Precordial stroke: indications, application technique, features. Correctly apply a precordial shock Precordial shock mechanical defibrillation of the heart

Restoring heart rhythm after clinical death or precordial stroke is classified as a method. Directed physical impact on the heart - concussion chest.

It is carried out with simultaneous monitoring of the pulse. Sudden cardiac arrest occurs in young and old people. Mastery of the precordial impact method is the only way to help the victim.

Physiological aspect

The precordial blow is used when providing first aid to the victim. Sharp compression of the chest triggers the contractile reflex. The ventricles of the heart fill with blood. The rhythm is restored. A sharp compression of the chest forms an impulse. Directed mechanical energy provokes excitation at the nerve endings.

On a note!

The strike is carried out within the first 65 seconds after the attack sudden stop hearts. After 1.5-2 minutes of clinical death, the method is useless.

Indications and contraindications

Cardiologists have identified a list of indications in the presence of which a precordial stroke is performed.

After 5 minutes of resuscitation measures, the physician makes a conclusion about the occurrence of death. Unfortunately, surgery does not always restore the heart rhythm. Doctors recommend stopping all attempts to revive the patient if several signs are present. The first is that the eyes do not respond to the influence of a light stimulus. The second sign is that the epidermis changes color.

Precautions and complications

Cardiologists allow manipulation to be carried out by those who know how to strike correctly. The procedure is considered traumatic. Hasty actions in the chest area will provoke injuries:

• rib fracture;
• internal bleeding;
• violation of the integrity of the lung tissue;
• pleural rupture;
• stop breathing;
• damage internal organs and so on.

It is up to everyone to minimize the likelihood of complications. It is enough to remember the precautions. Cardiologists prohibit honing your skills on healthy people. There is a high risk of causing irreversible changes in work of cardio-vascular system. The blow is allowed to be delivered in the presence of cardiac arrest. Other recommendations are as follows:

• efficiency and accuracy - the blow is delivered within the first 45 seconds after the onset of clinical death;
• before starting the manipulation, feel the pulse at 2-3 points;
• The patient's chest is freed from clothing.

Increased caution is required when acting on the xiphoid process, a narrow and short element of the sternum. Do not use excessive force when striking. Excessive exposure will cause damage to the appendix or disruption of liver tissue. Pathological changes in a vital organ will not keep you waiting.

On a note!

Precordial stroke is a controversial, not prohibited, method. Cardiologists continue to debate the advisability of its use. The effectiveness of the manipulation depends on the qualifications of the performer.

The patient will be saved by prompt and correct actions

The victim is placed on a flat and hard surface. The man lies on his back. The cardiologist is inclined to prohibit performing the shock on a bed or soft surface. It absorbs kinetic energy. The procedure loses its effectiveness. The further procedure is as follows:

• the pulse is checked in the carotid and femoral arteries;
• absence of a pulse is a reason to immediately call an ambulance;
• An assistant calls the doctors, and the person begins resuscitation;
• at the point where the blow will be struck, they are freed from clothing;
• everything is removed from the victim’s clothing pockets - small and not so small objects will damage the skin during the manipulation;
• a right-handed man puts his index finger and middle finger your left hand to the solar plexus area on the chest;
• the fingers are placed at the so-called point of convergence of the ribs (solar plexus) - the more accurately the point is found, the less the risk of violating the integrity of the xiphoid process;
• a left-handed person repeats what was described above with only one difference - they use the fingers of the right hand;
• the second hand, which will receive the impact (blow), is clenched into a fist;
• the cardiologist is inclined to prohibit applying the impact with the edge of the palm;
• the clenched fist is raised above the point where the blow will be struck by 25 cm;
• the person who carries out resuscitation measures sits on the side of the victim;
• the hand clenched into a fist is located above the heart area and parallel to the body;
• the elbow of the hand clenched into a fist “looks” towards the victim’s navel;
• deliver a sharp blow at equal intervals no more than 2 times;
• after each sudden impact, check the pulse in the carotid and femoral arteries.

As soon as the pulse is recorded, a cardiac massage is performed. It is performed before the ambulance arrives. Correct implementation of recommendations increases a person’s chances of survival. In percentage terms, the situation looks like this. Of every 10 victims who were hit, at least 6-7 survived.

On a note!

A precordial blow is administered to children under 10 years of age with great caution - this kind of resuscitation is possible only after a detailed calculation of the force of impact. There shouldn't be any mistakes. There is a high risk of damaging the child's internal organs.

Precordial stroke is a method of restoring heart rhythm in the event of clinical death. The essence of the manipulation is reduced to a sharp effect on the chest. If the procedure is carried out within the first 45 seconds after the onset of clinical death, there is a high probability of resuscitating the victim. Resorting to a blow is allowed in the case when the performer masters the technique perfectly. Mistakes are not allowed.

• There is no consciousness and
• wide pupils that do not respond to light, and
• there is no pulse in the carotid artery.

UNACCEPTABLE!

1. Waste time trying to find out the circumstances of what happened.
2. Give in to panic.
3. Waste time identifying signs of breathing using a mirror or cotton wool.

TECHNIQUE FOR PERFORMING A PRECARDIAL STROKE

1. Place two fingers of your right hand on the site of pulsation of the carotid artery and make sure there is no pulse.
2. Cover the xiphoid process of the sternum with two fingers of your left hand.
3. Apply a short blow to the sternum with your right hand above your fingers covering the xiphoid process.
4. The blow should be delivered with the edge of the palm clenched into a fist. In this case, the elbow of the hand delivering the blow should be directed along the victim’s body.

UNDER NO EVENT CAN YOU!

1. Strike the sternum when there is a pulse in the carotid artery.
2. Strike the xiphoid process.
3. Strike the upper edge of the sternum in the area where the collarbones attach.

RULES FOR INDIRECT HEART MASSAGE

1. Turn the victim onto his back.
2. Indirect cardiac massage can only be performed on a flat, hard surface.
3. Remove clothing from the victim's chest.
4. Place your palm on the sternum 2-3 cm above the xiphoid process so that thumb the rescuer was aimed at either the chin or the stomach of the victim.
5. Perform 10 - 15 push-like pressures on the sternum if assistance is provided by one rescuer, and 5 pressures with the participation of a group of rescuers.
6. You can begin the next pressure on the sternum only after it has completely returned to its original position. (The rescuer’s palm should not leave the skin of the victim’s sternum.)
7. carried out only with straight hands.
8. The depth of pressing through the sternum should be at least 2 - 3 cm.

UNDER NO EVENT CAN YOU!

1. Perform chest compressions if there is a pulse in the carotid artery.
2. Place bricks, backpacks or other flat hard objects under your shoulders.
3. Place your palm while pressing on the sternum so that the thumb is directed towards the rescuer.

WHEN NOT TO STOP CARDIOPULMONARY RESUSCITATION

In the absence of an independent pulse in the carotid artery, but the reaction of the pupils to light is preserved.

TECHNIQUE FOR INSPIRATION OF ARTIFICIAL VENTILATION BY THE “MOUTH TO MOUTH” METHOD

1. Ensure airway patency:

• or, placing the victim’s chin between the thumb and forefinger, tilt his head back so that an obtuse angle is formed between the lower jaw and neck;
• or, grasping the chin with your thumb and forefinger, push it forward and up.

1. Ensure tightness of the “inhalation”:

• Use the thumb and index finger of your other hand to firmly pinch the victim’s nose;
• press your lips tightly against the victim’s lips.

1. Exhale into the victim with maximum effort.

Proof of a correctly performed “inhalation” is the rise of the chest by 2-3 centimeters.

YOU CAN'T GET AN EFFECTIVE INSPIRATION IF:

1. Do not pinch the victim's nose.
2. Do not tilt his head back or extend his lower jaw.

PREDICTORS OF REPEATED HEART STOP

1. Loss of consciousness.
2. Frequent twitching of facial muscles.
3. Involuntary urination and defecation.

WHEN TO IMMEDIATELY APPLY A TURNTICK

1. If blood flows out of the wound in a gushing stream.
2. A bloody stain on clothing or a pool of blood near the victim exceeds a meter in diameter.

WHEN THESE SIGNS APPEAR, IT IS NOT ACCEPTABLE TO DELAY EVEN FOR A SECOND!

HOW TO CORRECTLY APPLY A HEMOSTANT

1. The tourniquet is applied only through the fabric.
2. Place a tourniquet behind the damaged limb 2-3 cm above the wound.
3. Grasp the end of the tourniquet with one hand and its middle part with the other.
4. Stretch the tourniquet and wrap it around the limb with maximum tension.
5. Ensure that after tightening the first round of the tourniquet, bleeding on the wounds stops and the pulse in the limb is no longer palpable.
6. Tighten the next rounds of the tourniquet with less force, and higher along the limb.
7. Secure the last round of the tourniquet with a hook or clasp.
8. Be sure to include a note under the last round of the tourniquet about the time it was applied.
9. The time for applying a tourniquet in summer is no more than 2 hours, in winter - 1 hour.

WHEN TO APPLY TIGHT PRESSURE BANDAGES

1. During bleeding, when blood passively drains from the wound.
2. Immediately after releasing the limb with compartment syndrome.

WHEN IT IS NECESSARY TO APPLY PROTECTIVE OR TURNTIQUE TOUCHES

1. With compression syndrome until the limb is released.
2. For signs of pulmonary edema.

WHEN IT IS NECESSARY TO APPLY TRANSPORT SPLINTS ON LIMBS

1. If bone fragments are visible.
2. If you complain of pain in the area of ​​deformation and swelling of the limb.
3. After releasing the crushed limbs.

RULES FOR TRANSPORTING VICTIMS ON STRETCHERS

WHEN IT IS NECESSARY TO CARRY VICTIMS ON A SHIELD WITH A ROLLER PUT UNDER THE KNEES OR ON A VACUUM STRETCHER IN THE “FROG” POSITION

1. If you suspect a fracture of the pelvic bones.
2. If you suspect a fracture of the upper third of the femur and damage hip joint.
3. If spinal injury is suspected and spinal cord.

WHEN THE VICTIMS ARE CARRIED ON THE STOMACH ONLY

1. In a state of coma.
2. With frequent vomiting.
3. For burns of the back and buttocks.
4. If spinal cord injury is suspected and only canvas stretchers are available.

WHEN VICTIMS CAN BE CARRIED AND TRANSPORTED ONLY IN A SITTING WAY OR WITH THE HEAD ELEVATED.

1. For penetrating chest wounds.
2. When signs of pulmonary edema appear.

WHEN A VICTIMS CAN BE CARRIED AND TRANSPORTED ONLY ON THE BACK WITH LEGS RAISED OR BENT AT THE KNEES

1. For penetrating wounds abdominal cavity.
2. With large blood loss.
3. If internal bleeding is suspected.

SIGNS OF THE MOST DANGEROUS DAMAGES AND CONDITIONS

SIGNS OF CLINICAL DEATH
(WHEN EVERY WASTED SECOND CAN BE FATAL)

1. Lack of consciousness.
2. Wide pupils that do not respond to light.
3. There is no pulse in the carotid artery.

SIGNS OF BIOLOGICAL DEATH
(WHEN CARRYING OUT RESUSCITATION IS MEANINGLESS)

1. Drying of the cornea - the appearance of a “herring” shine.
2. Residual pupil deformation after gentle compression eyeball fingers (cat's eye syndrome).
3. The appearance of cadaveric spots.

PS: From a legal point of view, dying occurs after cardiac arrest, that is, in principle we are trying revive a corpse(even if he still looks meaningfully), and if it doesn’t work out, it’s not our fault.

PPS: But the fact of death can be confirmed only doctor. Here.

SIGNS OF COMA

1. Loss of consciousness for more than 4 minutes.
2. The appearance of stridor breathing:

• when inhaling, you can hear wheezing and snoring,
• the muscles of the face and neck are involved in the act of inhalation,
• With each inhalation, the entire upper half of the torso tenses.

SIGNS OF ARTERIAL BLEEDING

1. Blood flows out of the wound in a gushing stream.
2. A ridge of escaping blood forms over the wound.
3. A bloody stain on clothing or a pool of blood near the victim exceeds a meter in diameter.

SIGNS OF VENOUS BLEEDING

1. Blood flows passively from the wound.
2. Very dark blood color.

SIGNS OF OPEN FRACTURE OF LIMB BONES

1. Bone fragments are visible.
2. Deformation and swelling of the limb with the presence of a wound.

SIGNS OF CLOSED FRACTURE OF LIMB BONES

1. Strong pain and restriction of movement or weight bearing on a limb.
2. Deformation and swelling of the limb.

SIGNS OF FRACTURE OF THE PELVIS AND UPPER THIRD OF THE FEGUR

A retained heartbeat can kill a person.

Attention! Remember: precordial beat when

The human heart is a four-chambered pump, small in size but with unique capabilities. No tissue created by nature or man has such contractility. Over 70 years of life at a heart rate of

standing at rest 70 beats per minute, the heart muscles will make 2,575,440 000 abbreviations. This is truly incredible performance! The heart muscle, like any other muscle, consists of a huge number of muscle fibers, and they all work as a single unit. For a number of reasons, the synchronicity of contraction of muscle fibers is disrupted, they begin to work uncoordinated, which leads to cardiac arrest and death. With the help of a precordial blow to the sternum, you can force the heart to beat as synchronously as before. The purpose of delivering such a blow is to shake the chest as much as possible, which can be an impetus to “start” the stopped heart. Often the blow restores the heartbeat and returns consciousness. A simple but very effective way.

The precordial blow is delivered to a point located on the sternum 2-3 cm above the xiphoid process with the edge of the palm clenched into a fist. The blow should be short and sharp enough. In this case, the elbow of the hand delivering the blow should be directed along the victim’s body. Immediately after the blow, you need to find out whether the heart has resumed its work, for which you place 2-3 fingers on the projection of the carotid artery. If the heart starts working, they begin artificial ventilation of the lungs; if not, they move on to chest compressions.

3.3. Indirect massage hearts

Indirect cardiac massage (direct massage is performed by open-heart surgeons) begins as soon as it becomes clear that the precordial stroke has not brought the expected result. The effectiveness of this method largely depends on strict adherence to the following rules:

The palms, placed one on top of the other, should be located in a strictly defined place: 2-3 cm above the xiphoid process at the point of precordial impact;

Jerky pressure on the chest should be done with such force that the chest is compressed by 5 cm in an adult, 3 cm in a teenager, one year old child- by 1 cm;

The rhythm of chest compressions should correspond to the heart rate at rest - approximately 1 time per second. Each correctly performed pressure on the sternum corresponds to one heartbeat;

The minimum time for chest compressions, even in the absence of signs of its effectiveness, should not be less than 15-20 minutes.

The effect of chest compressions in combination with artificial ventilation can be observed within 1-2 minutes: the skin of the face gradually acquires a normal color, the pupils react to light (they narrow) and pulsation is noted in the carotid artery.

\/ Indirect cardiac massage technique:

Place the person on a hard surface (if the victim is lying on a bed or sofa, he must be placed on the floor); then kneel on the left side of the victim parallel to the longitudinal axis of his body;

Place the palm of one hand at the projection point of the heart on the sternum, and the other palm on top (palms one on top of the other), fingers should be raised, thumbs should look in different directions;

It is necessary to press on the sternum only with straight arms, using the weight of the body (shoulder girdle, back and upper half of the body); when performing indirect massage on a child, you can use one hand, and on a newborn - one thumb;

The palms should not leave the victim’s sternum, and each subsequent movement should be made only after the chest returns to its original position.

3.4. Artificial ventilation

Artificial ventilation is carried out in two cases: when there is no heartbeat and breathing, i.e. the person is in a state of clinical death, and also when the heartbeat and spontaneous breathing are preserved, but the frequency of respiratory movements does not exceed 10 times per minute.

Mechanical ventilation technique:

ensure patency of the upper respiratory tract ways. Ensuring patency of the upper respiratory tract is carried out with the index and middle fingers, which must be wrapped in a clean handkerchief or gauze. Quickly clean oral cavity from foreign bodies - blood, mucus. Then tilt the victim’s head back, placing a small dense cushion made of any available material under his shoulders;

exhale into the victim’s lungs. Exhalation into the lungs is carried out using the mouth-to-mouth method. In this case, you need to take a deep breath and, tightly clasping the victim’s lips with your lips, exhale into his lungs. Simultaneously, when inhaling, the index and thumb One hand should seal the victim's nostrils tightly. There should be no gaps in the closed system formed in this way, otherwise air will not enter the lungs;

make sure that the chest moves (rises) when you exhale into the victim’s lungs. If this does not happen, it means that the airways are obstructed, air is not entering the lungs and your efforts are in vain. In this case, you need to clean it again Airways and slightly change the position of the victim’s head.

The effectiveness of resuscitation will depend not only on the accuracy of the technique of chest compressions and artificial ventilation, but also on their relationship in the process of your actions. If one person performs resuscitation, you need to do about 80

compressions per minute, for every 10-12 pressure on the sternum should be 2-3 exhalations (for preschool children, the intensity of pressure is 100 once a minute and for every 5 pressures there is 1 exhalation). Of course, it is better to carry out resuscitation with two or three people. In this case, for every 5 pressures there is 1 breath, and one of the participants presses quite hard on the victim’s stomach, since this excludes a significant volume of blood from the blood circulation (in the pelvis and lower limbs) and are created good conditions for complete blood supply to the brain.

If your actions are successful (the independent activity of the heart and lungs is restored,

Complex of resuscitation measures

Procedure for resuscitation

Indications for CPR

§ Lack of consciousness

§ Lack of breathing

§ Lack of blood circulation (in such a situation it is more effective to check the pulse in the carotid arteries)

Actions of medical workers when providing resuscitation care victims in Russia are regulated by Order of the Ministry of Health of the Russian Federation dated April 4, 2003 No. 73 “On approval of instructions for determining the criteria and procedure for determining the moment of death of a person and cessation of resuscitation measures.”

If the resuscitator (the person performing resuscitation) does not determine the pulse in the carotid artery (or does not know how to determine it), then it should be assumed that there is no pulse, that is, circulatory arrest has occurred.

According to the AHA CPR recommendations from 2011. The procedure for performing cardiopulmonary resuscitation has been changed from ABCDE to CABED. Mnemonic “memo” - ABCDE, according to the first letters of the English alphabet. The order, phasing and sequence of activities is very important.

Airway, air permeability.

Examine the oral cavity - if there is vomit, silt, sand, remove them, that is, ensure access of air to the lungs. Carry out the triple Safar maneuver: throw back your head, extend your lower jaw and open your mouth slightly.

Breathing, that is, “breathing.”

Breathing "mouth to mouth" or "mouth to nose" "mouth to nose and mouth." See below for the technique.

Circulation, ensuring blood circulation.

Provided by cardiac massage, direct or indirect. Properly performed indirect cardiac massage (by moving the chest) provides the brain with the minimum required amount of oxygen; a pause for artificial respiration impairs the supply of oxygen to the brain, so you must breathe through at least 30 compressions on the sternum, or not pause to inhale at all.

Drugs, medications.

Adrenalin. The medicine is administered intravenously with a syringe through a catheter installed in a vein or a needle. The previously used endotracheal (as well as intracardiac) route of drug administration is considered ineffective (According to the AHA recommendations on CPR from 2011). In the presence of arrhythmia, the use of amiodarone is indicated. Also, the previously recommended soda solution is not used.

Electrocardiogram, monitoring the effectiveness of resuscitation measures.

The components of the complex of resuscitation measures are listed

Scheme of indirect cardiac massage.

The only indication for a precordial shock is circulatory arrest that occurs in your presence if less than 10 seconds have passed and when there is no electric defibrillator ready for use. Contraindication: child's age is less than 8 years, body weight is less than 15 kg.

The victim is placed on a hard surface. The index finger and middle finger must be placed on the xiphoid process. Then, with the edge of the palm clenched into a fist, hit the sternum above the fingers, while the elbow of the striking hand should be directed along the victim’s torso. If after this there is no pulse in the carotid artery, then it is advisable to move on to chest compressions.

Currently, the precordial shock technique is considered insufficiently effective, but some experts insist that it is clinically effective enough for use in emergency resuscitation.

Chest compressions (indirect cardiac massage)

Indirect heart massage for a child.

Assistance is provided on a flat, hard surface. When compressing, the emphasis is on the bases of the palms. Hands in elbow joints must not be bent. During compression, the line of the rescuer's shoulders should be in line with the sternum and parallel to it. The position of the hands is perpendicular to the sternum. During compression, the hands can be held in a “lock” or one on top of the other “crosswise”. During compression, with the arms positioned “crosswise”, the fingers should be raised and not touch the surface of the chest. The location of the hands during compression is on the sternum, 2 transverse fingers above the end of the xiphoid process. Compression can be stopped only for the time necessary to perform artificial ventilation and to determine the pulse in the carotid artery. Compression should be performed to a depth of at least 5 cm (for adults) (AHA CPR 2011 recommendations).

The first compression should be a test to determine the elasticity and resistance of the chest. Subsequent compressions are performed with the same force. Compression should be performed at a frequency of at least 100 per minute, rhythmically if possible. Compressions are carried out in the anteroposterior direction along the line connecting the sternum to the spine.

When performing compression, you must not lift your hands from the sternum. Compression is performed in a pendulum-like manner, smoothly, using the weight of the upper half of your body. Push hard, push often (AHA recommendations for CPR 2011) Displacement of the base of the palms relative to the sternum is unacceptable. Violation of the relationship between compressions and forced breaths is not allowed:

The breath/compression ratio should be 2:30, regardless of the number of people performing CPR.

For non-medics, when finding the compression point, it is possible to place your hands in the center of the chest, between the nipples.

For newborn babies, indirect cardiac massage is performed with one finger. For infants - two fingers, for older children - with one palm. The depth of pressing is 1/3 of the height of the chest.

Signs of effectiveness:

§ appearance of a pulse on the carotid artery

§ pinking of the skin

§ pupillary reflex to light

IN last years is not as rare as before, and has become more common even in young patients. This condition can happen anywhere - on the street, in public transport, on sporting events etc. In this regard, any person, and not only a medical worker, should know how to correctly and timely provide emergency assistance to the victim. This is especially true for such techniques as precordial stroke. Of course, when carrying out such a strike, there are rules, which will be discussed below.

So, a precordial blow is a method of physical impact on the chest of a patient who has suffered. Such an effect can translate physical vibrations of the anterior chest wall and the wall of the heart into electrical excitation of the fibers of the heart muscle, since the heart tissue has the property of electrical excitability, as a result of which its mechanical irritation can provide an electrical impulse response. In other words, the mechanical effect on the heart area is a kind of mechanical pacemaker, thanks to which normal cardiac cycle. However, a number of authors are inclined to believe that such an effect is not enough to produce a full-fledged electrical systole, capable of ensuring adequate ejection of blood into the aorta, and, consequently, ensuring blood flow to the brain. There has been a lot of debate about this effect on the heart in the medical literature, and yet at the present time:

A precordial shock is considered an effective resuscitation aid, but only if the patient actually has a cardiac arrest, and the shock was carried out in the first 30-40 seconds after that.

When is it necessary to perform a precordial beat?

The indication for carrying out this resuscitation aid when providing first aid is the absence of an independent heartbeat in the patient, which is caused by and/or asystole (cardiac arrest) due to other rhythm disturbances. Clinically, asystole, which caused clinical death, is accompanied by such signs as:

• Loss of consciousness
• No pulse on carotid and femoral arteries,
• Dilated pupils with no reaction to light
• Lack of spontaneous breathing
• The presence of a blue tint on the skin of the face, neck, and hands.

If the doctor has the ability to conduct an ECG or cardioscopy using a monitor on a defibrillator, ventricular fibrillation, electromechanical dissociation of the heart and asystole can be reliably detected.

The algorithm for diagnosing cardiac arrest is as follows:

1. If a person falls and loses consciousness, you should call out to him and shake him by the shoulder. It is unacceptable to hit a person on the cheeks; you can sprinkle water on your face.
2. If there is no reaction, feel the pulse fluctuations of the carotid artery (at the angle of the lower jaw), assess the presence of independent respiratory movements - see if there is an excursion of the chest, listen to the sound of exhaled air with your ear or feel the exhaled air with your cheek (the “look, listen, feel” algorithm ).
3. In the absence of pulse and respiratory movements, immediately begin performing a precordial blow with further indirect and artificial ventilation using artificial respiration.

When should you not apply a precordial blow?

This resuscitation manual absolutely not to be applied in the presence of a pulse in the carotid artery and in the presence of independent respiratory movements. This is fraught with cardiac arrest in a person who has simply lost consciousness or is in a coma, as well as in a patient with convulsive syndrome. That is, the absence of consciousness in a patient with a normal heart rhythm can be mistakenly regarded as clinical death, as a result of which a precordial blow can cause irreparable harm to the patient.

If the victim has open chest injuries(open gaping wounds with massive bleeding, prolapse of the chest organs into the lumen of the wound), and also visually it is possible to determine rib fractures (deformation of the ribs, protruding parts of the ribs), performing a precordial blow is pointless. In this case, you should wait for doctors or rescuers to arrive.

Thus, the only contraindication for performing a precordial blow with an intact chest frame without visible damage is the presence of a pulse in the carotid or femoral arteries, as well as the presence of an independent heart rhythm on the cardiogram or on the cardioscope of the defibrillator.

Regarding patients childhood It should be noted that conducting a precordial beat strictly contraindicated for children under 7 years of age due to the high probability of damage to internal organs. For this category of victims, implementation immediately begins indirect cardiac massage.

Technique for performing a precordial stroke

So, the precordial blow is applied correctly in a certain way. After a person has fallen and lost consciousness, the person providing assistance (hereinafter referred to as the resuscitator) must perform a series of sequential actions within 30-60 seconds:

Figure: Performing a precordial beat

If cardiac arrest occurs in a medical facility, there is no point in wasting time looking for a defibrillator, since it is necessary to immediately begin delivering a precordial shock. If a defibrillator is at hand, for example, when cardiac arrest occurred in the intensive care unit, the resuscitator should immediately determine the type of asystole using a cardioscope and begin administering it using electrical pulse therapy.

Are complications possible when saving a person’s life?

The only complication of a precordial stroke is fracture of the ribs and sternum with possible damage to the lungs and pleura. This complication is very common, and lung damage is much less common. But if, with the help of a blow and subsequent cardiac massage, it was possible to bring a person back to life, a rib fracture can be quite successfully treated with conservative treatment, which does not cause significant discomfort in the patient.

Video: performing a precordial beat