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Orthopedics => Poliomyelitis => Artificial Respiration
Artificial Respiration
INTRODUCTION
Artificial Respiration, forcing of air into and out of the lungs of one person by another person or by mechanical means. It is usually employed during suspension of natural respiration caused by disease, such as poliomyelitis or cardiac arrest; electric shock; an overdose of depressive drugs such as barbiturates or alcohol; or suffocation resulting from drowning, breathing noxious gases, or blockage of the respiratory tract. If the brain is deprived of oxygen for five minutes, it may be permanently damaged; slightly longer periods without oxygen usually result in death. The exception is near-drowning in very cold water, in which the body's oxygen demand is greatly reduced; people have been revived after being submerged for half an hour in cold water.
HUMAN INTERVENTION
Because of the danger of even short periods without oxygen, artificial respiration should always be started immediately. The mouth-to-mouth method, shown to be superior to the back-pressure and arm-lift procedure, is now recommended by the Red Cross and other first-aid organizations. In the mouth-to-mouth method the unconscious person is placed on his or her back with the head tilted as far back as possible to prevent the tongue from blocking the air passages. The victim's nose is then pinched shut, the reviver's mouth is placed tightly over the victim's, and the reviver gives four quick, deep breaths. It is essential to check that the chest rises with each inflation. If breathing does not resume, the reviver proceeds to give one breath every four to five seconds, allowing the air to come out of the victim's lungs between breaths. This is continued until the victim resumes breathing or until trained help arrives. If the unconscious person is a baby or small child, both the mouth and nose are covered with the reviver's mouth, and air is blown into the victim's lungs at the rate of one puff every three seconds.
To restore breathing to a person who is choking, a rescuer gives five quick blows between the shoulder blades with the heel of the hand. If this does not dislodge the obstruction, the rescuer may use the stomach thrust, known as the Heimlich manoeuvre. This should be applied as a last resort only, and in the case of children, with far less force, as this manoeuvre can be damaging. The rescuer places the side of the fist against the victim's stomach, below the ribs and above the navel. Then, using the other hand, the rescuer thrusts the fist up into the upper abdomen once, followed by backslaps. With children, a rescuer first turns the child upside down and slaps the back.
RESPIRATORS
A machine for the administration of artificial respiration consists of a mechanical air pump connected by a flexible pipe to a tube passed into the patient's windpipe via the mouth, or through an artificial opening in the neck (tracheotomy). The pump rhythmically inflates, and allows passive deflation of, the lungs. The rate can be adjusted. If the patient tries to breathe spontaneously, the machine will react so as to allow this. Severe breathing difficulties may require help from such a mechanical ventilator. An external respirator called a heart-lung machine is used to maintain oxygen saturation in the blood during open-heart surgery. In this, a pump maintains the blood circulation and part of the machine oxygenates the blood, which flows out of the body via tubes inserted in the superior and inferior venae cavae of the heart. The oxygenated blood is pumped back into a major artery, such as the femoral artery.
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