Gaivinimas

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Gaivinimas

Organizmo gyvybei palaikyti būtina nuolatinė kraujotaka ir kvėpavimas. Įkvepiant į plaučius patenka oras. Per plaučius tekėdamas kraujas iš oro pasisavina deguonį, kuris nunešamas į smegenis. Nelaimingo atsitikimo metu sutrikus kvėpavimui, oras nepatenka į plaučius, kraujas nepasisavina deguonies, nes jo nėra plaučiuose, todėl į smegenis deguonis nepatenka. Organizmo būklė, kai sustojus kvėpavimui ir širdies veiklai, galvos smegenų ląstelės išlieka gyvybingos, vadinama klinikine mirtimi, o laikotarpis, per kurį šių ląstelių veiklą galima atgaivinti – klinikinės mirties trukme. Klinikinė mirtis nustatoma remiantis trimis požymiais: 1. Nėra sąmonės (nėra kontakto); 2. nėra kvėpavimo (nematyti krūtinės ląstos kvėpavimo judesių); 3. nėra kraujotakos (neužčiuopiamas pulsas). Sąmonė išnyksta po 1–2 min., o dar po 5 min. įvyksta negrįžtami pokyčiai smegenyse, žmogus miršta. Jeigu per šį laiką bus suteikta tinkama pagalba (dirbtinis kvėpavimas, dirbtinė kraujotaka, spaudinėjant krūtinės ląstą), gyvybę galima išgelbėti. Tai gali atlikti kiekvienas apmokintas žmogus, tuo metu esantis šalia, nes kol atvyks medikai, praeis per daug laiko, kad jie galėtų padėti. Todėl kiekvienas sąmoningas pilietis privalo mokėti gaivinti, kad galėtų išgelbėti savo draugų, artimųjų ar kitų į nelaimę patekusių žmonių gyvybę.
Kvėpavimo takų išvalymas ir atvėrimas
1. Prieš gaivinimą būtina nuimti mantą, atlaisvinti krūtinės ląstą nuo drabužių, nurišti kaklaraiščius, atsegti diržus, įsitikinti, kad krūtinės ląstos srityje nėra pakabukų, medalionų ir kitų pašalinių daiktų.
2. Paguldyti nukentėjusįjį ant nugaros. Jei nukentėjęs guli ant pilvo, reikia ištiesti tos pusės, į kurią planuojama versti, ranką virš galvos išilgai kūno, sukryžiuoti kojas, ant viršaus dedant priešingą vertimo pusei koją, ir, prilaikant už peties, galvos ir dubens atversti ant nugaros. Ranką grąžinti prie kūno.
3. Nukentėjusiojo smakrą suimti dešinės rankos nykščiu ir rodomuoju pirštu, o kairę ranką uždėti ant paciento kaktos ir galvą atlošti taip, kad tarp apatinio žandikaulio ir kaklo susidarytų bukas kampas. Tačiau, jei yra įtarimų, kad gali būti pažeista nukentėjusiojo stuburo kaklinė dalis, galvos atlošinėti negalima. Tokiu atveju kvėpavimo takų praeinamumą galima užtikrinti tik atitraukiant apatinį žandikaulį. Tam reikia už kampų suimti apatinį žandikaulį ir patraukti jį žemyn.
4. Patikrinti ar gulint ant nugaros neužkrito liežuvis ir neužspaudė kvėpavimo takų, taip pat ar nėra svetimkūnių, dantų protezų, gleivių, skrandžio turinio likučių, kraujo krešulių ir kt. Jei yra, įkišti rodomąjį pirštą į burną ir kablio formos judesiu juos pašalinti.
5. Patikrinti ar nukentėjusysis kvėpuoja (ausį priartinti prie nukentėjusiojo burnos, klausytis ar yra kvėpavimo garsas, pajausti šilumą, o akimis stebėti ar juda krūtinės ląsta). Stebėti ne ilgiau kaip 10 sekundžių.
6. Jei kvėpavimo požymių nėra, atlikti dirbtinį kvėpavimą.
 
Dirbtinis kvėpavimas
1. Jei atliktos kvėpavimo takų išvalymo ir atvėrimo procedūros, reikia užspausti nukentėjusiojo šverves, nes priešingu atveju per nosį išeis visas įpučiamas oras.
2. Giliai įkvėpus burna apžioti nukentėjusiojo burną, kad neliktų tarpų orui išeiti, ir tolygiai (nepūsti staigiai, daug, nes oras gali patekti į skrandį, o grįžęs skrandžio turinys į plaučius) per 1,5–2 sekundes įpūsti orą, kad pakiltų krūtinės ląsta (800–1200 ml oro). Jei krūtinės ląsta pakilo, palaukti, kol oras išeis ir atlikti dar vieną pūtimą. Jei įpūsti nepavyko, patikrinti gerklę ir kartoti kvėpavimo takų atvėrimo procedūrą. Gaivinant per minutę reikia atlikti 10–12 įpūtimų.
3. Jei sužalotas apatinis žandikaulis ar sunkiai sužalota nukentėjusiojo burna, jos negalima atverti, dirbtinį kvėpavimą reikia atlikti per nosį. Nukentėjusiojo galvą atlošti ir pakelti smakrą, apžioti nosį ir ptro ją įpūsti oro. Po to, kad gaivinamas žmogus galėtų iškvėpti, ranka, laikančia už smakro, praverti jo burną.
4. Po 2 veiksmingų įpūtimų tikrinti pulsą nukentėjusiojo kaklo arterijoje, žaste, kirkšnyje, bandyti išgirsti širdies darbą. Jei nukentėjusiojo širdis plaka 60 ir daugiau kartų per minutę, išorinio širdies masažo nereikia.
5. Jei po 2 įpūtimų pulso nėra – daryti išorinį širdies masažą.

Išorinis širdies masažas
1. Nukentėjusysis turi gulėti aukštielninkas ant kieto pagrindo.
2. Apnuoginti krūtinės ląstą.
3. Atlikti išorinį širdies masažą geriausia klūpint prie nukentėjusiojo ant kelių.
4. Delnus vienas ant kito dėti tarp vidurinio ir apatinio krūtinkaulio trečdalio (maždaug per 2 pirštus nuo krūtinkaulio apačios link galvos). Vienas nykštys turi būti nukreiptas link nukentėjusiojo smakro, kitas – link pilvo. Pirštai neturi liesti krūtinės ląstos. Rankas per alkūnes laikyti ištiestas.
5. Spausti reikia iš viršaus žemyn apie 3–5 centimetrus gylio, staigiu vidutinio stiprumo judesiu, vidutiniškai 60 kartų per minutę. Atliekant paspaudimus naudoti savo kūno svorio jėgą. Kiekvieno krūtinkaulio paspaudimo metu turi būti jaučiama pulsinė banga ties miego arterija.
6. Po kiekvieno paspaudimo krūtinės ląstą reikia atleisti, kad į širdį pritekėtų kraujo, tačiau rankų nenuimti. Kiekvieną paspaudimą atlikinėti tik tada, kai krūtinės ląsta grįš į pradinę padėtį.
7. Tarpuose tarp paspaudimų sustoti ir įpūsti oro iš burnos į burną (atrba iš burnos į nosį). Jei gaivina vienas, įpūtimų ir paspaudimų santykis turi būti 2:15 (1 ciklas), jei gaivina dviese – 1:5 (1 ciklas).
Jei gaivinamas vaikas, oro reikia įpūsti žymiai mažiau, krūtinę spausti mažesne jėga (kūdikio krūtinę spausti pirštais).
8. Tęsti gaivinimą (pradedant nuo įpūtimų) tol, kol nukentėjusysis atsigaus (parausvės jo oda, vyzdžiai pradės reaguoti į šviesą) ar atvyks greitoji medicinos pagalba.

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