-90	3-4

When performing respiratory resuscitation in children, it is done with a frequency of 18-24 “breaths” per 1 minute. The ratio of resuscitation movements of the cardiac impulse and “inhalation” in children is 30:2, and in newborns – 3:1.

The life and health of the victim depends on the speed at which resuscitation measures begin and the correctness of their implementation.

It is not worth stopping the victim’s return to life on your own, since even medical workers cannot always determine the moment of death of a patient visually.

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If there is a pulse in the carotid artery, but there is no breathing, begin artificial ventilation immediately. At first provide restoration of airway patency. For this the victim is placed on his back, head maximum tipped back and, grabbing the corners of the lower jaw with your fingers, push it forward so that the teeth of the lower jaw are located in front of the upper ones. Check and clean the oral cavity of foreign bodies. To comply with safety measures You can use a bandage, napkin, or handkerchief wrapped around your index finger. If you have a spasm in your masticatory muscles, you can open your mouth with a flat, blunt object, such as a spatula or the handle of a spoon. To keep the victim's mouth open, you can insert a rolled up bandage between the jaws.

To carry out artificial pulmonary ventilation using the "mouth to mouth" It is necessary, while holding the victim’s head back, take a deep breath, pinch the victim’s nose with your fingers, press your lips tightly against his mouth and exhale.

When performing artificial lung ventilation using the method "mouth to nose" air is blown into the victim’s nose, while covering his mouth with his palm.

After inhaling air, it is necessary to move away from the victim; his exhalation occurs passively.

To comply with safety and hygiene measures Insufflation should be done through a moistened napkin or a piece of bandage.

The frequency of injections should be 12-18 times per minute, that is, you need to spend 4-5 seconds on each cycle. The effectiveness of the process can be assessed by the rise of the victim’s chest when his lungs are filled with inhaled air.

In that case When the victim simultaneously lacks breathing and pulse, emergency cardiopulmonary resuscitation is performed.

In many cases, restoration of heart function can be achieved by precordial stroke. To do this, place the palm of one hand on the lower third of the chest and apply a short and sharp blow to it with the fist of the other hand. Then they re-check the presence of a pulse in the carotid artery and, if it is absent, begin indirect cardiac massage and artificial ventilation.

For this victim placed on a hard surface The person providing assistance places his crossed palms on the lower part of the victim’s sternum and vigorously presses on the chest wall, using not only his hands, but also the weight of his own body. The chest wall, shifting towards the spine by 4-5 cm, compresses the heart and pushes blood out of its chambers along its natural course. In an adult person, such an operation must be performed with frequency of 60 compressions per minute, that is, one pressure per second. In children up to 10 years massage is performed with one hand with frequency 80 compressions per minute.

The correctness of the massage is determined by the appearance of a pulse in the carotid artery in time with pressing on the chest.

Every 15 compressions assisting blows air into the victim's lungs twice in a row and again performs a heart massage.

If resuscitation is carried out by two people, That one of which carries out heart massage, the other is artificial respiration in mode one blow every five presses on the chest wall. At the same time, it is periodically checked whether an independent pulse has appeared in the carotid artery. The effectiveness of resuscitation is also judged by the constriction of the pupils and the appearance of a reaction to light.

When restoring breathing and cardiac activity of the victim in an unconscious state, must be laid on its side to prevent him from suffocating with his own sunken tongue or vomit. The retraction of the tongue is often indicated by breathing that resembles snoring and severe difficulty in inhaling.

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What kind of poisoning can cause breathing and heartbeat to stop?

Death as a result of acute poisoning can happen from anything. The main causes of death in case of poisoning are cessation of breathing and heartbeat.

Arrhythmia, atrial and ventricular fibrillation and cardiac arrest can be caused by:

In what cases is artificial respiration necessary? Respiratory arrest occurs due to poisoning:

In the absence of breathing or heartbeat, clinical death occurs. It can last from 3 to 6 minutes, during which there is a chance of saving the person if you start artificial respiration and chest compressions. After 6 minutes, it is still possible to bring a person back to life, but as a result of severe hypoxia, the brain undergoes irreversible organic changes.

When to start resuscitation measures

What to do if a person falls unconscious? First you need to identify signs of life. The heartbeat can be heard by placing your ear to the victim's chest or by feeling the pulse in the carotid arteries. Breathing can be detected by the movement of the chest, leaning towards the face and listening for inhalation and exhalation by holding a mirror to the victim’s nose or mouth (it will fog up when breathing).

If no breathing or heartbeat is detected, resuscitation should begin immediately.

How to do artificial respiration and chest compressions? What methods exist? The most common, accessible to everyone and effective:

external cardiac massage;
mouth-to-mouth breathing;
breathing "from mouth to nose".

It is advisable to conduct receptions for two people. Cardiac massage is always carried out together with artificial ventilation.

Procedure in the absence of signs of life

Free the respiratory organs (oral, nasal cavity, pharynx) from possible foreign bodies.
If there is a heartbeat, but the person is not breathing, only artificial respiration is performed.
If there is no heartbeat, artificial respiration and chest compressions are performed.

How to do indirect cardiac massage

The technique of performing indirect cardiac massage is simple, but requires the right actions.

Why is indirect cardiac massage impossible if the victim is lying on something soft? In this case, the pressure will be released not on the heart, but on the pliable surface.

Very often, ribs are broken during chest compressions. There is no need to be afraid of this, the main thing is to revive the person, and the ribs will grow together. But you need to take into account that broken ribs are most likely the result of incorrect execution and you should moderate the pressing force.

Age of the victim	How to press	Pressing point	Depth of pressing	Velocity	Inhalation/pressure ratio
Age up to 1 year	2 fingers	1 finger below the nipple line	1.5–2 cm	120 and more	2/15
Ages 1–8 years		2 fingers from the sternum		100–120
Adult	2 hands	2 fingers from the sternum	5–6 cm	60–100	2/30

Artificial respiration from mouth to mouth

If a poisoned person has secretions in the mouth that are dangerous to the resuscitator, such as poison, poisonous gas from the lungs, or an infection, then artificial respiration is not necessary! In this case, you need to limit yourself to performing an indirect cardiac massage, during which, due to pressure on the sternum, about 500 ml of air is expelled and again absorbed.

How to do mouth-to-mouth artificial respiration?

For your own safety, it is recommended that artificial respiration is best done through a napkin, while controlling the tightness of the pressure and preventing air “leakage”. Exhalation should not be sharp. Only strong but smooth (for 1–1.5 seconds) exhalation will ensure proper movement of the diaphragm and filling of the lungs with air.

Artificial respiration from mouth to nose

Artificial respiration “mouth to nose” is performed if the patient is unable to open his mouth (for example, due to a spasm).

Having laid the victim on a straight surface, tilt his head back (if there are no contraindications for this).
Check the patency of the nasal passages.
If possible, the jaw should be extended.
After a maximum inhalation, you need to blow air into the injured person’s nose, tightly covering his mouth with one hand.
After one breath, count to 4 and take the next one.

Features of resuscitation in children

In children, resuscitation techniques differ from those in adults. The chest of babies under one year old is very tender and fragile, the heart area is smaller than the base of the palm of an adult, so pressure during indirect cardiac massage is performed not with the palms, but with two fingers. The movement of the chest should be no more than 1.5–2 cm. The frequency of compressions is at least 100 per minute. From 1 to 8 years of age, massage is done with one palm. The chest should move 2.5–3.5 cm. Massage should be performed at a frequency of about 100 pressures per minute. The ratio of inhalation to compression on the chest in children under 8 years old should be 2/15, in children over 8 years old - 1/15.

How to perform artificial respiration for a child? For children, artificial respiration can be performed using the mouth-to-mouth technique. Since babies have small faces, an adult can perform artificial respiration by immediately covering both the child’s mouth and nose. The method is then called “mouth to mouth and nose.” Artificial respiration is given to children at a frequency of 18–24 per minute.

How to determine if resuscitation is being performed correctly

Signs of effectiveness when following the rules for performing artificial respiration are as follows.

When artificial respiration is performed correctly, you may notice the chest moving up and down during passive inspiration.

If the movement of the chest is weak or delayed, you need to understand the reasons. Probably a loose fit of the mouth to the mouth or nose, a shallow breath, a foreign body preventing the air from reaching the lungs.
If, when you inhale air, it is not the chest that rises, but the stomach, then this means that the air did not go through the airways, but through the esophagus. In this case, you need to press on the stomach and turn the patient's head to the side, as vomiting is possible.

The effectiveness of cardiac massage also needs to be checked every minute.

If, when performing an indirect cardiac massage, a push appears on the carotid artery, similar to a pulse, then the pressing force is sufficient for blood to flow to the brain.
If resuscitation measures are performed correctly, the victim will soon experience heart contractions, blood pressure will rise, spontaneous breathing will appear, the skin will become less pale, and the pupils will narrow.

All actions must be completed for at least 10 minutes, or better yet, before the ambulance arrives. If the heartbeat persists, artificial respiration must be performed for a long time, up to 1.5 hours.

If resuscitation measures are ineffective within 25 minutes, the victim has cadaveric spots, a symptom of a “cat” pupil (when pressure is applied to the eyeball, the pupil becomes vertical, like a cat’s) or the first signs of rigor - all actions can be stopped, since biological death has occurred.

The sooner resuscitation is started, the greater the likelihood of a person returning to life. Their correct implementation will help not only restore life, but also provide oxygen to vital organs, prevent their death and disability of the victim.

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Artificial respiration (Artificial ventilation)

If there is a pulse but no breathing: carry out artificial ventilation.

Artificial ventilation. Step one

Provide restoration of airway patency. To do this, the victim is placed on his back, his head is thrown back as much as possible and, grabbing the corners of the lower jaw with his fingers, he pushes it forward so that the teeth of the lower jaw are located in front of the upper ones. Check and clean the oral cavity of foreign bodies. To comply with safety measures, you can use a bandage, napkin, or handkerchief wrapped around your index finger. To keep the victim's mouth open, you can insert a rolled up bandage between the jaws.

Artificial ventilation. Step two

To carry out artificial ventilation of the lungs using the mouth-to-mouth method, it is necessary, while holding the victim’s head back, take a deep breath, pinch the victim’s nose with your fingers, press your lips tightly to his mouth and exhale.

When performing artificial lung ventilation using the mouth-to-nose method, air is blown into the victim’s nose while covering his mouth with his hand.

Artificial ventilation. Step three

After inhaling air, it is necessary to move away from the victim; his exhalation occurs passively.
To comply with safety and hygiene measures, insufflation should be done through a moistened napkin or a piece of bandage.

The frequency of injections should be 12-18 times per minute, that is, you need to spend 4-5 seconds on each cycle. The effectiveness of the process can be assessed by the rise of the victim’s chest when his lungs are filled with inhaled air.

Indirect cardiac massage

If there is no pulse or breathing: time for indirect cardiac massage!

The sequence is as follows: first, indirect cardiac massage, and only then inhalation of artificial respiration. But! If discharge from the mouth of a dying person poses a threat (infection or poisoning by poisonous gases), only chest compressions should be performed (this is called non-ventilation resuscitation).

With each compression of the chest by 3-5 cm during chest compressions, up to 300-500 ml of air are expelled from the lungs. After the compression stops, the chest returns to its original position and the same volume of air is sucked into the lungs. Active exhalation and passive inhalation occur.
With indirect cardiac massage, the rescuer’s hands are not only the heart, but also the lungs of the victim.

You must act in the following order:

Indirect cardiac massage. Step one

If the victim is lying on the ground, be sure to kneel in front of him. At the same time, it does not matter from which side you approach it.

Indirect cardiac massage. Step two

For indirect cardiac massage to be effective, it must be performed on a flat, hard surface.

Indirect cardiac massage. Step three

Position the base right palm above the xiphoid process so that the thumb is directed towards the chin or abdomen of the victim. Left palm place on top of the palm of your right hand.

Indirect cardiac massage. Step four

Move your center of gravity to the victim's sternum, keeping your arms straight at the elbows. This will allow you to maintain strength for as long as possible. Bend your elbows when performing chest compressions - the same as doing push-ups from the floor (example: resuscitate the victim with pressure at a rhythm of 60-100 times per minute, at least 30 minutes, even if resuscitation is ineffective. Because only after this time signs of biological death clearly appear. Total: 60 x 30 = 1800 push-ups).

For adults, indirect cardiac massage is performed with two hands, for children - with one hand, for newborns - with two fingers.

Indirect cardiac massage. Step five

Push the chest at least 3-5 cm with a frequency of 60-100 times per minute, depending on the elasticity of the chest. In this case, the palms should not come off the victim’s sternum.

Indirect cardiac massage. Step six

You can begin applying pressure on the chest only after it has completely returned to its original position. If you don't wait for the sternum to return to its original position and press, the next push will turn into a monstrous blow. Performing chest compressions can result in fracture of the victim's ribs. In this case, the indirect cardiac massage is not stopped, but the frequency of compressions is reduced to allow the chest to return to its original position. At the same time, be sure to maintain the same depth of pressing.

Indirect cardiac massage. Step seven

The optimal ratio of chest compressions and mechanical ventilation breaths is 30/2 or 15/2, regardless of the number of participants. With each pressure on the chest, an active exhalation occurs, and when it returns to its original position, a passive inhalation occurs. Thus, new portions of air enter the lungs, sufficient to saturate the blood with oxygen.

How to strengthen the heart and cardiac muscle

Artificial respiration (artificial ventilation) is the replacement of air in the patient’s lungs, carried out artificially in order to maintain gas exchange when natural breathing is impossible or insufficient.

The need for artificial respiration arises in cases of disturbances in the central regulation of breathing (for example, in cerebrovascular accidents, cerebral edema), damage to the nervous system and respiratory muscles involved in the act of breathing (poliomyelitis, tetanus, poisoning with certain poisons), severe lung diseases ( asthmatic condition, extensive pneumonia), etc. In these cases, various hardware methods of artificial respiration are widely used (using automatic respirators RO-2, RO-5, LADA, etc.), which allow maintaining gas exchange in the lungs for a long time. Artificial respiration is often used as an emergency measure for conditions such as asphyxia (suffocation), drowning, electrical injury, heat and sunstroke, and various poisonings. In these situations, it is often necessary to resort to artificial respiration using so-called expiratory methods (mouth to mouth and mouth to nose).

The most important condition for the successful use of expiratory methods of artificial respiration is preliminary

Rice. 30. Artificial respiration technique.

care of airway patency. Ignoring this rule is the main reason for the ineffectiveness of artificial respiration methods. mouth to mouth And from mouth to nose. Poor airway patency is most often caused by retraction of the root of the tongue and epiglottis as a result of relaxation of the masticatory muscles and movement of the lower jaw when the patient is unconscious. Restoring airway patency is achieved by maximally throwing back the head (extending it at the vertebral-occipital joint) with pushing forward the lower jaw so that the chin occupies the most elevated position, as well as inserting a special curved air duct through the mouth into the patient’s pharynx behind the epiglottis.

When performing artificial respiration (Fig. 30), the patient is placed horizontally on his back; neck, The patient's chest and abdomen are freed from constricting clothing (the collar is unbuttoned, the tie is loosened, the belt is unfastened). The patient's oral cavity is freed from saliva, mucus, and vomit. After this, placing one hand on the parietal region of the patient, and placing the second under the neck, tilt his head back. If the patient's jaws are clenched tightly, then the mouth is opened by pushing the lower jaw forward and pressing index fingers at its corners.

When using the mouth-to-nose method, the caregiver closes the patient's mouth, lifting the lower jaw, and after a deep inhalation, exhales vigorously, wrapping his lips around the patient's nose. When using the “mouth to mouth” method, on the contrary, the patient’s nose is closed, and the exhalation is carried out into the victim’s mouth, having previously covered it with gauze or a handkerchief. Then the patient’s mouth and nose are opened slightly, after which a passive exhalation of pain occurs.

pogo. At this time, the person providing assistance moves his head away and takes normal 1-2 breaths. The criterion for correct artificial respiration is the movement (excursion) of the patient’s chest at the time of artificial inhalation and passive exhalation. If there is no chest excursion, it is necessary to find out and eliminate the reasons (poor airway patency, insufficient volume of inhaled air, poor sealing between the resuscitator’s mouth and the patient’s nose or mouth). Artificial respiration is carried out at a frequency of 12-18 artificial breaths per minute.

IN emergency situations artificial respiration can also be carried out using so-called manual respirators, in particular an Ambu bag, which is a rubber self-expanding chamber with a special valve (non-reversible), which ensures the separation of inhaled and passively exhaled air. When used correctly, these methods of artificial respiration can maintain gas exchange in the patient’s lungs for a long time (up to several hours).

Basic resuscitation measures also include cardiac massage, which is a rhythmic compression of the heart carried out to restore its activity and maintain blood circulation in the body. Currently, they mainly resort to indirect(closed) cardiac massage; direct(open) cardiac massage, carried out by direct compression of the heart, is usually used in cases where the need for it arises during surgery on the chest organs with opening of its cavity (thoracotomy).

During indirect cardiac massage, it is compressed between the sternum and the spine, due to which blood flows from the right ventricle into the pulmonary artery, and from the left ventricle into the systemic circulation, which leads to the restoration of blood flow in the brain and coronary arteries and can contribute to resumption of spontaneous heart contractions.

Indirect cardiac massage is indicated in cases of sudden cessation or sharp deterioration of cardiac activity, for example, in case of cardiac arrest (asystole) or ventricular fibrillation (fibrillation) in patients with acute myocardial infarction, electrical injury, etc. At the same time, when determining the indications for starting chest compressions, they are guided by such signs as a sudden cessation of breathing, absence of a pulse in the carotid arteries, accompanied by dilated pupils, pallor of the skin, and loss of consciousness.

Rice. 31. Technique of indirect cardiac massage.

Indirect cardiac massage is usually effective if it is started in early dates after the cessation of cardiac activity. At the same time, its implementation (even by a not entirely experienced person) immediately after the onset of clinical death often brings greater success than the manipulations of a resuscitator performed 5-6 minutes after cardiac arrest. These circumstances necessitate a good knowledge of the technique of indirect cardiac massage and the ability to carry it out in emergency situations.

Before performing indirect cardiac massage (Fig. 31), the patient is placed with his back on a hard surface (ground, trampolines). If the patient is in bed, then in such cases (in the absence of a hard couch) he is transferred to the floor, freed from outer clothing, and his waist belt is unfastened (to avoid liver injury).

A very important moment of indirect cardiac massage is correct location hands of a person providing assistance. The palm of the hand is placed on the lower third of the chest, and the second hand is placed on top of it. It is important that both arms are straightened at the elbow joints and positioned perpendicular to the surface of the sternum, and that both palms are in a state of maximum extension at the radiocarpal joints, i.e. with fingers raised above the chest. In this position, pressure on the lower third of the sternum is produced by the proximal (initial) parts of the palms.

Pressure on the sternum is carried out with quick pushes, and to straighten the chest, the hands are taken away from it after each push. The pressure required to move the sternum (within 4-5 cm) is provided

not only by the effort of the hands, but also by the body weight of the person performing the indirect cardiac massage. Therefore, when the patient is positioned on a trestle bed or couch, it is better for the person providing assistance to stand on a stand, and in cases where the patient lies on the ground or floor, on his knees.

The rate of chest compressions is usually 60 compressions per minute. If indirect massage is carried out in parallel with artificial respiration (by two persons), then for one artificial breath they try to make 4-5 compressions of the chest. If indirect cardiac massage and artificial respiration are performed by one person, then after 8-10 chest compressions he makes 2 artificial breaths.

The effectiveness of indirect cardiac massage is monitored at least 1 time per minute. At the same time, attention is paid to the appearance of a pulse in the carotid arteries, constriction of the pupils, restoration of spontaneous breathing in the patient, an increase in blood pressure, a decrease in pallor or cyanosis. If appropriate medical equipment and medicines, then indirect cardiac massage is supplemented with intracardiac administration of 1 ml of 0.1% adrenaline solution or 5 ml of 10% calcium chloride solution. When the heart stops, it is sometimes possible to restore its functioning with a sharp blow to the center of the sternum with a fist. When ventricular fibrillation is detected, a defibrillator is used to restore the correct rhythm. If cardiac massage is ineffective (no pulse in the carotid arteries, maximum dilation of the pupils with loss of their reaction to light, lack of spontaneous breathing), it is stopped, usually 20-25 minutes after the start.

The most common complication during chest compressions is fractures of the ribs and sternum. They can be especially difficult to avoid in elderly patients, in whom the chest loses its elasticity and becomes inflexible (rigid). Less common are damage to the lungs, heart, ruptures of the liver, spleen, and stomach. The prevention of these complications is facilitated by technically correct performance of indirect cardiac massage and strict dosing physical activity when pressing on the sternum.

Poisoning with certain substances can cause respiratory and cardiac arrest. In such a situation, the victim needs help immediately. But there may be no doctors nearby, and an ambulance may not arrive in 5 minutes. Every person should know and be able to apply in practice at least basic resuscitation measures. These include artificial respiration and external cardiac massage. Most people probably know what it is, but do not always know how to correctly perform these actions in practice.

Let's find out in this article what kind of poisoning can cause clinical death, what kind of human resuscitation techniques exist, and how to properly perform artificial respiration and chest compressions.

What kind of poisoning can cause breathing and heartbeat to stop?

Death as a result of acute poisoning can happen from anything. The main causes of death in case of poisoning are cessation of breathing and heartbeat.

Arrhythmia, atrial and ventricular fibrillation and cardiac arrest can be caused by:

In what cases is artificial respiration necessary? Respiratory arrest occurs due to poisoning:

When to start resuscitation measures

If no breathing or heartbeat is detected, resuscitation should begin immediately.

How to do artificial respiration and chest compressions? What methods exist? The most common, accessible to everyone and effective:

external cardiac massage;
mouth-to-mouth breathing;
breathing "from mouth to nose".

It is advisable to conduct receptions for two people. Cardiac massage is always carried out together with artificial ventilation.

Procedure in the absence of signs of life

Free the respiratory organs (oral, nasal cavity, pharynx) from possible foreign bodies.
If there is a heartbeat, but the person is not breathing, only artificial respiration is performed.
If there is no heartbeat, artificial respiration and chest compressions are performed.

How to do indirect cardiac massage

The technique of performing indirect cardiac massage is simple, but requires the right actions.

Why is indirect cardiac massage impossible if the victim is lying on something soft? In this case, the pressure will be released not on the heart, but on the pliable surface.

Age of the victim	How to press	Pressing point	Depth of pressing	Velocity	Inhalation/pressure ratio
Age up to 1 year	2 fingers	1 finger below the nipple line	1.5–2 cm	120 and more	2/15
Ages 1–8 years		2 fingers from the sternum		100–120
Adult	2 hands	2 fingers from the sternum	5–6 cm	60–100	2/30

Artificial respiration from mouth to mouth

If a poisoned person has secretions in the mouth that are dangerous to the resuscitator, such as poison, poisonous gas from the lungs, or an infection, then artificial respiration is not necessary! In this case, you need to limit yourself to performing an indirect cardiac massage, during which, due to pressure on the sternum, about 500 ml of air is expelled and again absorbed.

How to do mouth-to-mouth artificial respiration?

Artificial respiration from mouth to nose

Artificial respiration “mouth to nose” is performed if the patient is unable to open his mouth (for example, due to a spasm).

Having laid the victim on a straight surface, tilt his head back (if there are no contraindications for this).
Check the patency of the nasal passages.
If possible, the jaw should be extended.
After a maximum inhalation, you need to blow air into the injured person’s nose, tightly covering his mouth with one hand.
After one breath, count to 4 and take the next one.

Features of resuscitation in children

How to determine if resuscitation is being performed correctly

Signs of effectiveness when following the rules for performing artificial respiration are as follows.

The effectiveness of cardiac massage also needs to be checked every minute.

If, when performing an indirect cardiac massage, a push appears on the carotid artery, similar to a pulse, then the pressing force is sufficient for blood to flow to the brain.
If resuscitation measures are performed correctly, the victim will soon experience heart contractions, blood pressure will rise, spontaneous breathing will appear, the skin will become less pale, and the pupils will narrow.

The uninterrupted functioning of the heart is a prerequisite for the continuation of life. 5 minutes after it stops, the cerebral cortex begins to die, so it is extremely important to start performing artificial or indirect cardiac massage (ICM) as early as possible, even if you are not entirely sure of the correctness of your actions.

The information, drawings, photos and videos in this article are of a general educational nature and are intended for absolutely all people who have reached the age of majority. We will tell you about the rules for performing chest compressions and artificial respiration, according to new instructions European Resuscitation Council from 2015, in the most difficult situation, when the person providing assistance is one-on-one with a person whose cardiac activity has stopped.

The main task of cardiac massage is to artificially replace myocardial contractions in cases where they have been stopped.

This can be achieved in two ways:

performing chest compressions by non-specialists, rescuers or emergency medical personnel;
manual manipulation by a cardiac surgeon directly on the heart during surgery.

Massage manipulations are aimed at maintaining blood circulation through large vessels of the brain, lungs and myocardium. The correct frequency and depth of indirect impact on the heart through the chest wall can provide a 60% release of blood volume compared to the blood flow that occurs with self-contracting myocardium.

Pressure imitates contraction of the heart muscle (systole), and its cessation during complete weakening of the chest - relaxation (diastole).

The basic complex of resuscitation measures also includes ensuring airway patency and performing artificial pulmonary ventilation (ALV). Their main goal is to maintain gas exchange through forced air renewal.

Just a note. It has been established that the main factor in the success of resuscitation is adequate actions during chest compressions. If you are afraid or disdainful to perform artificial respiration, then be sure to give the victim chest compressions, according to the rules described below.

Conditions under which external cardiac massage can be performed

Indications for chest compressions are the cessation of heartbeats - the onset of clinical death, recognized by the following signs:

persistent loss of consciousness;
lack of pulse;
respiratory arrest;
huge pupils that do not react to light.

In case of pain in the heart and/or other symptoms observed in cardiovascular diseases, for example, slowing of inhalations and exhalations, indirect massage and mechanical ventilation are prohibited.

Attention. Artificial massage for the heart “for future use” can result either in stopping its work, or in a significant deterioration in the condition of the sick person.

How to start the indirect myocardial massage procedure

Before we talk directly about the technique of heart massage itself, we will pay attention to the preparatory actions, which will simultaneously serve as permission to perform it:

Quickly inspect the scene to avoid getting into a similar situation yourself, for example, getting an electric shock from a bare wire.
Check the victim's consciousness. It is forbidden to shake him violently, hit him on the cheeks, pour water on him, let him sniff ammonia or ammonia, or waste time looking for and applying a mirror to his lips. Firmly squeeze the person who you think is lifeless by the arm or leg, carefully jog and call out to him loudly.
If there is no reaction, make sure the victim is lying on a hard, level surface and turn him onto his back. If there is no need, then do not move or carry a person in trouble anywhere.
Open the victim’s mouth slightly and tilt your ear towards him so that you can see his chest from the side and above; if you can, then try to feel the pulse where you can and know how. For 10 seconds, examine your breathing using the “SOS – listen, feel, see” method (see photo above). Here's what it is:
1. C – listen with your ear for sounds of inhalation and exhalation;
2. O – try to feel the presence of exhalation with your cheek;
3. C – look at the chest, whether it moves or not.

Why is the need for cardiac massage primarily determined by the absence of respiratory cycles, and not by cardiac arrest?

Firstly, it is difficult for ordinary people to quickly feel a “healthy” pulse on the wrist even in normal situations, let alone in extreme conditions in which, in addition to weak beating and/or too rare beats, it is recommended to palpate the heart rate on the carotid artery.
Secondly, a frightened person may be afraid to open the victim’s eyes to determine the size of the pupils, moisture and transparency of the cornea, or may not be able to correctly assess these characteristics.
Thirdly, because loss of breathing quite quickly ends in cardiac arrest and loss of consciousness. If there is no breathing, the main thing is to ensure access of blood to the brain and prevent its cortex from dying.

Indirect cardiac massage technique

At present, not for doctors or rescuers, but for ordinary people who, due to current circumstances, are forced to provide assistance to start the heart and restore respiratory cycles, the following procedure is recommended:

C (circulacion) – performing a cycle of external cardiac massage;
A (airwey) – control and ensure free passage of air into the lungs;
B (breathe) – artificial ventilation of the lungs.

How to do indirect cardiac massage correctly

The position of the hands of the person providing assistance should be perpendicular to the victim’s chest, and he himself should be on the side of it.
The palms should be folded one on top of the other, and the fingers should be raised, or the fingers should be interlocked.
In order not to injure the lower extremity of the sternum - the xiphoid process, the base of the “lower” palm should be rested in its middle.
The frequency of compressions during chest compressions is the optimal rate for an adult from 100 to 120 compressions per second.
When doing presses, do not bend your elbows! The pressure occurs due to the gravity of the body during its tilt.
The number of massage pressures in one continuous cycle is 30 times.
The pressure should be such that the palms “sink down” by 5-6 cm.

Just a note. It is imperative to ensure that the ratio of the time of pressing and the time of returning the hands to the starting position is the same. This is extremely important for filling the heart chambers with a sufficient volume of blood.

Ensuring access of air to the lungs and artificial ventilation of the lungs

Since cardiac massage only provides blood movement and cannot prevent hypoxia of the tissues of the cerebral cortex, massage should be combined with mechanical ventilation to ensure gas exchange.

Before starting artificial respiration, it is necessary to facilitate free access of air into the lungs.

First, place the victim’s head in a position that prevents the tongue from retracting (see picture above):

tilt your head back - at the same time press on your forehead with one hand, and lift your neck with the other (1);
push the lower jaw forward - pick up the lower jaw with your fingers and align the lower and upper teeth in one plane (2);
open your mouth, pulling your chin down a little (3);
Check the position of the tongue, and if it is stuck, pull it out with two fingers.

Then check the position of the tongue and the presence of mucus. If necessary, the tongue is pulled out with 2 fingers, like tongs, and the mucus is collected with the index finger, acting as a spatula.

Important. If a neck fracture is suspected, the head is not thrown back, and when performing artificial inhalation, in order not to further move the vertebrae, they try not to put strong pressure on the mouth.

Mechanical ventilation techniques and rules

If, after the first 30 rhythmic pressures on the middle of the sternum and restoration of airway patency, cardiac activity has not resumed, alternating mechanical ventilation with the mouth-to-mouth technique and IMS begins:

Take a deep breath yourself, pinching the victim’s nose with two fingers.
Within 1 second, exhale your air completely into his mouth. At this time, squint your eyes and look at the chest to see whether it has expanded or not.
Pause for 2-4 seconds. It will simulate passive exhalation.
Repeat the exhalation into your mouth for a second, controlling the movements of your chest.
Straighten up and begin doing 30 presses to the middle of the chest.

Number of artificial breaths

There is no need to make more than 2 exhalations into the victim’s mouth. Their excess quantity increases tidal volume, which leads to a decrease in cardiac output and blood circulation.

Artificial respiration techniques

The “mouth to mouth” method is replaced by “mouth to nose” if a person has an injury to his mouth or is unable to open it. In this case, you need to monitor the tightness of the ventilator, supporting your chin with your fingers just in case.

Reasons for the ineffectiveness of mechanical ventilation

If the chest does not inflate during the first artificial breaths, this may result in:

insufficient sealing of the respiratory tract - the nose (or mouth) is not tightly closed;
weak exhalation force of the person providing assistance;
the presence of mucus or foreign objects in the victim’s mouth.

What to do in the first two cases is clear, but when trying to remove a foreign object using your thumb and forefinger, act extremely carefully so as not to push it even deeper.

Features of cardiopulmonary resuscitation in children

To help children, you should remember a few simple and easy to remember rules:

The algorithm for performing cardiopulmonary resuscitation, the pace and frequency of pressing during chest compressions for all age categories, starting from birth, is the same, as is its ratio with mechanical ventilation - 30 to 2.
U infant tilting your head back should be easy. Strong neck deflection in infants leads to airway obstruction!
For a child aged 1 to 10 years, pressing on the middle of the sternum is carried out with only one hand. In newborns and infants, indirect heart massage is performed with bundles of 2 (middle and ring) or 3 (+ index) fingers.
Air is blown into the infant's mouth and nose at the same time. This technique is also recommended for older children, as long as the size of the facial skull allows for such a girth without violating its tightness.
Be careful! The force, depth and volume of air during passive inspiration should not be large, especially if mechanical ventilation is performed on an infant. Conventionally, the volume should be equal to the amount of air that fits “between your cheeks,” taken without a deep breath, and the exhalation should be like a blow.

Just a note. The recommended force (depth) of pressure in children and newborns is approximately 1/3 of the chest diameter. There is no need to be afraid of breaking bones. At this age, they are still pliable and have not completely ossified.

When you can and should call for help

It is absolutely impossible to delay starting external cardiac massage, but when can you be distracted by calls for help and calling an ambulance?

Presence of people and age of the unconscious person	Procedure
	Call loudly and briefly to those you see. Do this without stopping pressing on the sternum. After their arrival, quickly ask to call an ambulance, continuing resuscitation efforts. After the call, they can help, for example, you continue to do mechanical ventilation, and they, alternating with each other, do IMS.
	After performing “SOS”, first call an ambulance. Otherwise, all your efforts to maintain blood flow in the cerebral cortex may be pointless if professional medical assistance is not provided in time.
	No calls! First of all, do 4-5 cycles of IMS + ventilation. And only after that, stop to call an ambulance.

Duration of the IC and actions performed after it

It is necessary to continue resuscitation measures until you are relieved by a medic or rescuer who arrives on call.

If your actions were successful - signs of life appeared, then you need to follow the “Actions after resuscitation” protocol:

Lay the person down as in the picture above. While in it, he will not be able to accidentally tip over on his back. This will save him from choking on vomit, which quite often begins to erupt after IMS. For insurance, you can put a pillow, a rolled blanket or any other object, even a hard one, under your back, and cover it with a blanket on top. Please note:
1. the left palm is placed under the cheek, but it is better for the left forearm to serve as a cushion for the neck;
2. the left leg is bent and rests the knee on the floor;
3. The entire body is not clearly positioned on its side, but its stomach is slightly turned toward the floor.
The infant should be held in your arms, in a position on your side, so that you can see his face and chest at all times.
Do not give medications, drink, eat or give injections under any circumstances.
Do not leave a person unattended, monitoring the continuity of his breathing.

And at the end of this article, in order to convince you that doing cardiac massage and artificial respiration is not very difficult, watch a short video with the correct technique for performing these resuscitation procedures. The price of your composure, overcoming uncertainty and fears is a saved human life.

Everyone should know how to do artificial respiration correctly. To achieve oxygen supply to the brain, first aid is provided: artificial ventilation and cardiac massage. Basic Rule emergency care: It is better to perform resuscitation incorrectly, use alternative views artificial respiration rather than giving it up completely.

Everyone should know how to do artificial respiration correctly.

Methods and basic rules of mechanical ventilation

Before performing resuscitation measures, you need to call emergency help and try to find nearby people who will participate in rescuing the victim. It is also required to provide safe conditions performing resuscitation.

Algorithm for artificial respiration:

Before proceeding with artificial respiration, it is necessary to clear the airways

Clear the airways. It is forbidden to breathe if they are damaged or if there is a foreign object in them. In such cases, the air will not enter the lungs, but the stomach. If water has accumulated in the paths, then it can be removed: bend the person face down over the thigh of a bent leg, compress the chest from the sides with sharp pushes.
Kneel on the right side of the victim.
Tilt the victim's head back and bring the lower jaw forward. To fix the jaw, you can insert a rolled bandage into your mouth.
Pinch a person's nose.
Inhale the air. The depth of inspiration should be maximum.
Press your lips tightly against the victim’s mouth, trying to ensure a tight seal.
Exhale. Assess whether the chest is moving at this moment.
If it is impossible to open your mouth and unclench your jaw, air is blown into your nose. The lips should be closed.
If the chest does not rise, then the person’s head must be thrown back even more and the inflations repeated.
If the chest moves, then you need to make 2 such exhalations, then immediately begin chest compressions.
Resuscitation continues until the person begins to breathe on his own or until help arrives.

Artificial respiration techniques:

Breathing mouth to mouth.
Mouth-to-nose breathing during spasm of the masticatory muscles.
For young children, mechanical ventilation is performed in both the mouth and nose at the same time.

In cases where artificial ventilation of the lungs is impossible, chest compressions are immediately started.

When to start resuscitation measures

Before resuscitation begins, the person is turned on his back and the airway is opened.

It is important to understand in what cases artificial respiration is performed if clinical death is suspected:

The person is turned on his back on a hard surface and the airway is opened.
The head is gently thrown back.
Clothes are unbuttoned to reveal the chest.
Assess the state of breathing. If it is not audible, the sternum does not rise, resuscitation is started immediately. It is important not to confuse breathing with rare agonal sighs. The assessment is given 10 seconds, then mechanical ventilation is required.
Based on the situation, the method of artificial respiration is chosen.

The most common method of mechanical ventilation is mouth-to-mouth artificial respiration. It allows a person who does not have a special medical education, provide the necessary assistance in a critical situation.

It is important to cover the other person's lips tightly with yours so that air enters the respiratory tract.

Rules for mouth-to-mouth artificial lung ventilation:

If possible, cover the mouth with gauze or a light scarf that allows air to pass through to maintain safety and hygiene measures.
The oral cavity is cleaned of foreign bodies with a cloth wrapped around a finger.
You can try to open a clenched jaw using the handle of a spoon or other flat object.
It is important to tightly cover the other person's lips with yours so that air enters the respiratory tract.
The exhalation lasts 1.5-2 seconds and should be deep.
After insufflation, you need to step back, allowing the air to escape.
The frequency of air injections per minute during artificial respiration is 12-15 times, each cycle takes 4-5 seconds.

Artificial respiration from mouth to nose

If the victim’s jaws cannot unclench, then the question may arise about how to perform artificial ventilation. In this case, resuscitation is carried out using the mouth-to-nose method, the order of artificial respiration changes. From a physiological point of view, this technique of artificial respiration is preferable, since the victim inhales atmospheric air with a large amount of oxygen, while the air blown into the nose contains more carbon dioxide.

Algorithm for artificial nasal respiration:

Tilt the person's head back.
Clear the airways.
Cover your nose with a moistened tissue.
Cover your mouth with your palm.
Take a breath.
Exhale air into the victim's nose.
Step back and observe the movement of the chest.
The victim exhales passively.

Methods of mechanical ventilation are chosen based on the situation; breathing through the nose is done only if it is not possible to open the victim’s mouth. At the same time, you should not waste time trying to unclench your jaws, but immediately begin artificial respiration.

How to perform artificial respiration with closed cardiac massage

If the victim has no breathing and no pulse, then resuscitation measures include indirect closed cardiac massage. You need to know what actions are performed when performing artificial respiration in conjunction with cardiac muscle massage, so as not to harm the person. Indeed, in case of an error, the blown air will not enter the lungs.

Technique for artificial ventilation of the lungs with closed cardiac massage:

Place the victim on a hard, hard surface.
Free your chest from clothing.
Perform mechanical ventilation in an accessible way.
Then proceed to indirect cardiac massage.
Palms are placed on the center of the sternum, fingers intertwined. It is important not to touch the ribs with your hands, otherwise there is a risk of fracture.
Bend over the patient so that the arms rise perpendicularly above his sternum.
Using body weight, the rescuer bends the victim’s chest down 5-6 cm, then waits for her to full recovery.
The frequency of compressions is 100-120 per minute.
It is important to maintain a ratio of 30:2. After 2 breaths, 30 pressures are applied to the sternum.
Cardiopulmonary resuscitation is carried out until consciousness is restored.

Ventilation and closed cardiac muscle massage can be performed separately from each other.

Cardiopulmonary resuscitation is a difficult process, so it is best performed with assistants.

How to perform artificial respiration on young children

CPR is more difficult for young children because they are at high risk of rib fractures. If the child does not show signs of life, then it is unacceptable to postpone mechanical ventilation. Artificial respiration is performed simultaneously in the child’s mouth and nose, covering them with your lips. Pressure is applied to the sternum with your fingers or one hand.

Techniques for performing resuscitation for children:

Methods of performing mechanical ventilation for young children

Organize the airway, open the chest.
Remove foreign objects from the oral cavity.
Execute ID. If it is not possible to cover the nose and mouth at the same time, then mechanical ventilation is performed in an accessible way. Blowing air into a small child's airway takes 1-1.5 seconds.
It is necessary to make 5 insufflations, after each they are removed to control the movement of the chest.
If the sternum does not rise, perform 5 more exhalations.
If after this the chest does not move, this is a sign that the child has a foreign object in the respiratory tract. We must try to extract it. To do this, make 5 sharp strikes with the palm between the shoulder blades in the direction from the back to the head. Then the mouth is again inspected for the presence of a foreign body.
If the sternum moves, then massage the heart muscle begins. It is performed by applying pressure to the center of the chest.
Children under one year old are pressed on the chest with their fingers, over a year old- with your hand.
The depth of pressure is a third of the thickness of the chest, it is important not to overdo it and not to press too hard. The intervals between clicks are minimal.
You need to apply pressure often, up to 100 compressions per minute. After 30 pressures, mechanical ventilation is repeated, 2 breaths are taken. Repeat as many times as necessary to restore consciousness.
While waiting for doctors, you cannot leave the child alone; you need to keep him warm, in a position on his side.
You should be prepared to resume CPR at any time.

Providing first aid to a child is the responsibility of an adult.

Typical mistakes when performing mechanical ventilation

An untrained person can perform CPR with errors that will aggravate the problem:

Postponement of resuscitation measures. In a difficult situation, you cannot hesitate, the rescuer has a maximum of 8 minutes before stopping life-saving work important systems sick.
Incorrect ventilation sequence. First, the airways are cleared, the oral cavity is cleaned, and only then ventilation is performed.
Loose pressing of lips to the victim’s lips, lack of tightness. This causes less air to enter the lungs
Extra time is wasted trying to open the patient’s jaw. If the mouth cannot be opened, then mouth-to-nose resuscitation begins.
Long pauses between breaths and insufficient volume of blown air. Breaks are taken for the purpose of short-term rest; it is necessary to work at a fast pace. Optimal insufflation during artificial respiration lasts 1.5-2 seconds with a frequency of 120 times per minute.
The rescuer does not check the correctness of artificial respiration and does not control the movement of the sternum.
The person providing assistance does not stop performing artificial respiration and at the same time begins a closed massage. Insufflations in this case do not make sense, since oxygen will not enter the blood.

It is impossible to be as prepared as possible for a difficult situation, but every person must be able to perform resuscitation actions in order to help the victim survive until the arrival of professionals.