Article 95: Cardiopulmonary resuscitation, management of nasal bleeding, and methods of hemostasis after trauma

2. Artificial respiration.

After determining that there are no foreign objects obstructing the airway in the oral cavity, or clearing...

After removing the foreign object, the operator should maintain the patient's open airway position and use one hand to hold the patient upright.

Pinch the nostrils closed (to prevent air from escaping), and tightly wrap your lips around the patient's lips.

(Be careful not to leak air), blow two breaths consecutively, with a total air volume not exceeding 1200 ml.

The dose should be no less than 800 ml, and the patient's chest wall should be observed for any rise and fall.

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If there is no spontaneous breathing, begin ventilation at a rate of 12 breaths per minute and wait for rescue.

Medical personnel arrived.

3. External cardiac compression surgery.

To determine whether a patient has a pulse, one usually checks...

Check if the carotid artery pulse has disappeared.

If disappears, call for emergency medical services.

At the same time, the surgeon kneels beside the patient, close to their chest, and blows two breaths into their mouth.

Use your index and middle fingers to slide upwards along the xiphoid process and costal margin to find the manubrium of the sternum.

At the junction of the middle and lower thirds, press vertically downwards with both hands overlapping, to a depth of 4.

Press down 1-5 cm, apply even pressure, and do not remove your hand when releasing after each press.

Chest wall.

Press 60-80 times per minute. The person assisting should speak orally every 5 presses.

Blow a breath into the mouth. If only one person is performing CPR, the surgeon should give 15 compressions per minute.

Take a deep breath, blow two breaths into each other's mouths, and then quickly find the normal compression position.

Continue performing cardiac compressions, repeating this process until medical personnel arrive.

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Note: Cardiopulmonary resuscitation (CPR) should be performed continuously. If the method is correct, continuous resuscitation can be performed.

After 30 minutes of resuscitation efforts, the patient still had no spontaneous breathing or pulse, and the pupils did not reflex to light.

If the injection stops or the flow becomes more diffuse, it indicates that the rescue effort is ineffective and can be abandoned.

Furthermore, on-site first aid is only the initial means of rescue; in cases of cardiac arrest...

Afterwards, the body is in an anaerobic state, and a series of changes occur in acid-base balance and electrolytes.

Even if a patient is revived on the spot, they should still be closely monitored by medical personnel to determine the true extent of the damage.

While the patient is recovering, blind optimism could lead to a second cardiac arrest.

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For patients who have attempted suicide by poisoning or suffered from food poisoning, mouth-to-nose resuscitation should be performed as much as possible during resuscitation.

Inhalation involves pinching the patient's lips closed and blowing air into the patient's nostrils.

What to do after a nosebleed

One of the most common emergencies in otolaryngology is nosebleed, which is a common symptom in many diseases.

A symptom of the disease.

Long-term or recurrent nosebleeds can lead to anemia and affect...

Human health.

Therefore, if you experience a nosebleed, you should go to the hospital promptly to determine the cause and receive appropriate treatment.

Handle it promptly.

In daily life, if a nosebleed occurs, the first thing to do is to remain calm and apply pressure to the neck.

Apply cold compresses repeatedly to the face, head, or chest. If the patient's condition permits, allow the patient to...

People should sit or semi-sitting with their heads tilted slightly forward to prevent blood from flowing into the nasopharynx.

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For patients with severe blood loss and signs of shock, they should be placed in a supine position and sent to the hospital for emergency treatment.

The specific measures to stop nosebleeds vary depending on the location of the nose.

1. For bleeding in the anterior part of the nasal cavity, first remove the blood clots in the nasal cavity, then firmly pinch the area with your thumb.

Apply pressure to both sides of the nostrils, or place a cotton ball soaked in 1% ephedrine solution into the nasal cavity, and then perform finger insertion.

For pinpoint or patchy bleeding, cauterization can be used; for severe bleeding, vasectomy can be used.

Pack with strips of styrofoam, gelatin sponge, etc., and leave for 24–48 hours.

2. For bleeding in the posterior nasal cavity, Vaseline gauze strips can be packed into the posterior nasal cavity.

3. Bleeding caused by submucosal vasodilation can be treated surgically.

Nosebleeds can also be treated systemically by addressing the underlying cause, such as taking vitamin C,

Vitamin K and hemostatic drugs (such as Panax notoginseng, Yunnan Baiyao, and Anluoxue).

Blood loss

For seriously ill patients, intravenous fluids and blood transfusions can be administered to replenish blood volume.

Methods to stop bleeding after trauma

The outflow of blood from a damaged blood vessel is called bleeding.

Acute bleeding is caused by external injury.

The cause of early death is unknown, therefore, emergency measures should be taken first during on-site rescue.

Hemostasis measures should be taken to prevent shock or even death caused by massive bleeding.

Before attempting to stop bleeding, it is essential to determine the nature of the bleeding. Only by understanding the characteristics of the bleeding can one effectively control it.

Only by understanding the characteristics can we take targeted hemostatic measures.

Arterial bleeding, bright red blood

Red, blood spurting from the wound, is highly dangerous; venous bleeding, the blood is dark in color.

Red, blood flows out continuously, but without spurting; capillary bleeding, bright red blood.

Red, blood seeping from the entire wound, poses little danger.

When bleeding occurs due to external injury, the principle of treatment is to stop the bleeding promptly and effectively.

In emergency situations, temporary hemostasis is often used, which is briefly introduced below.

Several simple and easy-to-use methods for stopping bleeding.

1. Digital pressure hemostasis (compression hemostasis): Apply pressure with your fingers to the upper part of the wound (closer to the heart).

At the point of arterial compression (end of artery), forcefully press the artery against the bone to interrupt it.

Blood flow achieves the purpose of stopping bleeding.

2. Apply pressure bandage to stop bleeding: Cover the wound with a dressing, then apply a pressure bandage.

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It is used for bleeding from small arteries, veins, and capillaries.

3. Apply padding and flex the limb to stop bleeding: For bleeding in the forearm or lower leg, apply padding to the elbow crease or popliteal fossa.

Place a gauze pad, cotton ball, towel, or clothing, bend the joint, and use a triangular bandage.

Or bandages tightly bind the bent limbs.

4. Packing to stop the bleeding: Use a first-aid kit, cotton pads, or sterile gauze to pack the wound.

Inside the mouth, apply a pressure bandage.

For use on the groin, armpits, and shoulders.

Bleeding from the mouth, nose, uterus, etc.

5. Tourniquet hemostasis: Use a rubber tourniquet to stop the bleeding. The tourniquet can be applied to the area where it is wrapped.

The area (above the wound) should be padded with gauze, cotton cloth, or the injured person's clothing, then...

Then, hold the end of the tourniquet with the thumb, index, and middle fingers of your left hand, and pull the tourniquet taut with your other hand.

Wrap the tourniquet around the limb twice, and insert the end of the tourniquet into the index and middle fingers of the left hand.

Pull back and fix.

If you don't have a rubber tourniquet, you can use any readily available materials.

Materials such as triangular bandages, bandages, handkerchiefs, and strips of cloth can be folded into strips and wrapped around the wound.

At the proximal end, pad the wrapped area with a liner, tighten it firmly, and then tie a knot.

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Insert a short stick inside or below the knot, and rotate the stick to tighten the band until bleeding stops.

Stop, and fix the short stick to the limb.

If there is significant bleeding or damage to important blood vessels, the patient should be transported immediately after basic hemostasis is achieved.

They were rushed to the hospital to save the lives of the injured.

When the tourniquet is applied for an extended period of time, it is...

To prevent necrosis of distal limbs, the bandage should be loosened once every half hour and then tightened again.

How to handle limb amputation

When encountering limb amputation due to any cause, rescuers must ensure...

Remain calm, and after effectively bandaging the stump, wrap the severed limb in a plastic bag.

Okay, put another plastic bag over it, add some ice cubes, and keep the temperature at 2℃.

At around 5°C, quickly transport the patient and the severed limb (finger) to the hospital.

It is important to point out that you should never do anything to the severed limb, especially

Do not wash the severed limb.

Because the body fluids have a certain osmotic pressure.

Amputated limbs that have been washed with clean water or soaked in ice water will suffer damage due to low osmotic pressure.

Tissue edema occurs when cells swell and die due to absorbing excessive water, losing their function.

This gave them the opportunity to replant.

Which type of dressing is best for wounds?

Clean wound surfaces often have a small amount of blood or exudate, which will dry after the wound dries.

The physiological protective layer that forms a wound-the scab-is where healing takes place.

Because bacteria do not easily grow and multiply in dry environments, wounds should be kept dry.

It also has the ability to resist infection.

Therefore, for shallow, clean, and fresh wounds

For surgical incisions, especially sutured ones, only a thin layer of dry gauze is usually used as a dressing.

Wrap the wound in a protective manner, or leave it exposed as appropriate; no medication is necessary.

However, for wounds with excessive discharge or severe infection, the use of dry dressings often easily leads to...

The gauze may stick to the wound, hindering drainage and even damaging newly formed tissue.

Therefore, it is now generally recommended to use a damp gauze to wrap the affected area.

Its main advantage is that it can absorb [participants/resources].

Secretions reduce local bacterial concentration and create a certain concentration of drug locally.

The environment is being improved in order to control the infection.

For those with less discharge and relatively clean

For fresh wounds or areas where granulation tissue is developing, apply an oil-soaked gauze dressing.

To protect newly formed granulation tissue.

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