“Golden four minutes” is the key to the rescue of sudden cardiac death

Just getting up in the morning, Master Yang, an old man who lives in the post and telecommunications dormitory, suddenly had chest tightness, shortness of breath, pale face, and silence. In a hurry, his wife, Master He, immediately called the 120 emergency number. After calling the ambulance, he hung up in a panic without saying the address. The emergency center quickly called back the phone. After asking for the address, he learned that Master Yang was not breathing now, so he taught Master He how to perform chest compressions on the patient.

The doctor asked Master He to place the base of the palm of one hand on the center of the patient’s chest, right in the middle of the line between the two nipples; the other hand was stacked on top of this hand. The base of the palm of the lower hand touches the patient’s chest and presses down firmly, keeping the depth above 5 cm. Press at least 2 times per second and press 30 times continuously. The doctor did not hang up the phone and asked Master He to count loudly while pressing…

In this way, Master He operated under the guidance of the doctor’s professional emergency password from the emergency center. After 3 minutes, Master Yang succeeded in cardiopulmonary resuscitation.

Cardiac arrest is when the heart stops beating suddenly or unexpectedly, resulting in loss of effective pulse and blood pressure. Death caused by cardiac arrest is sudden cardiac death. Cardiac arrest can happen at any time, any place, and anyone. Once a cardiac arrest occurs, blood perfusion to the brain and other vital organs will stop. If not treated in time, it will lead to sudden death.

But the same are all cardiac arrests, some people can “escape from the dead” fortunately, but some people just die. The most critical point of this is the timely rescue! As soon as the heartbeat and breathing stop, life will disappear in minutes, and 4 minutes is the key to rescue. So, do you know how to face first aid “Golden Four Minutes”?

What is “Golden Four Minutes”

At normal room temperature, brain cells will be irreversibly damaged after 4 minutes of cardiac arrest; if the time is more than 10 minutes, even if the patient is rescued, it may be brain death, that is, a vegetative person. Therefore, there is a “golden four minutes” in the first aid for sudden cardiac death.

When a patient suffers a cardiac arrest, the cerebral blood flow of the patient decreases sharply until it is interrupted; but because it just happened, there is still a small amount of oxygenated blood in the brain, even if the patient has lost consciousness, the patient can still be stimulated by the respiratory center Intermittent breathing (sigh-like or short spastic breathing). However, the oxygenated blood remaining in the brain can support human life for a short time. After a cardiac arrest occurs, most patients will begin to suffer irreversible brain damage within 4 minutes, and then transition to biological death within a few minutes. If the patient can get the correct cardiopulmonary resuscitation and defibrillation as soon as possible within these crucial minutes, he can escape death.

How to carry out the “golden four minutes” first aid

The first is to recognize cardiac arrest. The first responder patted the patient’s shoulder while confirming the safety of the scene and shouted “Are you okay?” to see if the patient responds; check if the patient is breathing; touch his carotid artery to see if there is pulsation. If there is no breathing or normal breathing (that is, only gasping), first aid should be started immediately. The principle of first aid is to rescue on the spot, do not move the patient at will.

First aid for cardiac arrest is divided into four steps, namely, call for help, cardiopulmonary resuscitation (CPR), electrical defibrillation, and early advanced life support. The combination of these four steps is the “chain of survival” proposed by the American Heart Association to rescue patients with cardiac arrest. For ordinary rescuers, mastering the first three steps, that is, correctly completing the first three steps in the “golden four minutes”, is the key to making the patient “escape from the dead”.

The first step: Call for help immediately call the emergency number 120, contact the hospital with the qualification of chest pain center, and accurately report the patient’s basic situation and location. At this time, every second of time saved, there will be more hope in life.

Step 2: Cardiopulmonary resuscitation (CPR) Early cardiopulmonary resuscitation, also known as basic cardiopulmonary resuscitation, is a series of rescue measures for people who suddenly stop breathing and heartbeat due to various reasons. The operation is divided into 3 steps.

1. Chest compressions. If the patient no longer has a pulse, chest compressions are required. Place the patient on his back and place the rescuer’s fingers tightly on the middle and lower part of the patient’s sternum (the junction of the lower 1/3 of the sternum or the junction of the nipples and the anterior midline), with one hand in the middle of the sternum and the other on top Lock your fingers, lift them up crosswise, and press down vertically with the help of the gravity of your upper body. The frequency should be at least 100 beats/min, and the chest should be pressed down at least 5 cm. After pressing down, the chest should be fully rebounded to ensure that the release time is basically the same as the pressing time. Press 30 times rhythmically (see Figure 1).

2. Open the airway. People who are in a coma often cause airway blockage due to the fall of the tongue. At this time, the rescuer should kneel on the side of the patient’s body, lift the patient’s jaw, and tilt the head back. Eliminate foreign bodies (such as dentures, etc.) in the patient’s mouth.

3. Artificial respiration. Pinch the patient’s nose, wrap the patient’s mouth with his mouth, and blow in the air twice quickly. According to the chest compression: artificial respiration = 30: 2 alternately, until the resuscitation is successful.

Step 3: Early electrical defibrillation. Before CPR, you should call someone around you to help you find an AED (Automatic External Defibrillator) nearby. AED is a portable, easy-to-operate, and can be used proficiently after a little training. It is specially designed for first aid on site. It is gradually appearing on the streets or gathering places of people in big cities. In a sense, AED is not only a kind of first aid equipment, but also a new concept of first aid, a concept that witnesses at the scene perform effective first aid first.

If an AED is found during CPR, the AED can be used first. “Listen to it, follow it”, that is, follow the AED’s voice prompts and screen display to operate.

1. Turn on the AED. The AED is placed on the left side of the patient. Press the power switch or open the display cover, the instrument will give voice guidance for subsequent operations.

2. Place the electrode pads. Quickly paste the electrode pads on the patient’s chest, one on the upper right chest wall (below the collarbone) and one on the outside of the left nipple, the upper edge is 7 cm from the armpit. If the patient sweats a lot, dry the skin with clothes or towels in advance; if the patient has more chest hair, press the electrode firmly, if it is not effective, remove the chest hair before sticking the electrode.

3. Insert the electrode plug into the jack of the AED host.

4. Heart rhythm analysis and defibrillation. Press the “Analyze” button (some models will give a voice prompt after inserting the electrode plate, and automatically start to analyze the heart rate), the AED will start to analyze the heart rate. After the analysis is completed, the AED will issue a recommendation on whether to perform defibrillation. If the patient develops ventricular fibrillation, the instrument will alert by sound or graphic alarm. Note that emergency personnel and bystanders should ensure that they are not in contact with the patient during operation to avoid affecting the heart rate analysis of the instrument.

5. Electric shock defibrillation. Before pressing the shock button, make sure that no one is in contact with the patient, or announce “leave” loudly. When there is an indication for defibrillation, the operator presses the “discharge” button to defibrillate. After the first shock, if the patient does not regain consciousness and breathing, immediately continue cardiopulmonary resuscitation (CPR). AED will continue to detect and operate according to the instructions. Repeat until the arrival of emergency teachers.

Step 4: Advanced life support

Advanced life support (ALS) is based on basic life support, using auxiliary equipment, special techniques, etc. to establish more effective ventilation and blood circulation, including tracheal intubation, defibrillation and conversion to heart rhythm, establishing venous channels and medication, and heart Pacing, etc., are implemented by professional medical staff. It also includes follow-up treatment of underlying diseases and protection of organs.