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Sudden death comes, six steps can save lives

  The journey of human life is like a one-way line, and everyone lurches toward the given end point. However, there will always be some unexpected intrusions that force us to accelerate our pace, or even bring the road to an abrupt halt. Sudden death is the most terrifying accident.
  According to the World Health Organization, sudden death refers to the sudden and unexpected non-violent death of a person who appears healthy or unexpectedly died under the action of internal or no external causes. In view of this, let me talk about how to effectively prevent sudden death and how to effectively resuscitate respiratory and cardiac arrest.
who may die suddenly

  From the existing data, sudden death can occur at any age, including infants, children, adolescents, young adults, and the elderly, especially in people who are usually healthy or basically healthy, such as athletes.
  From the perspective of disease incentives, sudden death can be divided into two categories: sudden cardiac death and non-cardiac sudden death, and sudden cardiac death can be further subdivided into arrhythmic sudden death and circulatory failure sudden death. Studies have shown that in the young and middle-aged population, the incidence of sudden cardiac death in men is higher than that in women, but in the elderly population, there is no significant difference between men and women.

  Sudden cardiac death refers to unforeseen natural death due to cardiac causes. The patient may have suffered from heart disease or no history of heart disease in the past. The time from onset to death is generally within an instant to 1 hour. Sudden cardiac death is the main cause of sudden death, accounting for the vast majority.
  Typically, acute myocardial ischemia is most dangerous immediately after onset. Studies have confirmed that the probability of ventricular fibrillation (ventricular fibrillation) within the first hour of acute myocardial infarction is 25 times higher than that after 24 hours. Inside.
  In addition to coronary heart disease, there are two types of heart diseases that can lead to sudden cardiac death: one is structural heart disease, including myocarditis, pulmonary heart disease, rheumatic heart disease, and hypertensive heart disease. Patients may not usually show significant clinical symptoms or complaints of discomfort, but they will be found through physical examination and laboratory auxiliary examinations. The other category is non-organic heart disease, which is characterized by defects in cardiac ion channels, including arrhythmogenic right ventricular dysplasia syndrome, Marfan syndrome, catecholamine-sensitive polymorphic ventricular tachycardia (CPVT), and Certain cardiomyopathy, etc. Most of these diseases are caused by abnormal ion channel function due to genetic defects, and most of them have a family history of disease. Patients often have no intuitive morphological and structural abnormalities of the heart, and it is difficult to find them in general physical examinations. where the problem is. It is regrettable that many patients suffering from this disease die suddenly at a young age.
  Corresponding to sudden cardiac death, it is non-sudden cardiac death. Non-cardiac sudden death refers to sudden death caused by diseases other than the heart, accounting for about 1/4 of all sudden death cases. Common clinical causes include acute pulmonary embolism, severe asthma, acute stroke, subarachnoid hemorrhage, acute hemorrhagic necrotizing pancreatitis, aortic dissection, severe electrolyte imbalance, and drug/drug overdose. There are also some sudden deaths of unknown etiology, such as sudden infant death.
How to save yourself and first aid

  Respiratory and cardiac arrest is the most direct clinical manifestation of sudden death. 10 seconds after respiratory and cardiac arrest, the patient can lose consciousness and suddenly fall to the ground; 30 seconds can appear generalized convulsions; 60 seconds, spontaneous breathing gradually stops; 3 minutes begin to appear cerebral edema; 6 minutes begin to appear brain cell death; 8 Minutes later, even if the heartbeat is restored, it is still “brain dead” or “vegetative state”. Therefore, the only effective treatment for patients with respiratory and cardiac arrest is immediate cardiopulmonary resuscitation (CPR). Although the blood flow that can be affected by chest compressions is only a small part of the blood flow in our normal state, it is this blood flow that may win a lifeline for the patient.
  When seeing or discovering that someone suddenly fell to the ground, as witnesses, we should not panic. We can follow the following steps:
  First, while quickly approaching the patient, pay attention to observe whether the surrounding environment is safe and whether follow-up rescue can be carried out. To ensure the safety of the rescuer, for example, someone suddenly falls to the ground in the middle of the road passing through the traffic, and the rescuer should move him to a relatively safe place on the side of the road to start rescue.
  Second, when you reach the patient, immediately confirm whether the patient has lost consciousness. For example, pat the patient on both shoulders while shouting “Hello, sir, what’s the matter with you?” If there is no response after repeating twice, it can be determined that the patient has lost consciousness. call for help immediately. If there is someone beside you, ask him to immediately call the “120” emergency number, or ask others to get an AED (Automated External Defibrillator) if possible; if you are the only one, call “120” immediately, and make it clear during the call 5 things: who you are, where you are (if it is clearly marked), you suspect cardiac arrest, what is your contact number, and emergency personnel need to carry a defibrillator. After confirming that the “120” dispatcher has received the information, do not hang up the phone, turn on the hands-free and place it on the patient’s side, so that rescue can be carried out under the “120” dispatcher’s command.
  Do remember: you are not alone in the face of a person with respiratory and cardiac arrest!

  Third, we can place the index and middle fingers of one hand two fingers below the patient’s Adam’s apple, where the carotid artery passes. At the same time, silently count “1001” “1002” until “1007”. If the carotid pulse is not palpable, the patient must be in respiratory and cardiac arrest, and chest compressions should be started without hesitation. For non-specialists, as long as a patient with loss of consciousness is observed to have stopped breathing or is only wheezing, it can be considered a cardiac arrest and CPR should be started immediately.
  The findings showed that patients receiving chest compressions had a lower risk of injury when not in cardiac arrest; the risk of not performing CPR in a pulseless patient outweighed the risk of injury from unnecessary chest compressions. Therefore, everyone should not waste time on determining whether the patient is in cardiac arrest or not. As soon as you suspect respiratory and cardiac arrest, start CPR immediately.
  Fourth, select the middle and lower part of the patient’s sternum, place the palm of one hand on it, and press the other hand on top of this hand, keeping the wrist, elbow, and shoulder in a straight line and perpendicular to the ground, using our upper body Force Press firmly and quickly. The current guidelines recommend that the compression frequency is 100 to 120 times per minute, and we can do it by two-syllable counting, 01, 02, 03… The depth of compression should be at least 5 cm, not more than 6 cm; for children and adolescents, it is 1/3 of the anteroposterior diameter of the thorax. Don’t worry about meeting the above criteria, always remember that “press hard and fast”. It is not recommended to open the patient’s clothing to expose the chest for compressions, unless the clothing is too thick to affect the resuscitation effect.
  Fifth, give 2 mouth-to-mouth breaths for every 30 compressions given. Before giving artificial respiration, check whether there is obvious obstruction in the patient’s airway. If there is, try to remove it. Do not use your fingers to probe into the patient’s mouth to prevent foreign objects from falling into the airway. The patient’s airway can be opened by pressing the forehead and the chin, then open the mouth, take a deep breath and cover the patient’s mouth with the mouth, pinch the patient’s nose with the thumb and index finger of the forehead-pressing hand, and then blow at a constant speed. 1 time, let the patient exhale with the mouth out of the way, and repeat this action to blow 1 time. The time of each blow is about 1 second. If you see the patient’s chest rise and fall with the blow, it proves that the ventilation is effective.
  It is recommended to take necessary protection when performing mouth-to-mouth artificial respiration, such as using a special breathing film or mask, etc. If there is no protection, artificial respiration is not necessary. Because for adults, nearly 80% of the cause of respiratory and cardiac arrest is heart disease, continuous and uninterrupted compression is particularly important, especially the deformation of the chest during compression can also produce a certain amount of ventilation. If you have to interrupt compressions, do not interrupt for more than 10 seconds.
  Sixth, acute coronary syndrome leading to malignant arrhythmia is the most common cause of sudden death in adults, and ventricular fibrillation and pulseless ventricular tachycardia are the most common malignant arrhythmias. At this time, while giving chest compressions, electrical defibrillation is required to terminate the malignant arrhythmia and make resuscitation successful. So actively seek out or acquire an AED. 4 steps to use the AED: turn on the power, apply the pads to the patient’s chest as shown in the diagram, connect the pad leads, and follow the prompts to defibrillate or continue compressions.
  Regardless of whether they have received relevant training or not, rescuers should keep the following points in mind: they must rescue themselves under their own safety; they must call for help, especially to obtain an AED as soon as possible; Do chest compressions without hesitation; try to keep the compressions continuous and uninterrupted; use the AED immediately after obtaining the AED, and perform defibrillation immediately if the rhythm is judged to be defibrillable.
  Cardiopulmonary resuscitation may cause physical damage to the patient, such as rib fractures, so rescuers can seek help from onlookers, such as keeping each other’s contact information or pictures for possible follow-up self-evidence.
  In short, there is still the possibility of survival for those who suffer from respiratory and cardiac arrest. Even if we are not professionals, in the face of such a patient, as long as we act decisively and rescue him correctly, there is still a chance to reverse his sudden death.