Bearing loss is a fundamental part of our life cycle. There is birth and death, and there is growth and decline. This is the law of nature. We often forget that the body of the laws of nature will eventually die. Everything we can see around us will one day die and die. This includes all plants, animals, humans, buildings, cities, earth, the sun, and even the milky way. Everything in nature is temporary.
Death is a very heavy topic, in our cultural context, it is a "taboo", something that dare not be mentioned or thought about. In recent years, people who have heard about their hometown are leaving their relatives forever without any warning when they are young and strong, leaving behind young children, elderly parents, young wives or husbands, the pillars of the family or the thrifty and thrifty family. Life has been out of poverty and become well-off, living in a spacious and bright building, suddenly unhappy, lost the laughter, which is a very unfortunate thing. Especially in the face of the departure of their loved ones and their relatives, many people will be sad and sad, no matter what kind of cultural and religious background, the feelings are basically the same. The difference is that the duration and intensity of the feeling may be different for each person. Just in the winter of 2021, a loved one of mine died suddenly, without any warning. While grieving, as a doctor, I am also reflecting on what is the reason for such an unfortunate event? What should we do?
As far as the hometown of Fuping is concerned, one is diet, high salt and high fat, which is directly related to local eating habits, in the 1980s and 1990s, the living material is poor, the transportation is inconvenient, the villagers like to harvest the radish cabbage in autumn, etc., pickled up to make pickle sauerkraut. The tofu that is killed in winter is pickled and eaten for a year in the following year. The oil for cooking and cooking is the animal oil of the pig of the year, and almost no vegetable oil is eaten, and the cycle continues year after year. The second is the pressure of life, the concept of male and female protagonists in the hometown has continued for hundreds of years, and the daughter-in-law raises children at home, supports the elderly, takes care of housework, and manages farmland. Men work outside to earn money, construction sites, factories and mining enterprises, some working environments without any protective measures, toxic and harmful. Both husband and wife are very tired, tired and tired! Third, health examinations, ideological concepts, economic conditions, and medical conditions at the grass-roots level have restricted the health examinations of villagers. There is not even a physical examination once in a lifetime, and some diseases cannot be detected early, treated early, and intervened early in time. However, now with the implementation of the national basic public health services, the elderly over the age of 65 can enjoy a basic health examination once a year. Chronic diseases are followed up four times a year. Fourth, the basic diseases are not paid attention to, the most common are hypertension, diabetes, high blood lipids, cardiovascular and cerebrovascular diseases, the medication is not standardized, the value is not up to standard, it is difficult to achieve regular monitoring. Fifth, genetic factors, smoking and drinking, smoking has hundreds of harms and no benefits, alcohol has been recognized by the World Health Organization as a first-class carcinogen. Sixth, there are other uncertainties or situations that have so far been unexplained by medicine.
Sudden death refers to the sudden death of a normally healthy person due to a natural disease in an unexpectedly short period of time. Sudden death is often without warning, and may cause chest pain, difficulty breathing, blackening in front of the eyes, dizziness, etc., and death in a short period of time. About 80% are caused by sudden cardiac death, with the rest being caused by other major acute illnesses. Sudden death cannot be treated, it can only be prevented, and cardiopulmonary resuscitation can be taken in the event of cardiac arrest.
Fuping, the hometown of Fuping, is a mountainous area, although the traffic situation has improved greatly in recent years. Fuping is about 100 kilometers long from east to west and 75 kilometers wide from north to south. Some remote areas are more than 100 miles away from the county seat, and each township health center does not have 120 points. Dial 120 and wait until the best prime time has been lost.
Patients with sudden cardiac death are often encountered in clinical work and in real life. In this case, proper CPR is the key to rescuing the patient. The golden time of CPR rescue, cardiac arrest will occur loss of consciousness in 5-10 seconds, general convulsions will occur 30 seconds after falling to the ground, dilated pupils will occur in 60 seconds, no spontaneous breathing will occur in 60 seconds, cerebral edema will begin to appear in 3 minutes, brain cell death will begin to appear in 4 minutes, brain death will appear in 8 minutes, and enter the vegetative state. Therefore, for patients with cardiac arrest, time is life, and early CPR is the key to successful rescue. From the above, it can be concluded that the golden time for CPR rescue is 4 minutes.
Before performing CPR, first determine whether the respiratory heartbeat has stopped.
First of all, the judgment of the heart, to see if there is no heartbeat at the tip of the heart, you can use a stethoscope or a finger to touch the carotid artery of the human body, located about one centimeter outward from the laryngeal node, the inside of the sternocleidomastoid muscle, to see if there is still a beat in the carotid artery and other aorta, if the beat disappears, the tip of the heart beats disappear, indicating that the heart has stopped beating.
Then make a breathing judgment to see if the chest is undulating, you can also put some cotton wool in the nostrils, if you breathe, these cotton wool will swing back and forth. And to look at the lips and the color of the face, if the lips cyanosis, indicating severe lack of oxygen, there may be a case of respiratory arrest, and to see the face. If the heartbeat and breathing have stopped, the face is pale, and there are some dark colors, without the previous rosiness.
If there is an AED on the spot, when calling 120, the AED should be called at the same time and used immediately according to the instructions. Without AED, or without AED treatment, follow these steps for CPR
Chest compressions, preparation for movement: the patient is placed on his back on a hard ground and the rescuer kneels next to the patient's chest. Pressure site: at the midpoint of the patient's two nipple connections. Pressing action: the rescuer places one palm on the pressed site, the other palm on the first hand, the two hands overlap in parallel, the elbow joint is straight, and the body gravity is vertically downward, and the chest is pressed hard and fast; infant and young child patients can use two fingers of one hand to press in the same position. Frequency of compression: Each compression and relaxation time is roughly equal, pay attention to allow the thoracic cage to fully rebound, and the frequency of compression is 100 to 120 times per minute. Compression depth: adult thoracic depression 5 to 6 cm. Children and infants have a sunken chest 1/3 of the anterior diameter of the chest (about 5 cm for children, about 4 cm for infants). Other: In order to ensure the depth and frequency of compression, when there are multiple rescuers present, the compression can be alternately performed.
Open the airway, prepare for the action: the patient lies on his back, the rescuer lifts the patient's neck with one hand, and the other hand presses down on the patient's forehead so that his head is tilted back and the airway is open. Precautions: There are foreign bodies, dentures, etc. in the mouth, which need to be removed in time.
Artificial respiration, first aid action: let the patient's head lean back, lift his jaw upwards with one hand, squeeze the patient's nostrils with the other hand, and press the patient's lips after routine inhalation (no deep inhalation), completely enveloping the patient's mouth, and blowing air mouth-to-mouth. Standard of movement: Each ventilation should be at least 1 second until the patient's thoracic cage is lifted upwards, then the patient's mouth is opened and the finger pinching the nose is released. It can also be used if an auxiliary artificial respiration device is available on site. Frequency: Compressions and artificial respiration are performed at a frequency of 30:2 in a compression-ventilation ratio, and the duo can be combined 15:2. Special population: If the patient is a baby under 1 year of age, the rescuer covers the baby's nose and mouth with his mouth, blows the air into the patient's mouth and nose, blows the air 2 times in a row, do not leak, observe that the baby's chest is undulating, and then loosen the nose and continue to press; if it is a larger infant or child, you can use conventional mouth-to-mouth blowing. Note: 30 chest compressions and 2 artificial respirations are a complete CPR cycle, which needs to be repeated on-site until a healthcare professional arrives.
Suddenly, severe cough, hoarseness, difficulty breathing, vomiting, cyanosis, suffocation, etc. occur during the diet. Patients often pinch their necks with one hand or both hands, have a painful expression, cannot speak, and nod their heads in confirmation when asked if they are choked by a foreign body.
Children and infants behave similarly to adults, but are often characterized by increased wheezing, coughing, and abnormal breathing due to inability to express themselves clearly.
In the above cases, the Heimlich First Aid Method should be immediately rescued. For the rescue of a patient who is conscious and able to stand or sit, the rescuer stands behind the patient, and the rescuer places one foot between the patient's legs and wraps his arms around the patient's waist. When assisting a child of short stature, the rescuer may kneel behind the child on one foot. Keep the patient's head and upper body slightly forward. With one hand in a fist, the fist clenches the thumb side of the patient's sword protrusion, the umbilicus is tilted to the position of two fingers, and the other hand clenches the fist. Both hands quickly inward and upward so that the fist repeatedly impacts the abdomen until the foreign body is discharged.
Rescue of patients who are unconscious or unable to stand or sit allows the patient to lie flat, with the index finger supporting the lower jaw and the thumb pressing the lower lip to help the patient open the mouth and keep the patient's airway open. The rescuer rides across the outer thigh, with the palms of the two hands overlapping, and is placed on the two fingers above the patient's umbilicus. Repeatedly use the palm root to press forward and downward until the foreign body is discharged.
Rescue of pregnant or excessively obese patients, for patients with late pregnancy or excessive obesity, the rescuer can not wrap his arms around the patient's waist, and can be replaced by chest impact. The rescuer stands behind the patient, places the upper limb under the patient's armpit, and wraps the chest around. The boxer's thumb is placed on the side of the midline of both nipples, avoiding the sword process and the lower edge of the ribs, and the other hand holds the fist and presses backwards until the foreign body is discharged.
For the rescue of the baby, the child is placed in the prone position of the rescuer's forearm, the rescuer's forearm is placed on the thigh, and the child's jaw is supported by the fingers open and the head is fixed, keeping the head low. Use the palm base of your other hand to vigorously tap 5 times in the shoulder blade area of the baby's back. Place your free hand on the baby's back, fingers on his head and neck, and carefully flip the baby over so that he lies on his back on the forearm of the other hand, with the forearm on the thigh, still in the lower position of the head. Use the two fingers of one hand to press the two nipples to the line 5 times quickly, using a sudden increase in pressure in the lungs to expel the foreign body. If a foreign body in the child's mouth or nose can be seen, it can be removed. If the foreign body is not visible, repeat the above actions until the foreign body is discharged.
Self-help, the airway obstruction person himself can hold a fist in one hand, use the fist thumb side to hold the abdomen, the part is the same, with the other hand to clench the fist, repeatedly, rhythmically inward, upward so that the fist impacts the abdomen. If unsuccessful, the patient should quickly press the epigastric abdomen against a hard object, such as the back of a chair, the edge of the table, the corridor guardrail, and vigorously impact the abdomen, the same as above, and repeat many times until the airway foreign body is discharged.
If airway obstruction is not relieved in time, patients may quickly experience loss of consciousness. In patients with loss of consciousness and cardiac arrest, CPR is required immediately.
We should popularize this knowledge from primary school. Publicity should be intensified, and everyone should learn CPR and Heimlich first aid to avoid the occurrence of tragedies around them.
All phases are illusory, and if they are seen in non-phases, they are seen as they are. Everything that has a way of doing things, such as dream bubbles, such as dew and electricity, should be viewed as such.