During external cardiac massage, the palms are placed on the How to do indirect cardiac massage: technique. Let's turn to physiology: what happens after the heart stops

IN emergency situations when you can save a person’s life, you just need to know the basics of first medical care. One of these fundamental skills is the technique of which is described in this publication. By learning some techniques for its use, you can save a human life.

Performing chest compressions

First of all, they determine the sudden lack of breathing and consciousness and then begin resuscitation, simultaneously calling an ambulance. First, place the patient on a hard surface.
Resuscitation should be carried out immediately at the location where the victim is found, if this is not dangerous for the person resuscitating.

If assistance is provided by a non-professional resuscitator, then only pressure on the sternum is allowed. Indirect massage heart, the technique of which is described below, includes the following points.

Sequencing

First, determine the location of compression in the lower third of the sternum.
Place one hand with the protrusion of the palmar surface (“fifth hand”) almost on the very bottom of the sternum. The other hand is placed on top of it in the same way. It is possible to place the palms according to the lock principle.
Compressive movements are performed with hands straightened at the elbows, while transferring the weight of your body when pressing. When performing compression, the hands are not removed from the chest.
The frequency of pressure on the sternum area should be no less than 100 times per minute or approximately 2 compressions per second. The displacement of the chest in depth is at least five centimeters.
If carried out, then for 30 compressions there should be two respiratory movements.

It is highly desirable that the periods of pressure on the sternum and the absence of compression be the same in time.

Nuances

Indirect cardiac massage, the technique of which is familiar to every doctor, requires, if tracheal intubation is performed, that movements be performed at a frequency of up to 100 times per minute without interruption for respiratory resuscitation. It is carried out in parallel, with 8-10 breaths per minute.

Compression of the sternum in children under ten to twelve years of age is performed with one hand, and the ratio of the number of compressions should be 15:2.

Since fatigue of the resuscitator can lead to a decrease in the quality of compression and death of the patient, if there are two or more people providing assistance, it is advisable to replace the one performing the pressure with chest every two minutes to prevent a decrease in the quality of chest compressions. Replacing the resuscitator should last no longer than five seconds.

It must be remembered that the rules for performing indirect cardiac massage require ensuring the patency of the respiratory system.

In individuals with a lack of consciousness, muscle atony and obstruction develop respiratory tract epiglottis and root of the tongue. Obstruction occurs in any position of the patient, even lying on his stomach. And if the head is tilted with the chin to the chest, then this condition occurs in 100% of cases.

The following initial steps precede chest compressions:

The “triple maneuver” and tracheal intubation are the gold standard during respiratory restoration.

"Triple trick"

Safar developed three sequential actions that improve the effectiveness of resuscitation:

Throw your head back.
Open the patient's mouth.
Move the patient's lower jaw forward.

When performing such a cardiac massage and artificial respiration, the anterior neck muscles are stretched, after which the trachea opens.

Caution

You must be attentive and careful, since it is possible to damage the spine in the neck area when performing actions on the air ducts.

Spinal injuries are most likely to occur in two groups of patients:

victims of road accidents;
in case of a fall from a height.

Such patients should not bend their neck or turn their head to the side. You need to moderately pull your head towards you, and then hold your head, neck, and torso in the same plane with minimal tilting of the head back, as indicated in the Safar technique. Indirect cardiac massage, the technique of which in such cases requires special care, is performed only if these recommendations are followed.

Opening of the oral cavity, its revision

The patency of the airways after throwing back the head is not always completely restored, because in some unconscious patients the nasal passages close due to muscle atony soft palate while breathing.

It may also be necessary to remove foreign objects from the oral cavity (blood clot, tooth fragments, vomit, dentures)
Therefore, first, in such patients, the oral cavity is examined and freed from foreign objects.

To open the mouth, use the “crossed fingers technique.” The doctor stands near the patient’s head, opens it and conducts an examination. oral cavity. If there are foreign objects, they must be removed. Right index finger The corner of the mouth is pulled down from the right, this helps to independently free the oral cavity from liquid contents. Using your fingers wrapped in a napkin, clean your mouth and throat.

Try using air ducts (no more than 30 seconds). If the goal is not achieved, stop trying and continue performing mechanical ventilation using a face mask or “mouth to mouth”, “mouth to nose” techniques are also used. Cardiac massage and artificial respiration in such cases are carried out depending on the result.

After 2 minutes of resuscitation, it is necessary to repeat the attempt at tracheal intubation.

When indirect cardiac massage is performed, the technique of which is described here, then when performing mouth-to-mouth breathing, the duration of each breath should be 1 second. This method is considered effective if movements of the victim’s chest occur during artificial respiration. It is important to avoid excessive ventilation (no more than 500 milliliters), as it can cause complications in the form of reflux from the stomach and ingestion or entry into the lungs of its contents. In addition, excessive ventilation increases the pressure in the chest cavity, which in turn reduces the return venous blood to the heart and survival rate sudden stop hearts.

The indirect method of cardiac massage is one of the methods of resuscitation carried out by pressing on the chest. This activity must be performed as a result of stopping the heartbeat to restore blood circulation.

In contact with

The concept of indirect massage

Injuries associated with blood loss entail a shutdown of the functioning of the heart muscle. To prevent cell death, the victim must be resuscitated.

In terms of time it takes no more than 0.5 hour, but if this period has expired, then clinical death occurs.

There are two ways to provide first aid to the victim - indirect and direct massage heart muscle. When blood circulation stops circulating, the exchange of gases in tissues at the intercellular level in the body stops.

Cells begin to die and poisoning occurs internal organs decomposition products. Cell death depends on the speed of synthesis of useful components. This especially affects the brain, it gradually dies after 4 minutes after cessation of blood access to the brain.

Circumstances of resuscitation

External cardiac massage must be performed if the injured person has the following:

lack of consciousness;
the pupils do not react to light during forced opening;
no signs of heartbeat;
no breath is felt.

Chest compression is the most acceptable way to show signs of life, especially if drugs are not used for this.

Indirect cardiac massage, including the technique for performing it, involves squeezing the bones between the chest and spine. During this period, the victim’s ribs become most pliable.

If a person is in a state clinical death It is easy to move the chest; during the event, the pressure in the heart muscle simultaneously increases and its volume decreases.

When performing movements in a given rhythm, the blood pressure in the cavities of the heart and in the vessels becomes unequal. From the left ventricle, blood flows to the aorta of the brain, and from the right ventricle to the lungs, where organ cells are saturated with oxygen.

Important! When the pressure on the chest stops, the muscle straightens and fills with blood, and when pressed it is pushed out again. In this way, the artificially created heartbeat is maintained.

How to restore blood circulation

External cardiac massage is performed by squeezing the ribs. The following happens in the body:

Having passed from the area of the atria through the cavities of the valves, the blood fluid enters the area of the ventricles and then spreads through the vessels;
Since pressure is applied periodically, blood circulation is not inhibited, and the blood continues to spread.

How to do a heart massage

This technique is necessary to create electrical impulse heart muscle, which ensures restoration of the functioning of the organ. If this process is not stopped, then consciousness can be restored within 0.5 hours, but you should know how to do chest compressions and have basic skills.

Advice! When performing these actions, it is imperative to artificial inhalations and exhalations. The force of pressure on the chest should not exceed 3 to 5 cm, which ensures the release air masses in an amount of approximately 500 ml with each press. In this case, mechanical ventilation is performed.

What actions are performed during indirect cardiac massage?

Performing indirect massage

Every person should know the rules for performing indirect cardiac massage for an adult.

Indirect cardiac massage training

Execution technique contains the following information:

The injured person lies on a solid base or on the ground. If the first aid provider is right-handed, then it will be preferable for him to kneel on his right side in order to perform the precordial blow with his right hand. If, on the contrary, you are left-handed, then the position on the left will be most convenient.
The maximum result from a closed massage will be ensured if the victim is found on a flat and hard surface.
To apply pressure, palm right hand must be located approximately 4 cm above the xiphoid process, but the location thumb you need to focus on the victim’s stomach or chin. The other palm should be placed on the first at a right angle.
When directly performing the activity, you do not need to bend your elbows, and the center of gravity should be kept relative to the chest. Restoring the work of the heart is quite a difficult task, as it would seem, and therefore you need to be able to maintain the strength to conduct it, and when bending your elbows you can quickly become exhausted. To make sure that it brings results, you should periodically check the presence of a pulse in the injured person. The number of presses per minute is 60 - 100 times - this is the optimal rate of indirect cardiac massage.
The pressure between the ribs should not exceed 3 to 5 cm. This depends on how elastic the bones are. Do not remove your hands from the body of an injured person. The chest should return to its previous position, but if you remove your palms and put them back, then this action is equivalent to powerful blow. So may injure the victim even more.
For 30 compressions, take 2 breaths. As a result, inhalation and passive egress occur, which helps saturate the lungs with oxygen.

As stated earlier, after 0.5 hours signs of life should appear, but if this does not happen, then death comes.

Heartbeat

To know how to do indirect cardiac massage correctly, must be remembered following:

If the ribs are broken, you should not stop working, you can only reduce the number of presses, but the depth of the pressure should be left the same.
When performing resuscitation measures, you should pay more attention to pressure rather than artificial inhalation of air.
Before performing immediate resuscitation, you should make a precardinal fist bump from a height of about 0.3 m and only then carry out the required measures.

Resuscitation of children

What sequence of actions should be followed when providing first aid to children under one year of age and older?

Helping children is different from helping adults. The difference is in the depth of pressure and the area of influence on the body area. Actions should be performed with one palm. For newborn babies, perform compression using two fingers.

Where to learn to do indirect cardiac massage

Indirect cardiac massage in children produced in this way:

Place your fingers below the level of the nipples and begin pressing, with a frequency of more than 120 times per minute, the depth of pressing is from 1.5 to 2 cm, while air inlets should be performed at least once per 5 presses.
If the baby is one year old and no more than 7 years old, then the optimal rate of chest compressions is from 100 to 200 pressures with a depth of 3 to 4 cm. The number of breaths is 1 with 5 pressures. Before performing the procedure, 2 fingers are placed higher from the xiphoid process.
If the child is over 7 years old, then the placement of the fingers is the same as in the previous version, the depth of pressing is from 4 to 5 cm with a frequency of 80 to 100 times. Air is blown in at the rate of 2 times per 15 pressures.

Important nuances

When Indirect massage should not be used hearts? This depends on a number of circumstances. The technique of resuscitation is related to cardio- vascular system, therefore there are a number of contraindications:

1. Fractured ribs and other chest injuries.

2. If the heart muscle does not work for half an hour.

3. If there is a heartbeat, even if it is weak.

4. With an increased degree of risk to your own life.

5. For open wounds and bleeding you have to make your own decision about providing first aid of this kind.

Advice! Cardiac muscle massage must be performed according to technology. IN regulatory framework There is an article on the right of everyone to provide first aid, but only in relation to an adult. If you resuscitate a baby, then there should be consent from parents. The effectiveness of the event depends on the readiness for action and skills.

Video: Performing chest compressions

If an accident occurs or a person is found unconscious, this area of the area must not be left until the ambulance arrives. Executed correctly indoor massage heart, and timely assistance to the victim contribute to the preservation of life.

In contact with

To restore the function of the cardiac system after stopping its central organ and maintaining blood circulation, artificial, i.e., indirect cardiac massage is performed, which is a set of measures.

The essence of the procedure

This is a resuscitation measure that is effective in the first 3-15 minutes after the heartbeat stops. Subsequently, irreversible consequences occur, leading to clinical death.

Closed heart massage and direct impact are not the same thing.

In the first situation, pressure occurs on the chest mechanically, as a result of which the heart chambers are compressed, which allows blood to enter first the ventricles and then into circulatory system. Thanks to this rhythmic effect on the sternum, the flow of blood does not stop.
Direct is produced at the moment surgical intervention when opening the chest cavity, and the surgeon squeezes the heart with his hand.

Indoor massage should be correctly combined with artificial ventilation. The depth of pressure is at least 3, maximum 5 cm, which promotes the release of air in the range of 300-500 ml.

After compression is completed, the same volume is returned to the lungs. As a result, active-passive inhalation and exhalation occurs.

Indications for use

Before you start external massage heart, it is important to assess how necessary it is for the victim. There is only one indication for its implementation - stopping the heartbeat.

Signs of this condition are:

sudden onset of sharp pain in the area of the heart, which has never happened before;
dizziness, loss of consciousness, weakness;
pale skin with a bluish tint, cold sweat;
wide pupils, swelling of neck veins.

This is also indicated by the absence of pulsation on carotid artery, loss of breathing or convulsive breaths.

As soon as similar symptoms arise, you must immediately seek help from any person (neighbor, passer-by on the street) and call a medical team.

Cardiac arrest is possible due to hemorrhagic or anaphylactic shock, due to lack of oxygen, hypothermia, and other unidentified factors.

First aid algorithm

Before you start resuscitation measures, you need to call immediately ambulance. In the future, the algorithm of actions is based on belief:

in the absence of heartbeats and pulse, for which the carotid arteries are felt with the fingers, the left region of the chest is listened to with the ear;
there are other indicators of clinical death - no reaction to any actions, no breathing, fainting, pupils are dilated and do not respond to light.

The presence of such signs is an indication for a cardiac massage procedure.

Methodology and sequence

After the final conclusion that there is no heartbeat, resuscitation begins.

The technique consists of several stages:

Place the patient on a hard, flat surface (the floor is optimal). The massage rules do not allow the victim to be placed on a bed, sofa or other soft spot, so there should be no deflection when pressing, otherwise the effectiveness of the procedure will be zero.
Use a napkin or handkerchief to clean the patient’s mouth from foreign objects (residues vomit, blood).
Tilt the victim's head back; you can place a cushion of things under the neck, which will prevent the tongue from sinking. Free the massage area from clothing.
Kneel on the left side (or to the right, if the rescuer is left-handed) of the patient, place your palms on the lower third of the sternum and above the xiphoid process by two folded fingers.
Determine the position of the hands so that one palm is perpendicular to the axis of the chest, and the second is on the back surface of the bottom, at 90 degrees to it. The fingers do not touch the body, but on the lower palm they are directed upward, towards the head.
Using straight arms, using the strength of the whole body, rhythmic, jerk-like pressure is applied to the chest until it deflects by 3-5 cm. At the maximum point, you need to hold your palms for at least 1 second, then stop the pressure, leaving your hands in place. In one minute, the frequency of pressing should not be less than 70, optimally 100-120. Every 30 compressions, artificial respiration is needed into the victim’s mouth: 2 exhalations, which will saturate the lungs with oxygen.

During massage, pressure should be applied strictly vertically, along the line connecting the spine and sternum. The compression is smooth and not harsh.

Duration and signs that determine the effectiveness of massage

The procedure should be done until the heart rate and breathing resume, or if they do not, until the ambulance arrives, or within 20-30 minutes. After this period of time, if not positive reaction the victim, biological death often occurs.

The effectiveness of massage is determined by the following criteria:

change in skin color (pallor, grayish or bluish tint decreases);
constriction of the pupils, their reaction to light;
the occurrence of pulsation in the carotid arteries;
return of respiratory function.

The effect of resuscitation measures depends both on the speed and order of implementation, and on the severity of the illness or injury that provoked cardiac arrest.

Massage for infants

It happens that an indirect heart massage is required for a child, even a newborn. It must be carried out immediately to prevent irreversible consequences.

In a baby, heartbeat and breathing may stop due to:

drowning while swimming;
complicated neurological diseases;
acute bronchospasm, pneumonia;
sepsis.

Similar conditions occur in babies as a result of the syndrome sudden death or primary cardiac arrest.

The symptoms of cessation of respiratory and cardiac work are the same as in an adult, the same technique and sequence of activities, but with individual nuances.

For infants, pressure is applied not with the palm, but with two folded fingers - the middle and index fingers, for children 1-7 years old - with one hand, for victims over 7 years old - in the same way as for an adult - with 2 palms. When pressing, the fingers are located lower than the nipple line; the compression should not be strong, since the chest is quite elastic.

During massage, its deflection is:

from 1 to 1.5 cm in a newborn child;
from 2 to 2.5 cm in babies older than 1 month and up to a year;
from 3 to 4 cm in children after 12 months.

In one minute, the number of clicks should correspond to the child’s heart rate: up to 1 month - 140 beats, up to a year - 135-125.

Basics for massage

For the procedure to be effective, it is important to follow the basic rules:

When compressing the chest, the next pressure should be after returning it to its normal position.
The elbows do not bend.
In an adult victim, the sternum deflection is at least 3 cm, in newborns - 1.5 cm, in children older than one year - 2 cm. Otherwise, there will be no normal blood circulation and it will not be released into the aorta. Consequently, blood flow will not be established, and brain death will begin due to oxygen starvation.

The first aid technique prohibits the procedure in the absence of breathing, but the presence of a pulse. In such a situation, only artificial respiration is used.

Render necessary help allowed to a person who is in fainting, since he cannot consent to it or refuse. If the victim is a child, then such measures can be used if he is alone and there are no people close to him (parents, guardians, accompanying persons). Otherwise, their consent is required.

It is important to remember that providing emergency care start immediately in any situation. But it is highly not recommended to carry it out if there is a threat to your own life.

Complications and errors during massage

The main negative aspect of a massage may be a rib fracture. The fact that this happened is indicated by a characteristic rather loud crunch and subsidence of the chest.

If such a complication occurs, interrupt resuscitation actions you shouldn’t, just reduce the frequency of compressions on the sternum.

In such a situation, the priority becomes restoring the heartbeat, not broken ribs..

Often the effectiveness of resuscitation is low due to mistakes made:

compressions are performed higher or lower the right place;
positioning the patient on a soft rather than a hard surface;
there is no control over the victim’s condition, and impulsive twitching is mistaken for a meaningful body movement.

When cleaning the oral cavity before a massage, do not rinse it with water, since the liquid will fill the lungs and bronchi and will not allow breathing to be restored (the condition of drowned people).

After regaining consciousness, patients often behave inappropriately. This is a normal reaction. It is necessary to prevent them from excessive activity and mobility until the ambulance arrives.

Efficiency forecast

The effectiveness of resuscitation has a different prognosis - from 5 to 95%. Typically, 65% of victims manage to restore cardiac activity, which allows them to save their lives.

Complete restoration of all functions is possible in 95% of cases when resuscitation measures were effective in the initial 3-5 minutes after the heartbeat stopped.

If breathing and heartbeat the victim recovered after 10 minutes or more, then there is a considerable probability that the functioning of the central nervous system, as a result of which he will remain disabled.

Heart massage(artificial rhythmic compression of the victim’s heart, simulating its independent contractions) is carried out to artificially maintain blood circulation in the victim’s body and restore normal natural contractions of the heart (Fig. 1). Since oxygen is delivered to all organs and tissues during blood circulation, during massage it is necessary to enrich the blood with oxygen, which is achieved by artificial respiration. Thus, artificial respiration should be performed simultaneously with cardiac massage.

When providing assistance to a person struck by an electric current, a so-called indirect or external heart massage is performed by rhythmically pressing on the chest, i.e. on the front wall of the victim's chest.

As a result of this, the heart is compressed between the sternum and the spine and pushes blood out of its cavities. After the pressure stops, the chest and heart straighten, and the heart fills with blood coming from the veins. In a person in a state of clinical death, the chest, due to loss of muscle tension, easily shifts (compresses) when pressure is applied to it, providing the necessary compression of the heart.

When performing a massage, apply pressure with a quick push so as to displace bottom part sternum down 3-4 cm, and fat people- by 5 - 6 cm.

The pressure when pressing is concentrated on the lower part of the sternum, which is more mobile. Avoid pressing on top part the sternum, as well as at the ends of the lower ribs, as this can lead to their fracture; press below the edge of the chest, as this can damage the organs located here, primarily the liver.

The dotted line shows the displacement of the chest and heart when pressing on the sternum. Pressing (push) on the sternum should be repeated approximately every 1 second to create sufficient blood flow. After a quick push, the arms should remain in the achieved position for approximately 0.5 s. After this, the person providing assistance straightens slightly and relaxes his hands without removing them from the sternum. To enrich the victim’s blood with oxygen, simultaneously with cardiac massage, it is necessary to perform artificial respiration using the “Mouth to mouth” (“mouth to mouth”) or “Mouth to nose” (“mouth to nose”) method. If there are two people providing assistance, then one of them performs artificial respiration, the other - cardiac massage (Fig. 2).

It is advisable to alternately perform artificial respiration and cardiac massage, replacing each other every 5-10 minutes. In this case, the order of assistance should be as follows: after two deep insufflations, thirty compressions are performed on the chest, i.e. new optimal ratio of chest compressions and breaths artificial ventilation lungs - 30:2, regardless of the number of participants in providing assistance).

Practical lesson No. 5

“First medical aid for victims

At emergency situations»

Goal of the work: teach students first aid skills.

Methods of providing first aid depend on the condition of the victim. The signs by which you can quickly determine the health status of the victim are as follows:

Consciousness: clear, absent, impaired (the victim is inhibited or excited);

Color of the skin and visible mucous membranes (lips, eyes): pink, bluish, pale;

Breathing: normal, absent, impaired (irregular, shallow, wheezing);

Pulse in the carotid arteries: well defined (rhythm correct or incorrect), poorly defined, absent;

Pupils: dilated, constricted.

With certain skills and self-control, the person providing assistance must assess the condition of the victim in a minute and decide in what volume and order assistance should be provided to him.

The victim's lack of consciousness is determined visually. To finally make sure of this, you should contact the victim with a question about his well-being. The color of the skin and the presence of breathing (by the rise and fall of the chest) are also assessed visually.

To determine the pulse on the carotid artery, place your fingers on adam's apple(trachea) of the victim and, moving them a little to the side, feel the side of the neck.

Pupil width at closed eyes defined as follows: pads index fingers put on upper eyelids both eyes and, lightly pressing them to eyeball, lift up. Wherein palpebral fissure opens and a rounded iris is visible on a white background, and in its center there are rounded black pupils, the state of which (narrowed or dilated) is assessed by the area of the iris that they occupy.

If the victim is conscious (and before that he fainted or was in an unconscious state, but with stable breathing and pulse), he should be laid on a bedding, for example, from clothes; unbutton clothes that are restricting breathing; create an influx fresh air; warm the body if it’s cold; provide coolness if it’s hot; create complete peace by continuously monitoring your pulse and breathing; delete extra people; give me a drink water solution valerian tincture (20 drops).

If the victim is unconscious, it is necessary to observe his breathing and, in case of breathing problems due to tongue retraction, push out lower jaw forward. To do this, grab the lower jaw by the corners from behind with four fingers of both hands and, resting thumbs to its edge below the corners of the mouth, pull it back and push it forward so that lower teeth stood in front of the top ones. It should be maintained in this position until the tongue stops sinking. The unconscious victim should be given a sniff ammonia, spray your face with cold water.

If the victim has no consciousness, breathing, pulse, skin covering cyanotic, and the pupils are dilated, you should immediately begin artificial respiration and external cardiac massage.

Methods of performing artificial respiration and

external cardiac massage

Artificial respiration. It is carried out in cases where the victim is not breathing or is breathing very poorly (rarely, convulsively), as well as if his breathing is constantly getting worse.

Most effective way artificial respiration is a “mouth to mouth” or “mouth to nose” method, since this ensures that a sufficient volume of air enters the victim’s lungs. The “mouth to mouth” or “mouth to nose” method is based on the use of air exhaled by the person providing assistance, which is forcibly supplied into the respiratory tract of the victim.

To carry out artificial respiration, the victim should be laid on his back, unbuttoned clothing that restricts breathing and ensure the patency of the upper respiratory tract, which in the supine position and in an unconscious state is closed by a sunken tongue.

After this, the person providing assistance is located on the side of the victim’s head, puts one hand under his neck, and with the palm of the other hand presses on the forehead, throwing his head back as much as possible. In this case, the root of the tongue rises and clears the entrance to the larynx, and the victim’s mouth opens. The person providing assistance leans towards the victim’s face and makes deep breath open mouth, then completely tightly covers the victim’s open mouth with his lips and exhales vigorously, blowing air into his mouth with some effort; at the same time, he covers the victim’s nose with his cheek or the fingers of his hand on the forehead. In this case, be sure to observe the victim’s chest, which should rise. As soon as the chest rises, the air injection is stopped, the person providing assistance raises his head, and the victim exhales passively. In order for the exhalation to be deeper, you can gently press your hand on the chest to help the air leave the victim’s lungs. Interval between artificial breaths should be 5 seconds, i.e. 12 times per minute.

If the victim’s jaws are clenched tightly and it is impossible to open his mouth, artificial respiration should be performed using the mouth-to-nose method.

If there is not only breathing, but also a pulse, artificial respiration alone is not enough, since oxygen from the lungs cannot be transferred by the blood to other organs. In this case, external cardiac massage should be performed.

In the position of a person on his back (on a hard surface), the spine is a rigid, motionless base. If you press on the sternum, the heart will be compressed between the sternum and the spine and blood from its cavities will be squeezed into the vessels. If you press on the sternum with jerking movements, the blood will be pushed out of the cavities of the heart in almost the same way as it happens during its natural contraction. This is called external cardiac massage.

If one person is providing assistance, he is located on the side of the victim and, bending over, makes 2 quick energetic blows (using the “mouth to mouth” or “mouth to nose” method), then unbends, remaining on the same side of the victim, palm puts one hand on bottom half the sternum, stepping back 2 fingers higher from its lower edge, and lifting the fingers. He places the palm of his second hand on top of the first across or lengthwise and presses, helping by tilting his body. When applying pressure, your hands should be straightened at the elbow joints.

The duration of pressure is no more than 0.5 seconds, the interval between individual pressures is no more than 0.5 seconds.

If revival is carried out by one person, then for every two deep breaths he makes 15 pressures on the sternum. In a minute you need to do at least 60 pressures and 12 blows.

When two people are involved in resuscitation, the ratio of “breathing to massage” is 1:5, that is, after one deep insufflation, five pressures are applied.