10.1. Fundamentals of the intensive cure
Cardiopulmonary resuscitation (CPR) is a complex of therapeutic measures directed to restoring adequate circulation and ventilation. CPR is divided into basic and advanced. Basic cardiopulmonary resuscitation is a complex of therapeutic measures aimed at restoring effective ventilation and adequate circulation which include only non-invasive mechanical ventilation (mouth-to-mouth, mouth-to-nose techniques) chest compression. Basic resuscitation methods do not require any special equipment and medications and can be used in any conditions. Basic CPR methods used to maintain airway and ventilation are non-invasive. Rescuers can use a face mask during ventilation from the mouth to the mask during basic CPR.
The modern CPR complex (A - airway, B - breathing, C - circulation) starting with the recommendations of ERC-2010 is modified into the C-A-B algorithm in connection with which the first stage after the diagnosis of circulatory arrest is the immediate start of chest compressions and only then the restoration of the airway and artificial respiration.
10.1.1. Heart massage
Indirect heart massage, which is a rhythmic compression of the heart carried out to restore its activity and maintain blood circulation in the body. Currently, indirect (closed) heart massage is mainly used; direct (open) heart massage performed using direct compression of the heart is usually used in cases where the need for it occurs during surgery on thoracic organs with the opening of its cavity (thoracotomy).
During indirect massage of the heart, it is compressed between the sternum and the spine due to which blood flows from the right ventricle to the pulmonary
artery, and from the left ventricle to the systemic circulation that leads to restoration of blood flow in the brain and coronary arteries and can contribute the resumption of spontaneous heart contractions.