Baby drowning First Aid Resuscitation Activities. Drowning

Based on drowning Lying the aspiration of fluid into the upper respiratory tracts and lungs. According to the form and reasons of drowning distinguish: True (primary, "wet"), asphisical ("dry", "syncopal") and secondary drowning.

With true drowning into the lungs of the victim, a large amount of water flows (at least 10-12 ml / kg).

Asphisic drowning is characterized by persistent laryngospasm due to small amounts of water in the upper respiratory tract. The "false examinations" inchs in the spasmodized voice cream significantly reduce intrastallyolar and intragenuous pressure, which leads to the exit of the liquid and protein from the vascular bed into the alveoli to form a stack of foam filling the respiratory tract.

With a syncopal drowning, the death of the victim comes from the primary reflex stop of the heart and respiration with a sharp peripheral vascular spasm due to water ingress even in small quantities in the upper respiratory tract.

The secondary drowning occurs during transportation and at the hospital stage after the restraint of the victim from the state of clinical death. It is characterized by a sharp deterioration of the state in connection with the repeated election of the lungs.

Diagnostics

Anamnesis - immersion in water. In the initial period of true drowning, extracted from the water is excited or inhibited. Inadequate reaction to the situation: the victims are trying to get up, go away, refuse medical care. Skin and visible mucous membranes cyanotic, respiration is noisy, with cough attacks. Hypertension and tachycardia are quickly replaced by hypotension and bradycardia. It is often observed vomiting by switched water and gastric content.

In the agonal period of true drowning, consciousness is lost, but still preserved heart abbreviations. Skin cut sharply cyanotic, cold. From the mouth and the nose flows the foam fluid pink color; Subcutaneous veins of neck and forearm expanded and swollen. The triumism of chewing muscles; Rogue and corneal reflexes are sluggish.

When clinical death, breathing and cardiac activity are absent; Pupils are expanded and not react to light. For asphisical and "syncopal" drowning is characterized by an early onset of agonal state or clinical death.

Drilling should be differentiated with crock, supercooling and death in water.

The summer period is associated with good warm weather, rest and reappearing in cool water. But few at the same time think about accidents on accidents, such as drowning. And if this trouble is found in the life path, not many will be able to correctly and adequately assess the situation and provide timely and qualified assistance. It is in order to arm your knowledge and skills we want to convey these information. Let us turn to the question of help in the situation of drowning.

Drowning is a pathological condition that develops as a result of a random or deliberate immersion of a person into a liquid, as a result of which its lungs are filled with liquid substance, which leads to the development of acute heart failure (OSN) and acute pulmonary failure (exhalation).

1. True or wet.
2. Asphisic or dry.
3. Death in water, or syncopal drowning.

True drowning. Etiology

The basis of this type of drowning is the injection of liquid in the alveios of lungs. The pathogenesis of the true drowning is associated with the type of water in which drowning, fresh or salty, is precisely from this factor and will depend on the course of the pathological process. As for fresh water, it has a difference in a osmotic gradient with blood, thanks to which she quickly leaves the alveoli and falls into the vascular bed. Next, there is an increase in the volume of circulating blood (BCC) and blood dilution (hemodeload), edema, erythrocytes (erythrocyte hemolysis) are destroyed, sodium ions concentration, plasma calcium, chlorine and plasma proteins decreases.

When drowning occurs in sea water, the difference in the osmotic gradient, in this case, is located on the side of sea water. Then part of the plasma comes out of the vascular bed. This helps to reduce the mass of circulating blood and an increase in hematocrit.

Asphisic drowning

Asphischexoe drowning in water It happens without mechanical aspiration of water. The mechanism of action of this aspiration is based on the reflex larying pump. It turns out that the spasmned voice gap does not pass water, but it does not pass the air. As a result of this unit, mechanical asphyxia is obtained.

Death in water, or syncopal drowning

Death in water occurs as a result of a reflex stop of cardiac and respiratory activities. Most often, this type of drowning concerns dives in cold water.

True drowning. Clinic

In true drowning, it is customary to share three stages:

• agonal;
• elementary;
• clinical death.

If we talk about consciousness, it depends on the time and type of drowning. Disruption of breathing varies from agonual. At the same time, the victim begins chills, cyanosis, "goose skin" appears.

For drowning in fresh water, the clinic is characterized in the form of edema, venous and arterial hypertension, tachycardia and arrhythmias. From the upper respiratory tract, foam can be released due to the decay (hemolysis) of red blood cells.

When drowning in seawater, it is characteristic: arterial hypotension and bradycardia (deceleration of the pulse).

Emergency care when drowning

First medical care when drowning should not depend on the type of drowning. In all cases, a number of resuscitation activities are held.

Starting resuscitation should be started with the liberation of the upper respiratory tract (VDP) from water and foreign bodies, that is, from algae, river sand, etc. This resuscitation stage is necessary in order to prepare victim to conduct an artificial respiratory procedure. The most productive and sure way of liberating the VDP from foreign substances is the rise of the victims of the legs. Especially this method concerns children. If, due to the mass of victim or other reasons, this method of emptying of the VDP is impossible, the following method is applied. The drunkenness is laid by the belly down on the bent knee of the reanimating person and are waiting for the moment of leakage of excess fluid, falling out of foreign bodies. This resuscitation phase should not take over 10 seconds.

In the conditions of the clinic Medical assistance in drowning Depends on clinical symptoms and complex of syndromes:

• Resuscitation activities are carried out and, as necessary, the patient is transferred to artificial ventilation of the lungs (IVL).
• The drainage of the tracheobronchial tree, therapy of bronchio-rolls and pulmonary edema is carried out.
• Prescribed drugs buying acute cardiovascular failure.
• The acid alkaline state is stabilized and the electrolyte balance is normalized.
• Attention is paid to the prevention of renal failure and pneumonia.

If you suddenly witnessed drowning and you know what to do, do not lose and act. Just know that the life of another person may depend on your decision in this situation.

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Distinguish "true", "asphy" and "syncopal" drowning. "True" drowning is the hitting of large volumes of water in the respiratory tract. "Asphymen" or "false"; Drilling is characterized by laryngospasm due to fluid ingress. "Syncopal" drowning develops as a result of a reflex stop of the heart and breathing.

Symptoms

With the "true" drowning in fresh water, hemolysis develops. Drowning in seawater leads to hemokoncentration and hyperosmolar syndrome. The fibrillation of the ventricles of the heart does not occur. For the "true" drowning is characterized by purple-blue skin painting. When the "asphy" drowning cyanosis of the skin is less pronounced, the blood pressure decreases, bradycardia develops, then asistolia. For the "syncopal" drowning characteristic of a sharp pallor of the skin. The duration of dying during drowning fluctuates in very wide limits. With the "syncopal" drowning in ice water, it can reach 30 minutes or more, so the resuscitation must be carried out persistently and for a long time.

First aid

Pre-finger, wrapped with cloth, clean the oral cavity and a sip from foreign bodies, mucus. Remove the foam and liquid from the lower airways and the stomach, for which the victim with the head-down head quickly laid down the belly on the knee of the rescuer (no more than 20-30 seconds) and produce 2-3 impacts between the blades, removing fluid and foam from the respiratory ways. When developing the terminal state - artificial respiration by the method of "mouth to mouth" and indirect heart massage.

Prefigure help

Remove shy clothes from the victim, proceed to its warming. Inhalation of oxygen. When developing the terminal state - IVL, indirect heart massage. To prevent aspiration with a thick probe, evacuate the contents of the stomach.

Medical emergency care

Medical Center

Continuation of resuscitation events. Warming of the injured to the temperature of the body 31-33 ° C. When respiratory failure (Tahipne has more than 40 breaths per minute) - IVL with a breathing apparatus 100% oxygen. Intravenously slowly 1 ml of 0.06% of the harril solution in 20 ml of 40% glucose solution, intramuscularly 2 ml of 1% diploma solution, vitamins C, B1, B6 (in one syringe not to enter).

Content

A life-threatening condition that is characterized by the onset of asphyxia during fluid penetration into lungs with their subsequent swelling is called drowning. In the absence of timely resuscitation activities, a person can dare to die from acute respiratory failure. This cannot be allowed, so everyone is useful to remember which preference actions on the part of the rescuer involves emergency assistance in drowning. Act immediately.

What is the first help when drowning

Before you begin to resuscitation measures, it is important to realize what processes flow in the body when drowning. If fresh water falls into the lungs in large quantities, the cyclicity of reduction of heart ventricles is disturbed, extensive edema develops, the system of systemic circulation is terminated. When salty water penetrates the blood pathologically thickens, which leads to a stretching and rupture of the alveoli, the swelling of the lungs, the impaired gas exchange and the subsequent rupture of myocardium with a fatal outcome for the patient.

In both cases, in the absence of first aid, the victim may die. This can not be allowed. Proponial assistance in drowning provides for a special complex of resuscitation activities, aimed at the forced extinguishing of water in order to maintain the functionality of the internal organs, systems. Promoting the imminent important to render no later than 6 minutes from the moment of the loss of consciousness. Otherwise, extensive brain edema develops, and the victim dies. Due to the observance of the algorithm of actions, the statistics of drunks reduced the indicators.

First aid rules for drowning

First of all, you need to pull the victim to the shore, after which the first aid must follow when drowning. It is important to know the main and simple rules that will help save the person life:

1. First of all, it is necessary to clearly define the pulse and the presence of signs of breathing from the victim.
2. Be sure to call an ambulance carriage, and before the arrival of all the necessary activities to maintain the life of the body's vital activity.
3. It is necessary to put a person on the horizontal surface on the back, gently place the head, put under the neck of the roller.
4. Reliable wetting clothes victims, try to restore the disturbed heat exchange (whenever possible to warm the patient).
5. Clear the nose and the mouth of a person without consciousness, be sure to pull out the language, thereby avoiding the aggravation of the attack of choking.
6. Implement one of the techniques of artificial respiration - "mouth in the mouth" and "from the mouth to the nose" (if you manage to break the jaw of the victim when drowning).
7. Resuscitation events When drowning it is important to carry out knowledge, otherwise a person can only harm, aggravate his condition.

Rescue man on water

Human salvation takes place in two consecutive stages: rapid extraction from the water and assistance to the drowning already on the shore. In the first case, it is necessary to pull the victim of the victim from the reservoir as soon as possible and do not drown yourself. Therefore, it is very important to adhere to such events:

1. When drowning, it is necessary to swim to a person from behind and grab it so that that reflexively clutch into his Savior. Otherwise, two people can die at once.
2. It is best enough for the hair and pull. This is the most convenient way that is not very painful for the victim, and for the Savior is practical for the purpose of rapid movement on water towards the shore. In addition, you can comfortably grab the hand just above the elbow.
3. If the victim during drowning still grabbed his savior at the level of reflex, it is not necessary to sprinkle it and resist. It is necessary to dial in the easy air as possible and deeply dive, then it reflexively squeezes the fingers and increases the chances of salvation.
4. If the patient has already passed under the water, it is required to dive, grasp the hair or hands, and then raise the surface of the water. The head should be touched in order to avoid further admission of excess water into light and systemic blood flow.
5. To drag a sinking person on the water is laid only face up so that he is even no longer fought water. Thus, it turns out to significantly increase the chances of the unfortunate to salvation on the shore of the reservoir.
6. Before the first help is carried out, it is necessary to assess the features of the reservoir - fresh or salty water. This is very important for the implementation of the further actions of the rescuer.
7. Put the patient on the stomach, to provide first prefigure aid depending on the specific type of drowning (wet or dry).

First aid with dry drowning

This type of drowning is also called asphy, pale. The progressive spasm of the voice gap prevents the flow of water into the respiratory tract. All further pathological processes of the body are more connected with the coming shock and attacks of suffocation, in the absence of the first resuscitation activities may cost the affected life. In general, the clinical outcome is more favorable than with wet fatigue. The sequence of the rescuer actions is as follows (there is only 6 minutes in stock):

1. First medical care when drowning begins with the liberation of the language so that the person does not suffocate.
2. Next, clean the nasal and oral cavity (sand, tina, Il) can accumulate.
3. Turn over the patient face down so that water came out of the lungs, be sure to check the presence of the pulse and the features of the respiratory function.
4. Lay on your back so that the head is tracked, for example, under the neck, place a roller roller roller.
5. Spend a respiratory resuscitation, and for this, do artificial respiration "through the mouth to the nose" or "mouth in the mouth".

It is necessary to talk more about the technique of artificial respiration "from the mouth to the mouth" with the simultaneous implementation of the indirect massage of the heart. So, put a person on your back, free from the wet squeezing clothes, throw the head (the chin should rise) and hold down the nose. Perform two blows into the mouth, after laying one palm over the second on the chest. Holding limbs straight, press up to the sternum up to 15 times in 10 seconds. Then reinforce air through the mouth. During a minute, make 72 manipulations - 12 exhalations, 60 pressing.

If a person came into consciousness and coughed, quickly flip his head on his side. Otherwise, he may again chollow leave out of light water. When performing such integrated activities to save the life of the turmoil, two people are necessary. The first assistance in drowning with the vigilant control of the pulse is required, while the person does not come into consciousness, or the undeniable signs of death will not appear, for example, a complete stop of the heart, corpany spots on the skin and the symptoms of the stuffing.

With wet drowning

In this case, we are talking about true drowning (still called "blue" asphyxia), when even when first aid, the chances of salvation are small. The main symptoms are the sinusiness of the skin, the reflex stop of the heart (with a syncopal drowning), cold sweat, the presence of white or pink foam from mouth, clinical death, no pulse and respiratory signs. It is required in such a sequence:

1. Pull out the victim to the shore by the hand, hair, head or other part of the body.
2. Then put on the stomach and clean the mouth, the nasal cavity from the sanding of the sand, sludge.
3. Lift the patient and by pressing the root of the language forcibly proving the vomit reflex.
4. Call vomiting while the lungs, stomach and systemic blood flow will not leave the residues of the liquid. Additionally, you can paint the drowned on the back.
5. After flipping onto the side, bend your knees, let me pump out after the hypoxia of the brain cells experienced. The skin gradually acquires natural color.
6. If the vomit's reflex does not appear, turn the droplet onto the back, spend resuscitation activities with the participation of artificial respiratory techniques and the indirect heart massage in several approaches.

Precautions when providing medical assistance

If you wish to save the lives to another person, it is important for ignorance not to ruin your own. Therefore, you need to swim by a drowned man so that it does not strengthen his Savior in fear. When promoting towards the shore will have to act with one hand, since another limb holds the patient without consciousness or in a shock. Other precautions from the Savior, who relate to the topic: "First aid for drowning", presented below:

1. It is necessary to quickly remove wet and squeezing clothes, otherwise the clinical picture is noticeably complicated, while the patient's chances of salvation decrease.
2. The termination of the first aid is possible in three cases: if the ambulance carrier arrived, when the drowner came to himself and sank, if the signs of the coming death are obvious.
3. Do not be surprised at the appearance of foam oral cavity. When drowning in seawater, it is white (fluffy), in low reservoir drinkers - with blood impurities.
4. If the child suffered, the rescuer must turn it downside down, leaning on the thigh of his own leg.
5. If you managed to break the jaw to the patient, artificial respiration can be carried out according to the "mouth - nose" technique.
6. When compression of the chest (pressed), both hand brushes should be placed on the chest at a point, which is located on two fingers above the lower end of the sternum.
7. Hands with reanior measures should remain straightforwards, the body weight is transferred to them. Press the sternum is allowed only with a soft part of the palm.

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Drowning in fresh water. When penetrating into light fresh water is rapidly absorbed into the blood, since the concentration of salts in fresh water is much lower than in the blood. This leads to a discharge of blood, an increase in its volume and the destruction of red blood cells. Sometimes the edema is developing. A large number of stable pink foam is formed, which is even more gas exchange. The circulatory function is terminated as a result of a violation of the reduction of the ventricles of the heart.

Drowning in sea water. Due to the fact that the concentration of dissolved substances in sea water is higher than in the blood, when seawater, in the light liquid part of blood, together with proteins penetrates blood vessels in the alveoli. This leads to blood concentration, an increase in concentration of potassium ions, sodium, calcium, magnesium and chlorine. In the alveolis, a large amount of fluid is increasing, which leads to their stretching up to the gap. As a rule, when drowning in seawater, the edema is developed. The small amount of air that is in the alveoli contributes during the respiratory movements of the fluid whipping with the formation of a protein foam. Gas exchange sharply breaks, a heart stop occurs.

When conducting resuscitation events The time factor is extremely important. The earlier the revival started, the greater the chance of success. Based on this, artificial respiration is desirable to start on the water. To do this, perform periodic blowing air into the mouth or into the nose of the victim during its transportation to the shore or to the boat. On the shore there is an inspection of the victim. If the victim did not lose consciousness or is in a state of light fainting, then to eliminate the effects of drowning, it is enough to give a sniffing alcohol and warm the victim.
If the circulatory function is preserved (pulsation at carotid arteries), but no breathing, the oral cavity is released from foreign bodies. To do this, it is purified by a finger, wrapped by a bandage, removal removable dentures. Often the mouth of the victim is impossible to open due to the spasm of chewing muscles. In these cases, artificial respiration "mouth in the nose"; With the ineffectiveness of this method, the rotor seater is used, and if it is not, then a flat metal object is used (do not break your teeth!). As for the release of the upper respiratory tract from water and foam, it is best to apply suction for these purposes. If it is not, the injured put the stomach down on the dismissant's hip, bent in the knee joint. Then sharply, vigorously compress its chest. These manipulations are needed in those intensive care cases, when it is impossible to carry out artificial ventilation of the lungs due to the overlap of the respiratory tract with water or foam. It is necessary to conduct this procedure quickly and energetically. If there is no effect for a few seconds, it is necessary to start artificial ventilation of the lungs. If the skin is pale, then it is necessary to move directly to artificial ventilation of the lungs after cleansing the oral cavity.
The victim is placed on the back, free from the shocking clothes, they throw the head back, placing one hand under the neck, and the other is imposed on the forehead. Then they push the lower jaw of the victim forward and up so that the lower cutters turn out to be ahead of the upper. These techniques are performed in order to restore the passability of the upper respiratory tract. After that, the rescuer makes a deep breath, a little delays her breathing and, tightly pressing her lips to mouth (or to the nose) of the victim, doing exhale. It is recommended to clamp the nose with your fingers (when the mouth in the mouth) or mouth (when the mouth is breathing in the nose) of the animated one. Exhalation is carried out passively, while the respiratory tract should be open.
If with artificial ventilation of the lungs from the respiratory tract of the victim, water is distinguished, which makes it difficult to ventilation of the lungs, you need to turn your head to the side and raise the opposite shoulder; At the same time, the mouth of the drowned will be lower than the chest and the liquid will turn out. After that, it is possible to continue artificial ventilation of lungs. In no case cannot cease artificial ventilation of the lungs when independent respiratory movements have the victim, if his consciousness has not yet been restored or disrupted or sharply rhythm respiratory rhythm, which indicates incomplete recovery of the respiratory function.
In the event that there is no effective blood circulation (there is no pulse on large arteries, the heart blows do not listen, the blood pressure is not determined, the skin of pale or blue), simultaneously with artificial ventilation of the lungs spend an indirect heart massage. The help provided becomes on the side of the victim so that his hands are perpendicular to the surface of the chest drowned. The resuscator places one hand perpendicular to the sternum in its lower third, and the other put on top of the first hand, parallel to the plane of the sternum. Massage is effective if the pulsation of sleepy arteries begins to determine, tested before the extended pupils, the sinusiness decreases. When these first signs of life appear, the indirect heart massage should be continued until he starts to listen to the heartbeat.
It should be borne in mind that the stomach of the victim can be filled with water, food masses; This makes it difficult to carry out artificial ventilation, indirect heart massage, provokes vomiting.
After removing the victim from the state of clinical death, it is warmed (wrapped in a blanket, look with warm heels) and make a massage of the upper and lower extremities from the periphery to the center.
When drowning the time during which the human revival is possible after extracting from the water is 3-6 minutes.
Of great importance on the time of returning to the life of the victim is the water temperature. When drowning in ice water, when the body temperature decreases, the recovery is possible and 30 minutes after the accident.
As if a quickly saved man came into consciousness, no matter how safely his condition seemed to be, the premises of the victim in the hospital is an indispensable condition.
Transportation is carried out on stretchers - the victim is placed on the stomach or on the side with the head lowered. With the development of the ethnic body position on stretchers horizontal with a raised head end. During transportation, artificial ventilation of lungs continue.