The recovery of the organism (reanimation)

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Intra-arterial injection of blood is a powerful tool to improve hemodynamics during prolonged hypotension, especially in patients with blood, and also significantly increases the efficiency of cardiac massage. It is carried out by injection of blood or plasma substitutes (poliglyukin, gelatinol and so on) under the pressure of 200-250 mm RT. century in one of the peripheral arteries (better in the left radiation). If the patient has had massive blood loss, you should add a significant amount of blood (1-2 l). If blood loss was not, then we can restrict 250-500 ml and add 0.3-0.5 ml of 0.1% solution of adrenaline. The most common errors: forcing through a thin needle (significantly reduces the rate of infusion), artery ligation after infusion without stopping bleeding from the puncture site long pressing.
During clinical death, especially in the long dying, develops atony of the myocardium. To improve the tone of the heart muscle apply intracardiac injection of epinephrine (0.3-0.5 ml of 0.1% solution) and chloride calcium (5,0-10,0 ml of 1% solution). Injections should be done with a long needle in the IV intercostal space at the left sternal border. Holding the needle deep, it should always be sipping piston, to impose a solution, when in the syringe blood appeared. The most common errors: the introduction of the solution in the thickness of the myocardium (and not in the cavity of the heart), a long break cardiac massage during injection.
In some cases (electrical trauma, asphyxia, drowning, koronarospazm) stop the blood flow can occur due to ventricular fibrillation (indiscriminate reduction of myocardial fibers). This, along with heart massage and artificial respiration necessary defibrillation, which is carried out by a special device - a defibrillator, affecting heart single capacitor discharge of electric current (voltage 3500 - 5500, duration of 0.01 seconds). The most frequent error: the application of defibrillation without prior cardiac massage.
If cardiac activity is not restored, resuscitation should continue as long as they are effective. Evidence of effectiveness: the disappearance of cyanosis, the emergence of spontaneous breathing (the earlier they come, the better the prognosis), pulsation of large vessels in the rhythm of massage, narrowing pupils. If these signs are there for 20-25 minutes, recovery, you can stop.
Heart massage in children should be made with great caution. The newborn massage do not palm and fingertips. Accordingly, reduce the dosage of all medicines and stress at defibrillation (see also Reanimation of newborns).
Newborn asphyxia, the most effective method to remove them from the terminal status is artificial respiration, which can be run on a way "the mouth in a mouth" or vdova the air in a catheter inserted into the trachea. With the same purpose use of special devices (DP-5, RD-1).
Busy body needs careful observation and care. First of all, in no event it is impossible to stop artificial respiration should be intubation of the trachea or the tracheotomy and continue artificial lung ventilation special vehicles (RO-1, bag Ruben or bag anaesthetic apparatus) to the full restoration of consciousness and the disappearance of all signs of respiratory distress. To combat disorders, intravenous administration of sodium bicarbonate (200,0-400,0 ml of 4% solution drip), prednisolone (150-180 mg) or cortisone (600 - 800 mg per day), glucose (400,0 - 600,0 ml of 20% solution of a day drip) with insulin and vitamins. A careful prevention of pneumonia, strict control of diuresis, struggle with hyperthermia. In case of seizures shows hypothermia to temperature 30-32 degrees, the introduction of GHB (sodium oxybutyrate), the relaxants. To counter the use of respiratory analeptics (bemegride, korazol, lobeline), Pressor amines (norarenalina, mezaton) and mochegonnah preparations for dealing with swelling of the brain".
The revival of organism may be carried out not only the doctor but also the average health worker. There are many cases when medical assistants and nursesand trained lay independenly heart massage and artificial respiration, saving the sick and injured. Especially great is the role of nurses in the recovery period, when special care and strict compliance can be a decisive factor in the eventual outcome of a recovery.