Resuscitator

The resuscitator is in charge of solving the most complicated task of restoring the respiratory and cardiac functions that are disturbed or temporarily lost, as well as maintaining them "in working order" with the help of special equipment.

Resuscitation refers to emergency medicine or medicine for critical conditions. It deals with the fact that other clinical specialties are beyond the power - urgent help in case of threat to the vital functions of the body, saving the very life of a person and, very often, practically its revitalization in case of clinical death.

[1], [2], [3]

Who is the resuscitator?

When the respiratory system stops and the contractions of the heart muscle cease, the human body does not give external signs of life, the doctors state the first stage of the dying process - clinical death. This condition is reversible, because for several more minutes - despite stopping blood circulation and stopping oxygen supply - metabolic processes in the body continue.

It is in these few moments that the resuscitator - a doctor who thoroughly knows how the human body functions - learns all the terminal states of the organism, that is, pathological functional changes that result from the increasing hypoxia of the brain and all tissues, acidosis (pathological acid alkaline imbalance of the body) and intoxication.

When should I go to the intensive care unit?

Most often, cases where you should go to the intensive care unit are related to the shock state, which is typical for many injuries and certain diseases and has several varieties. Depending on the cause of the shock, the shock can be traumatic, cardiogenic, hypovolemic (with large blood loss), infectious-toxic (with bacterial and viral lesions), septic (with sepsis and severe purulent inflammation), neurogenic (after spinal cord injury), anaphylactic for allergies) or combined.

And the reanimatologist will be able to properly assist in case of cardiogenic shock in case of myocardial infarction, and with a pain shock accompanied by perforation of the stomach ulcer.

But, as the resuscitators themselves note, traumatic shock is the most common case.

What tests should I take when I go to the intensive care unit?

Patients who enter the hospital - in the intensive care unit - take blood to find out blood type and Rh factor, general and biochemical blood tests. A blood coagulation test (hemostasiogram), total protein, creatinine, urea, alkaline phosphatases, bilirubin and others are also conducted.

What tests need to be handled when contacting the resuscitator depends on the specific disease or injury in which it is necessary to take action against life-threatening pathological symptoms and conditions.

What diagnostic methods does the resuscitator use?

Resuscitators use various diagnostic methods, starting with laboratory tests of blood and urine, and electrocardiography, ultrasound, computed tomography and MRI.

Control of the main functional parameters - pulse, pressure, respiration rate, temperature, acid and gas composition of blood - is carried out round the clock, and the results of all measurements are seen by reanimatologists on monitors.

In addition, the patient can be connected to a life supportive resuscitation apparatus (artificial lung ventilation device, oxygen concentrator, pacemaker, drop system). All processes are also constantly monitored.

What does the resuscitator do?

In your clinic, the resuscitator you will not see, since his work is not to treat specific diseases. His business is to timely identify and prevent such states of patients, in which there is a violation of the most important functions of the body, which can lead to fatal consequences.

Working in the intensive care unit of a clinical hospital, the resuscitator knows what to do in such situations. The physician starts all necessary resuscitation measures - using defibrillation shock (electric discharge to the heart area), medications, and using artificial heart and lung devices that provide auxiliary blood circulation and artificial ventilation.

In addition, the doctors of this specialization work in the intensive care teams of the ambulance.

From the professionalism of the reanimatologist, from the efficiency and correctness of his actions, human life depends. Because in the absence of resuscitation after three or more five to six minutes, biological death sets in: the brain not only stops, but also irrevocably loses its ability to perform its functions, and all the physiological processes in the cells and tissues of the body stop ...

What kind of diseases is treated by the resuscitator?

There are many diseases, as well as their complications (primarily, conditions after surgery), in which there is a high risk of death of patients and the need for carrying out certain resuscitation measures.

Resuscitators help people survive in clinical death, as well as in severe trauma accompanied by a life threat. These include damage to the skull and brain, thermal and chemical burns (accompanied by pain shock), penetrating injuries, electric shock, pulmonary edema or water ingress due to drowning, anaphylaxis (anaphylactic shock), severe intoxication (household and industrial poisoning) .

What kind of diseases is treated by the resuscitator? The list of diseases in which the resuscitation specialist often requires intervention includes myocardial infarction and serious cases of cardiac arrhythmia; coma (diabetic, hypoglycemic, hepatic, etc.); embolism of various etiologies and thrombosis of the arteries; infection of blood (sepsis), as well as some especially dangerous infectious diseases such as tetanus, rabies, etc.

Advice of a resuscitator

Sometimes it happens that emergency resuscitation is needed for a person just on the street. The first thing - without delay - you need to call an ambulance at number 103.

If the victim does not move - check the pulse (on the carotid artery). In the presence of a pulse and independent breathing, one should lay the person on his side and wait for the arrival of the ambulance, while constantly monitoring the presence of the pulse.

If there is no pulse, then prior to the arrival of physicians, it is necessary to conduct worldwide basic support activities for the life of man - alternating artificial ventilation (artificial respiration) and chest compression (indirect heart massage).

Advice of a resuscitator for cardiopulmonary resuscitation:

• put the victim on his back, unbend his head, raise his chin up, once again (but very quickly!) check his breathing - pulse on the carotid artery, chest movement, noise at exhalation, color of lips;
• kneel on the side of the victim, open his mouth, pinch his nostrils with the thumb and forefinger, bend over, inhale normally and exhale the air in the victim's mouth (repeat two times);
• the presence of the so-called "passive expiration" will testify to the patency of the person's airways.

Then proceed to restore the contraction of the heart through his indirect massage:

• put the palms of both hands (one on top of the other, the stop - on the base of the hand) in the center of the sternum of the victim, arms in elbows straightened;
• to make rhythmic pressure on the sternum of the victim, strengthening them with the upper part of his body;
• The sternum should be lowered by 4 or 5 cm, after each pressing the chest must necessarily take its original position;
• the number of starts is 30, then again you need to do artificial respiration twice.

With unsuccessful attempts to restore the heart by means of cardiopulmonary resuscitation (and if emergency medical care has not yet arrived) resort to a precardial stroke, the goal of which is to "run" the unbreakable heart with a strong concussion of the chest.

The technique of impact is as follows:

• make sure that there is no pulse on the carotid artery;
• the xiphoid process of the sternum is covered with two fingers;
• the back of the tightly clenched fist (the elbow of the hand should be located along the chest of the victim) from a distance of 20-25 cm to apply a sharp short blow to the lower part of the sternum - above the covering of the xiphoid process of the fingers;
• again check the pulse (on the carotid artery), and in case of his absence, repeat the stroke 1-2 times.

It should be remembered that in the presence of a pulse, the precordial stroke is by no means applied. Resuscitators say that in emergency situations, the first pre-hospital care for clinical death (in particular, with electric shock) is just a blow to the sternum, which is especially effective immediately after cardiac arrest.

[4], [5], [6], [7]