The road to the rise of great doctors

Chapter 33 First Aid Skills

Liu Dong walked over. Because there was no one else, he could only simulate cardiopulmonary resuscitation in one person mode first.

He attaches great importance to this skill.

According to reports, more than 50 people die suddenly in our country every year, with an average of about 1000 people every day. The main cause of sudden death is cardiac arrest.Cardiopulmonary resuscitation is the "sharp tool" to save cardiac arrest.

These cold statistics may sound far away from our lives, but we can see that many such examples in news reports will become hot searches and will make people in society remember a certain person for a period of time. The names of several doctors or nurses.

There was also an impressive example around Liu Dong.At that time, Liu Dong was still in the first grade of elementary school.One evening, while playing at the intersection, I noticed that many people suddenly flocked to a house.The middle-aged male neighbor who had been chatting for a while just finished his meal and was cleaning the pots at the door when he suddenly fell to the ground and passed out.At that time, cardiopulmonary resuscitation was not yet widely available, and no one in his family told them what to do except calling for an ambulance. Therefore, by the time they arrived at the hospital, they had already missed the "golden time" and could not be saved.

Of course, the basic principles of cardiopulmonary resuscitation remain unchanged, but the assessment and practice are still somewhat different.

There are many knowledge points in the assessment that need to be memorized and spoken orally in addition to doing them.To get high scores, the best way is to do the actual operation several times to see where there are still omissions or what needs to be improved urgently?

While operating, Liu Dong thought of various short stories he had seen on the Internet.

Someone was unconscious, and passers-by went over to perform cardiopulmonary resuscitation regardless of who was doing it, and then the patient groaned while being pressed.Some may look both funny and helpless.

Not all comas require cardiopulmonary resuscitation!
Cardiopulmonary resuscitation is the most basic and important medical method to save the lives of patients who suddenly stop breathing or heartbeat.

Therefore, for those people whose breathing and heartbeat have not stopped, who are comatose due to other diseases, cardiopulmonary resuscitation will not work!
When you see a person fall to the ground, slap him loudly and call his name to see if the person reacts.If there is no response, continue to see if the person's chest is still rising and falling?Based on this, we can initially judge what situation and state the patient is in?
For example, for people with diabetes, the cause of coma may be diabetic ketoacidosis coma, or too long a gap between meals may cause hypoglycemia and fainting.Therefore, first check to see if anyone around you knows the person's past illnesses to initially determine the cause.This is very important.

For another example, we often see in TV dramas that when a person is angry or tired, he suddenly falls to the ground while clutching his chest. The narration tells the audience that this person has a history of heart disease, or he can't take the medicine by holding a bottle of medicine. In the form, it indicates that myocardial infarction or myocardial ischemia may have occurred.

……

When encountering a person who suddenly falls into coma, how can you tell whether breathing has stopped?You can tilt your head close to the front of the comatose patient's mouth and nose, and use the side of your face to feel whether there is breathing gas coming out of the mouth and nose.

How to tell whether the heartbeat has stopped?You can use your hand to feel the carotid artery in your neck to see if there is a pulse. If not, it means cardiac arrest.

Without breathing and heartbeat, call for help as soon as possible. One more person means more effort.

When some people encounter a patient whose breathing or heartbeat has stopped, they will be eager to save the patient. Regardless of the danger to their own lives, they will rescue the patient where he fell.This can be dangerous sometimes.

Not all cardiopulmonary resuscitation must be performed on the comatose patient.

If you need first aid, you should judge whether the place where you are receiving first aid is safe before giving first aid.Just like taking a driver's license test, the first step in getting in a car is to walk around the car to see if there are any problems with the vehicle and if there are any dangers around it.

From a medical point of view, for example, if you encounter carbon monoxide poisoning, you must open the windows for ventilation immediately, and take the person away and put them in a ventilated place.If you don't pay attention, you may fail to save someone and end up with someone else instead.

For another example, if there is a car accident, the patient must be taken to the emergency lane instead of staying in the original lane.

During the assessment and actual operation, there are a lot of particularities.During the exam, those precautions need to be told orally.And when they appear on the scene, they really need to pay attention, but they may make judgments at a glance.

After medical students have passed this kind of training, when they encounter this kind of situation in real life, they will feel stable in their hearts, and most of them will not panic or be at a loss.Liu Dong went through the train of thought, "In general, the first step is to see if cardiopulmonary resuscitation is needed and determine where to perform cardiopulmonary resuscitation. Also, when one person is performing external compression, if another one comes, call the emergency number in time ( 120).”

After confirming the patient's initial status and needs, the subsequent implementation of cardiopulmonary resuscitation is also a bit particular.

First, do it on a flat, hard surface, or put a hard board or cardboard behind your back.

Secondly, check whether there is a lot of secretions in the mouth. If there is, remove it as soon as possible, otherwise it will affect breathing.Even if it is accidentally inhaled into the trachea, the consequences will be more serious.

Again, it’s a matter of technique!One person, two people, three people, outside the hospital and in the hospital, all while maintaining the same general principles, there are some differences in details.

Let’s talk about the technique first. The first key point is to press the middle and lower 1/3 of the sternum of the chest. Cross your hands and press with the heels of your hands. Straighten your arms and press the whole body. This uses the strength of the body instead of the strength of the arms. .Let’s talk about the key point of the second technique, which is that it needs to be fast and powerful, slightly faster than the heartbeat rate (the normal heartbeat of adults is 60-100 beats/min, think about how fast it is), and each cycle is 30 times of compression. (The best time is 15-18 seconds).

The result of using force quickly and forcefully can break a rib.But compared with saving lives, rib fractures are nothing, and they are also within the scope of expected combined injuries.

The difference in the number of people and whether the rescue location is outside the hospital or inside the hospital is related to the way breathing is handled.

Both are based on opening the airway. For one person, compressions and artificial respiration are performed in a ratio of 30 times: 2 times.Two people can take turns performing external compressions, or one person can perform external compressions and the other can perform artificial respiration.If in the hospital, another person can provide oxygen through a mask without the need for artificial respiration.If there are three people, then there are more people doing cardiac compression. On the premise of cardiopulmonary resuscitation, other issues can also be done, such as maintaining order, contacting first aid, making overall arrangements, etc.

Generally, the recovery of breathing and heartbeat is quickly re-evaluated every 5 cycles.If there is no recovery, the operation should continue until the arrival of rescue vehicles, or until there is no hope at all...

If resuscitation is successful, further life support treatment is required.

High-quality cardiopulmonary resuscitation = (clearing the respiratory tract) + artificial respiration + correct chest compressions + subsequent professional medication
After Liu Dong operated for 5 cycles, he temporarily stopped.Looking around, I saw a sign for an AED device, but no equipment.

AED, a portable automated external defibrillator.Liu Dong recalled the expert guidelines for cardiopulmonary resuscitation, which mentioned: "If there is an AED near the place where sudden death occurs, then the AED should be used immediately after chest compressions."

"Timely use of a defibrillator is the key to saving the patient's life!" Liu Dong thought silently.

He did it again himself and felt that he had mastered single-person CPR.I just want to continue practicing other types.

Looking at the crowd, one could see that Cai Mingming was watching the aseptic dressing change operation.Finding that Cai Mingming was not looking at him, Liu Dong quickly walked over and pulled Cai Mingming over.

"Love Saint, let's do double cardiopulmonary resuscitation!" Liu Dong pulled Cai Mingming and said.

Cai Mingming was a little helpless. He saw that the sterile dressing change was in progress, so he was pulled over.But good friends still have to cooperate.After rolling his eyes, he agreed to practice the role of alternating chest compressions and artificial respiration.

When you focus on something, you will find that time passes quickly.They also heard the notice from the teacher of the Management Training Center that "it will close in 10 minutes" when the exercises and discussions were in full swing.

Tired and full, this is the portrayal of this group of interns at this time.

　Newbies and new books, please recommend, collect, and vote~
　　


(End of this chapter)