Artificial respiration and resuscitation methods.

 

Introduction to Artificial Respiration.

  • The more appropriate term for this is “Artificial Ventilation / Breathing” as respiration is a biochemical process.

  • It means breathing induced by some of the manipulative techniques. 

  • Artificial respiration is applied quickly and properly to prevent people from dying due to drowning, choking, suffocation, carbon monoxide poisoning, opiate overdose or electric shock. 

  • Machines of artificial respiration are also known as artificial lung ventilation machines.  

  • Artificial respiration mainly consists of two actions, 

    • To maintain and establish an open-air passage from the upper respiratory tract to the lungs. 

    • The exchange of air and carbon dioxide in the terminal air sac of the lungs, while the heart is still functioning.

  • Methods of Artificial Ventilation:

    • A) Manual Methods:

  1. Schaffer’s Method.

  2. Silvester method.

  3. Holger-Nielsen method.

  4. Mouth-to-mouth respiration.

  • B) Mechanical ventilation:

  1. Ventilator.

  2. Endotracheal intubation.

  1. Schaffer’s Method:

  • In this method, the victim is made to lay on his belly, with one arm extended directly overhead and the other arm bent at the elbow. 

  • The face is turned outward and resting on the forearm. 

  • In this position, the nose and mouth are free for breathing. 

  • Now, the rescuer kneels to the victim’s waist and puts his palm on the victim’s loin. 

  • The first step will be to apply the pressure by bending forward, then the rescuer pushes the abdominal viscera to bring about the expiration. 

  • Pressing forward expiration takes place and the bending backwards inspiration takes place. 

  • Advantages:

    • Prone position, so that water from the abdomen and lungs can be easily drained.

    • Simple method, non-tiring 

    • Can be continued for a long time. 

    • Can be applied to victims with injury to thorax.

  • Disadvantage:

    • Inspiration is passive and the expiration is active, which is not physiological. 

    • This method is not applied to the victim with injuries in the abdomen.

  1. Silvester method:

  • Performed in supine position, in which the pillow is given below the shoulder and the neck is fully extended. 

  • During this method, the rescuer will kneel near the victim's head, facing towards the victim. 

  • The rescuer will catch the victim's wrist and by bending the doctor will pull the victim’s arms up, this will result in inspiration. 

  • Then bending forward the rescuer will put deep pressure on the chest with the victim’s hand, this will cause expiration. 

  • Advantage:

    • Both inspiration and expiration are active, so good ventilation is obtained. 

  • Disadvantage:

    • No drainage of water from the lungs not used in cases of drowning. 

    • This method is quite tiring, 

    • Can not be used in case of rib fracture or thorax injury.

  1. Mouth-to-mouth respiration:

  • This is one of the best methods of the artificial method of respiration. 

  • In this method, the rescuer kneels near the victim’s neck facing toward him. 

  • A pillow is placed below the victim’s shoulder so that the neck is extended fully. 

  • With the left-hand rescuer closing the victim’s nostril and placing the handkerchief on the victim’s mouth, and then the rescuer will blow the expired air in the victim’s mouth this will cause inspiration. 

  • When the mouth is taken away, expiration occurs passively. 

  • Advantage:

    • The expired air used in this method contains more amounts of CO2 which helps stimulate the victim’s respiration.

  1. Mechanical Ventilation:

  • Mechanical ventilation is a method to mechanically assist or replace spontaneous breathing.

    • This may involve a machine called a ventilator or the breathing may be assisted by a trained person compressing a bag valve mask or set of bellows. 

    • There are two main modes of mechanical ventilation: 

    • positive pressure ventilation, where air (or another gas mix) is pushed into the trachea, and negative pressure ventilation, where air is, sucked into the lungs.

  • Tracheal intubation:

    •  A tube is inserted through the nose (nasotracheal intubation) or mouth (orotracheal intubation) and advanced into the trachea. 

    • Tracheal tubes inevitably cause pain and coughing.

    • Causes damage to the mucosal lining of the nasopharynx or oropharynx.

Resuscitation Introduction:

  • It is the process of correcting lack of breathing or heartbeat in an acutely ill patient.

  • It is an important part of intensive care medicine, trauma surgery and emergency medicine. 

  • e.g.  cardiopulmonary resuscitation (CPR) and mouth-to-mouth resuscitation.

  1. Cardiopulmonary resuscitation (CPR):

  • It is the procedure of maintaining artificial respiration and artificial circulation in a person who has gone into cardiac arrest through repeating cycles of chest compressions and artificial ventilations. 

  • It is used to maintain adequate oxygenation and circulation of critical body tissues, particularly those of the CNS and heart so that advanced life support procedures can restore the circulatory system to a functional state.

  • Cardio = heart, pulmonary = lungs, and resuscitation means to revive from death or unconsciousness.

  • CPR is indicated for people who are not breathing and are unable to maintain adequate circulation.

  • CPR involves chest compressions for adults between 5 cm and 6 cm deep and at a rate of at least 100 to 120 per minute.

  • The rescuer may also provide artificial ventilation by either exhaling air into the subject's mouth or nose (mouth-to-mouth resuscitation) or using a device that pushes air into the subject's lungs.

  • Chest compression to breathing ratios is set at 30 to 2 in adults and for childrens it is 15:2.

Commonly Asked Questions.

  1. What is Artificial Respiration? Write in detail about different techniques used in it.

  2. Write a short note on CPR (Cardiopulmonary resuscitation).

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