Lump Groin Heart Cath

NEW PROTOCOL BLS (emergency medical emergency with x updated the link)

procedure BLS

Abstract: The BLS secular
The following procedure is based on the lines guides of the European Resuscitation Council, and is meant to be performed by anyone. Why does not require medical capabilities or the use of special equipment. To this layman is defined BLS. The procedure involves the use of aids (Ambu bag, pharyngeal cannula, semi-automatic defibrillator) is designed for the medical and nursing staff and certified and trained rescuers.
If you are in the position of having to apply the BLS strongly urge you, if you are aware of this procedure, to intervene. In case of doubts as to the evaluation of the patient to perform maneuvers on the only reference is 118, which has always been available to physicians for evaluations telephone in an emergency. In particular, always refer to the first 118 to act in any way subject to trauma patients: the risk of aggravating the injury is very high.
You may also want everyone to attend the free courses organized by various national relief organizations in the area: the explanation is certainly more depth than can give a simple reading of a text and in addition there is the presence of simulations practices.
must be said that the ERC guidelines are updated and change with time: the latter are those of 2005, which does not make a few changes to the previous (research point compression entity insufflation etc.).

Rating scene
Before any action on a subject, the rescuer must ensure that the area in which it acts is free of dangers: for example, to ascertain that the subject is not in contact with live parts, which there is no smell of gas or liquid, or cords of light. In cases where an area is not safe to be alert the relevant authorities, such as firefighters. If the area is safe, then you can proceed with the ABCs of cardiopulmonary resuscitation.
resuscitation is practiced only on a person unconscious, unresponsive to verbal warning and tactile stimuli (for example, if shaken). Consider whether the subject is victim of an illness or an injury in the second case does not move the patient and immediately contact 118.
If, confronted the victim unconscious for an injury, you should be required to intervene (there is no possibility of summoning assistance or was responsible for this function: eg. Lifeguards, medical staff, etc..), You should know that the BLS will have two slightly different procedures depending on whether you are ill or specifically to trauma (such as trauma, drowning, too), so it must be said that when you do not have the opportunity to assess with certainty the cause of the event (for es. was not present and there are no witnesses or evidence of what can be done), we must act whereas the injured victim of trauma suspicion ", then acting just as if the trauma had really happened.

Assessment of consciousness
The assessment of consciousness of the subject is his ability to respond to external stimuli. Communication with the person should be using all five senses.
The person must be shaken gently by the shoulders and call aloud, to be taken out and also be requested to enter into that of the rescuer. If you do not react to any of these stimuli is defined then the person unconscious. In this case, the request must be made immediately to those around us to call the number phone for medical emergencies (118 in Italy, 144 in Switzerland, 112 in most EU countries). In cases where the patient is conscious, however, can be alerted to the power station to send qualified personnel to better checks.
ABC of Basic Life Support

The second phase of the BLS is a procedure that is named ABC, from the initials of the words Airway, Breathing, Circulation.
A: Airways The body of the patient should be positioned supine on a hard surface, such as a table or floor. The head and limbs must be aligned with the body. To do this, it is often necessary to move the injured person and make him various muscle movements (Take for example the case of a man lying on his stomach), these shifts must be made with caution, and in case of injury or trauma suspected, you will need to pay close attention to the rotation of the neck and / or spine who, having suffered damage is perhaps more exposed to high risks. In these cases, therefore, be appropriate to move the injured several people and in a uniform and coordinated, causing the least deviation. The chest must be discovered and any ties that bind or clothing must be loose because they can obstruct the airway. Often, such garments are cut with a pair of scissors to avoid wasting time. The

risks they run an unconscious person is the airway obstruction: the same language can also fall back and prevent breathing, due to loss of muscle tone. Before testing the patency of the airway and therefore the absence of items that may obstruct the air passage is made hyperextension of the head, just to avoid a self-suffocation with the language. To perform the maneuver dell'iperestensione, it placed a hand on his forehead, brought his head back and put two fingers under the chin lifting. The hyperextension maneuver contains the prefix "hyper" because it goes beyond the normal extension that makes the neck of course, so the action, although not violent (the neck is very delicate) to be effective. Also for this reason, if there is a cervical trauma, even suspicion, hyperextension should never be complete: in this case will be only partial and, while sacrificing a bit 'of effectiveness of the BLS, surely will prevent permanent damage to the spine cervical cause of partial or total paralysis of the body. The oral cavity should be inspected by "maneuver purse" which is done by rotating the index finger and thumb together. If there are objects blocking the airway should be removed by hand or with pliers, being careful not to push the foreign body even deeper. If there is water or other liquid (eg after a drowning) will need to tilt the head of the injured side (the whole body in more people if there is a suspicion of cervical spine trauma, not to move my neck) to permit liquid to escape.

B: Breathing After being Airway you need to check if the person breathes. The ideal location to do this is to pull over her cheek to his mouth (about 3-5 cm), observing meanwhile the chest, and placing a hand if necessary. This maneuver is called "gas" is going to look, listen, listen:
1. Watch the movement of the chest
2. Listen for breath

3. Feeling the flow of air over cheek
This observation must be maintained for 10 seconds, counting aloud, keeping the patient's head hyperextended. Count aloud who used to intervene in the meantime, and knows the basics of BLS, without stopping to realize that you may need your help. You must be careful not to confuse panting and gurgling issued in the event of respiratory arrest with normal breathing.
C: Circulation
While making the maneuver GAS must consider whether there are movements of the person, coughing, breathing, which signals the presence of circulatory activity. The maneuver is called engine (movement, coughing, breath). In addition to these two operations, it is always should search for the wrists, preferably carotid (press with the fingertips of index and middle fingers on the carotid artery, located on the side of the throat), by allowing the perception of heart rate even at a systolic blood pressure (maximum) of 20-30 mmHg, while the radial and femoral pulse is not possible to find heart with systolic blood pressure lower than 90 mmHg and 60 mmHg. However, since it is easy to check the carotid pulse, especially if you have not experienced the presence of engine, even when the carotid pulse signals no cardiac activity, is a certain proof that the heart is beating.
The search for signs of movement (motor) does not in any way delay relief operations, so if in doubt, it is assumed that cardiac activity is absent.
In the absence of motor is essential to begin cardiopulmonary resuscitation. If you are alone is called to help at this time 118. If relief has already been called, it is important to inform you that there is a person in cardiac arrest.
CPR
The procedure of CPR is in these stages:

The patient must be on a hard surface (a soft or weak compression makes it completely useless).
Kneel next to the chest. Remove
, opening or cutting, if necessary, the clothes of the injured. The maneuver requires contact with the chest, to be sure of the correct hand position.
Place your hands directly above the sternum, one above the other, the center of the chest. To avoid breaking the ribs, only the palms of your hands should touch the chest. More specifically, the point of contact should be the eminence handheld, or the lower part and near the wrist of the palm, which is more hard and put in line with the limb. To facilitate this contact may be useful interlace your fingers and lift them slightly.
Shift your weight toward the front, staying on his knees, until your shoulders are directly above your hands.
Keeping your arms straight, without bending elbows, move up and down vigorously. The pressure on the chest to cause a movement of about 4-5cm for each compression. It is important to release completely after each compression. it is imperative that throughout the period of compression the palm of your hand does not fall off from the chest, creating a dangerous rebound effect.
The correct rate of compression is about 100 compressions per minute, to help you achieve the correct speed, count out loud as you do compressions.

After every 30 compressions, 2 rescue is necessary to practice artificial respiration. The head is rotated backwards, the rescuer closes the nose with one hand while extends the lower jaw with the other to keep the mouth open. It is vital that the head remains hyper inflations, since the incorrect position of the airway exposes the victim to the risk of air entering the stomach, causing easily rigurgito.Quest 'last is caused by the power which is blown or if it blows too much air is sent into the stomach. The CPR involves blowing forced air into the respiratory system of the injured, with the help of a mask or a boccaio. In the absence, a cotton handkerchief can be used to protect the rescuer from direct contact with the mouth of the injured. The new 2005 guidelines warn the rescuer from the risk of hyperventilation: excessive increase in intrathoracic pressure, risk of blowing air into the stomach, excessive venous return to heart, for this reason should not be overly forceful breaths, but do not emit air more than 500-600 cc (half a liter, in not more than a second). Finally it should be noted that the air breathed by the first rescuer to blow must be as "pure", that contain the highest possible percentage oxygen: why un'insufflazione between the rescuer and the other will have to raise your head to breathe at a safe distance because they do not breathe the air emitted by the victim, which has a lower density of oxygen.
Back from the chest and reposition your hands in the correct position.
Repeat the cycle of 30:2 until the patient resumes its normal functions.
be assessed every two minutes the engines exist, and if recovery is still absent from the cardio-pulmonary resuscitation. However, if present (the victim's arm moves, coughs, moves his eyes, talks etc..), Proceed to the evaluation of breathing (point B. I listen to hear = look for 10 sec.) Then the breathing is present, it can place the victim in PLS (recovery position), otherwise it will run only ventilation (10 per minute), double-check your GAS ENGINE 2 minutes until complete recovery of respiration.
Resuscitation should always begin with compressions unless the question is one of trauma, drowning or the victim is a child in these cases we will start with 5 rescue breaths, then continue normally with the alternating compressions-insufflation. This is because in case of drowning or trauma, it is assumed that the oxygen in the lungs of the injured is not sufficient to ensure the efficiency of blood circulation, the more so as a precautionary measure, starting with the breaths in the case the victim is a child, by virtue of the fact that it is likely that a child, enjoying good health, is in a state of cardiac arrest due to causes are more likely to trauma or drowning.
A rescuer may stop heart massage when:
a physician (by 118 and then with expertise in resuscitation) notes the death occurred
get qualified assistance such as more efficient equipment
is exhausted and no longer forces (although in this case usually require changes that must take place in the middle of the 30 compressions, so as not to interrupt the cycle compression-breaths).
the subject takes up the vital functions
something happens for which the site becomes more 'sicuro.In event of a serious danger to the rescuer has duty to rescue.
The recovery position (PLS)
.
If breathing returns to be present, but the patient is still unconscious and is not supposed trauma, it should be placed on the side of safety. To do this we must bend one knee and bring the foot of that leg below the knee of the leg. Need to slide the arm opposite the bent leg on the ground until it is perpendicular to the trunk. The other arm should be placed on the chest, so close that your hand on the side of the neck. Subsequently, the rescuer should stand on the side that does not have the arm extended outward, put his arm between the arch formed by the legs of the patient and the other grasping his head. Leveraging on their knees, gently roll the patient onto the side of the external arm, the accompanying head movement. The head is hyperextended and then maintained in that position by placing his hand under the cheek of the arm does not touch the ground. This position is designed to maintain a patent airway and prevent sudden jets of vomit obstruct the respiratory cavity and enter the lungs, damaging its integrity. By the Side of Safety issued each liquid is expelled from the body.