الإنعاش القلبي أو تدليك القلب

[align=center]الإنعاش القلبي أو تدليك القلب

اثناء القيام بعملية التنفس الصناعي أو الإنعاش الرئوي فإن المسعف يقوم بتفقد النبض هل هو يعمل أم لا, فإذا لم يحس المسعف بنبض القلب فهذا يعني توقفه وبالتالي الحاجة لعمل تدليك أو إنعاش قلبي حيث أن عمل التنفس الصناعي أثناء توقف القلب يعتبر بلا معنى لأن الهواء الذي يصل للرئتين مع النفخ لابد من وصوله للمخ خلال حركة الدم لذا فلابد بالإضافة للتنفس الصناعي من عمل تدليك للقلب

طريقة القيام بعمل الإنعاش القلبي


أولا عند وجود اي حالة أو إصابه وتكون تلك الحالة في وضع الإغماء فإنك تقوم بفتح مجرى الهواء وعمل كل خطوات الأنعاش الرئوي للتأكد من التنفس فإذا كان التنفس واقف فإنك تقوم بإعطائه نفسين عميقين وبعد ذلك نفس كل خمس ثواني تقريباً , اثناء هذا العمل تقوم بتحسس النبض هل هو موجود أم غائب فإذا كان النبض موجود هذا يعني لا داعي لعمل الأنعاش القلبي إما اذا كان النبض غير موجود فيجب علينا القيام بلإنعاش القلبي كالتالي



ثانياً:افتح مجرى الهواء برفع الذقن ودفع الرأس للخلف




ثالثاً :أنضر اسمع استشعر ......لا يوجد تنفس



رابعاً : اعطه نفسين عميقين ثم نفس كل 5 ثواني



خامساً: تأكد من النبض ....... النبض غير موجود



سادساً: حدد الجزء الأسفل من عظمة القص بوضع السبابة عليها اترك مسافة عرض إصبعين من هذه النقطة ضع راحة إحدى يديك على عظمة القص بعد هذه المسافة,ضع راحة اليد الأخرى فوق الأولى بحيث تكونا متوازيتين وغير متعادمدتين وتكون تلك النقطة في الجزء الذي بين المربعات 4 , 3 , 1 كما في الصورة



سابعا: اجعل ذراعيك مستقيمتين عند الكوع اضغط عظمة القص بوزن جسمك دافاعاً إياها مسافة 3 - 5 سنتيمترات , خفف ضغط يديك لترتفع عظمة القص لأعلى مع الإستمرار في ملامسة الصدر وعدم رفع اليدين وتركر تلك الضغطاط المتتالية 15 مرة


ثامنأُ: اعطه نفسين عميقين ثم 15 ضغطة لتدليك القلب ثم نفسين



تاسعاُ:وكرر العملية اربع مرات ثم تحسس النبض فإذا مازال واقف كرر تلك الدائرة حتى يعود النبض أو تأتي وحدة الطوارئ لإكمال ما قمت به


ملاحظات
1 - يجب وضع المصاب مستلقياً على ظهره وعلى سطح مستوي وصلب أو على الأرض , إذا كان المصاب على سرير ذو مرتبة يصبح الإنعاش القلبي أو التدليك غير مجدي وبدون فائدة

2 - لا يكون الضغط عنيفاً لكي لا يحدث مضاعافات مثل كسر عظمة القص والضلوع أو نزيف ودخول هواء للتجويف الصدري , أ, تمزق أو تهتك القلب أو الرئتين أو الكبد أو الطحال

3 - يكون الضغط بمعدل منتضم ضغطة في الثانية تقريباً ويكون التوقف فقط لحظة إعطاء الهواء أي تكرر العملية بمعدل حوالي 60 مرة في الدقيقة أو 15 مرة في ربع دقيقة لمواصلة عملية التنفس وإذا كان هناك شخص آخر يقوم بعملية التنفس يكون تنفس مرة وتدليك خمس مرات ,أما إذا كان المسعف وحده فيقوم بعمل تنفس صناعي مرتين وتدليك القلب 15 مرة مثل ما اسلفنا سابقاً

4 - إذا كان المصاب طفلاً من 1 - 8 سنوات تستخدم يد واحدة لعمل تدليك القلب بمعدل حوالى 80 مرة في الدقيقة مع عمل تنفس صناعي بعد كل أرع ضغطات ويكون الضغط على عظمة القص لأسفل مسافة 2،5 - 4سم

5 - إذا كان المصاب رضيعاً أقل من سنة يتم عمل تدليك القلب بإصبعين فقط الوسطى والسبابة ويكون معدل التدليك 100 - 150 مرة في الدقيقة ويتم عمل تنفس صناعي مرة كل 3 ضغطات وتضغط عظمة القص لأسفل مسافة 1،5-2،5 سم

6 - عند وجود نبض ضعيف لا يدلك القلب

7 - ليس من اللازم تعرية الصدر تماماً عند تدليك القلب إلا لو كانت الملابس تعوق ذلك فيمكن رفعها , المهم ألا تضيع الوقت
الأخطاء الواجب مراعاتها عند عمل تدليك القلب أو الإنعاش القلبي
1 - الوضع غير الصحيح للمصاب : غير مستلقي على ظهره - السطح تحت جسمة ليس صلباً

2 - الوضع غير الصحيح ليدي المسعف

3 - الأسلوب غير الصحيح
ضغطات سريعة أو بطيئة عن المعدل
قوة الضغط غير مناسبة
التوقف عن التدليك لفترات طويلة

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