Artificial respiration

- BY a.s.a SUVEC M.B.B.S

kapvgmc

•artificial respiration, any measure that causes air to flow in and out of a person's lungs when natural breathing is inadequate or ceases, as in respiratory paralysis, drowning, electric shock, choking, gas or smoke inhalation, or poisoning

MANUAL METHODS•Mouth to mouth •Mouth to nose •Mouth to mouth and nose •Mouth to mask -Bag valve mask•Silvester method•Holger Nielsen

•Mouth to nose –in maxillofacial injuries, performing the procedure in water or the remains of vomit in the mouth

•Mouth to mouth and nose - Used on infants (usually up to around 1 year old), as this forms the most effective seal

•Mouth to mask – to reduce cross infection risk. One popular type is the 'pocket mask'. This may be able to provide higher tidal volumes than a Bag Valve

• In Drowning do not waste time trying to "empty water out of the lungs" by jackknifing or rolling on a barrel.

•bag valve mask When the air chamber or "bag" is squeezed, the device forces air through into the patient's lungs; when the bag is released, it self-inflates, drawing in ambient air or a

low pressure oxygen flow supplied

from a regulated cylinder, whilst the

patient's lungs deflate to the air through the one way valve

The Silvester Method of

artificial respiration in which the patient is laid on their back, and their arms are raised above their head to aid inhalation and then pressed against their chest to aid exhalation.The procedure is repeated sixteen times per minute

Holger nieslen method:

MECHANICAL METHODS

• Drinker and Shaw tank • Mechanical ventilator -Transport ventilators -ICU ventilators -High Frequency ventilator -Tracheal intubation -Oesophageal obturator airway -Cricothyrotomy -Tracheostomy

Drinker’s method -iron lung chamber

In the iron lung by means of a pump, the air is withdrawn mechanically to produce a vacuum inside the tank, thus creating negative pressure. This negative pressure leads to expansion of the chest, which causes a decrease in intrapulmonary pressure and flow of ambient air into the lungs. As the vacuum is released, the pressure inside the tank equalizes to that of the ambient pressure, and the elastic coil of the chest and lungs leads to passive exhalation.

•Positive pressure machines

•Positive-pressure ventilators work by increasing the patient's airway pressure through an endotracheal or tracheostomy tube or tracheoHand-controlled ventilation

High frequency ventilator

High frequency ventilation is a type of mechanical ventilation that employs

very high respiratory rates (>150 breaths per minute) and very small

tidal volumes (usually below anatomical dead space)

• NICU ventilators--Designed with the preterm neonate in mind

• PAP ventilators-- these ventilators are specifically designed for non-invasive ventilation. this includes ventilators for use at home, in order to treat sleep apnea.

• Tracheotomy and tracheostomy are surgical procedures on the neck to open a direct airway through an incision in the trachea (the windpipe

•Tracheal intubationA tube is inserted through the nose (nasotracheal intubation) or mouth (orotracheal intubation) and advanced into the trachea

•Cricothyrotomy where an airway is inserted through a

surgical opening in the cricothyroid membrane

Kiss of life

•Cardiopulmonary resuscitation (CPR) is an emergency medical procedure for a victim of cardiac arrest or, in some circumstances, respiratory arrest

•CPR consists of artificial blood circulation and artificial respiration (i.e. chest compressions and lung ventilation).

•CPR is unlikely to restart the heart, but rather its purpose is to maintain a flow of oxygenated blood to the brain and the heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage.

•Defibrillation and advanced life support are usually needed to restart the heart.

•The best estimate of the heart efficiency during CPR is 20-30% of normal.

•You are breathing oxygen into the lungs. Your exhaled breath contains 16% oxygen which is close to the 20% contained in the air you breathe in, while the carbon-di-oxide stimulate the respiratory center

• A universal compression-ventilation ratio (30:2) recommended for all single rescuers of

-infant ,child and adult victims (excluding newborns).

Ratio for  the  two  person  CPR  is  5 :1,  at  a  rate  

of  80  compressions  per minute

• The primary difference between the age groups is that

with adults the rescuer uses two hands for the chest compressions,

• while with children it is only one, and • with infants only two fingers (index and middle

fingers).

• CPR is only likely to be effective if commenced within 6 minutes after the blood flow stops,

because permanent brain cell damage occurs when fresh blood infuses the cells after that time, since the cells of the brain become dormant in as little as 4-6 minutes in an oxygen deprived environment and the cells are unable to survive the reintroduction of oxygen in a traditional resuscitation

.

•Remember the ABCs

Think ABC - Airway, - Breathing and

-Circulation

.

• AIRWAY: Clear the airway • Put the person on his or her back on a firm surface. • Kneel next to the person's neck and shoulders. • Open the person's airway using the head-tilt, chin-

lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.

• Check for normal breathing, taking no more than five or 10 seconds: Look for chest motion, listen for breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven't been trained in emergency procedures, skip mouth-to-mouth rescue breathing and proceed directly to chest compression

BREATHING:• With the airway open (using the head-

tilt, chin-lift maneuver) pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.

• Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.

CIRCULATION: Restore blood circulation with chest compressions

• Place the heel of one hand over the center of the person's chest, between the nipples.

Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.

• Use your upper body weight (not just your arms) as you push straight down on (compress) the chest 2 inches (approximately 5 centimeters). Push hard and push fast — give two compressions per second, or about 100 compressions per minute.

• After 30 compressions, tilt the head back and lift the chin up to open the airway. Prepare to give two rescue breaths. Pinch the nose shut and breathe into the mouth for one second.

•Timing devices--They can feature a metronome (an item carried by many ambulance crews) in order to assist the rescuer in getting the correct rate.

•Manual Assist device– CPREzy •Automatic device-LUCAS

Rhythmic Abdominal Compressions

•Rhythmic abdominal compression-CPR works by forcing blood from the blood vessels around the abdominal organs,

an area known to contain about 25 percent of the body's total blood volume. This blood is then redirected to other sites, including the circulation around the heart.

•Frequently ribs are broken with the pressure CPR places on the sternum. Some studies quote up to 30% of cardiac arrest victims have broken ribs as a result of CPR.

But remember, it's better to have a cracked rib than be dead.

•Can I kill someone if I do CPR incorrectly?

•No. Remember the person in cardiac arrest is already clinically dead. CPR can only help. Even if it's not done "letter perfect" it will probably provide some benefit to the victim.

•When should I stop CPR? When help arrives to take over, or the victim starts to move.

CCR (Cardiocerebral Resuscitation) is simply chest compressions without artificial respiration is the key to helping someone recover from cardiac arrest.

•CPR can double or triple the victim's chances of survival when commenced immediately

•On average, only 5%-10% of people who receive CPR survive.

•There has never been a case of HIV transmitted by mouth-to-mouth CPR

•If the victim is obviously pregnant or known to be pregnant, adjust your hand position to be slightly higher on the chest

-THANK YOU