Call 15, massage, defibrillate:These are the three actions to be taken in the event of a cardiac arrest, that is to say a sudden death, which can occur anywhere and which is not uncommon:we speaks of 40 to 50,000 cases per year in France, or nearly 130 per day!
In the vast majority of cases, cardiac arrest is linked to a rhythm disorder, we speak of ventricular fibrillation, which corresponds to anarchic electrical activity of the heart. This arrhythmia very often occurs during a coronary occlusion:we speak of acute coronary syndrome (or myocardial infarction). The heart starts pounding, it is no longer effective in circulating blood in the organs and in particular in the brain. The sudden lack of blood circulation in the brain leads to loss of consciousness, then very quickly respiratory arrest, and death inevitably occurs if nothing is done in the minutes following the discomfort.
You walk quietly in the street, and in front of you you see a person who collapses on the ground. You rush in, you realize she's unconscious , that she doesn't answer simple questions - "Can you hear me?" ", "Shake my hand" -, she does not react , and she is not breathing or she is breathing completely abnormally (we speak of "gasp", respiratory reflex preceding an imminent death). There is no doubt, it's cardiac arrest, and you have to keep in mind three simple actions, three "citizen" gestures, three reflexes!
When an event of this type occurs, you have to keep calm, not be alone, so call for help from other witnesses to the tragedy. We all have a mobile phone . It is then very simple to dial 15 and contact the SAMU. You will be asked four very specific questions:
1) What happened?
2) Where are you, where is the victim located? (do not hesitate to repeat several times where the exact place of the event is located)
3) What have you already done?
4) Do you know how to do CPR?
It is very important not to hang up; Indeed, the medical regulator of the SAMU can help you by explaining to you over the phone how to do cardiac massage if you do not know how to do it. The SAMU regulating doctor triggers the immediate departure of the resuscitation team (SMUR). He will ask you to hang up your cell phone.
You should know that in the case of sudden death, the arterial blood is still well oxygenated and the immediate problem is not to provide oxygen. The heart, the pump, has stopped, the blood circulation is no longer happening. This pump must be replaced to circulate blood, particularly to the brain. You should know that beyond 6 minutes without cerebral blood flow, brain damage will quickly become irreversible. So the immediate urgency is to get the blood flowing.
To do this, it is necessary to perform external cardiac massage:you must position the victim on his back and bare the chest , then kneel on your side, put your hands on top of each other with your arms straight in the center of your chest (between the two nipples), and do at least 100 compressions per minute (ideally 2 per second !) in sets of 30 (counting) and pushing your hands down at least 5 cm (not to exceed 6 cm) in the chest and rising well between each compression.
This massage must be carried out continuously until the arrival of the SAMU. Even a great sportsman can't last more than two minutes! It is therefore necessary to take turns every two minutes with other witnesses to the tragedy. Cardiac massage should never be stopped, except of course if the victim regains consciousness. The SAMU resuscitation team will take over when they arrive on the scene.
After five to six minutes of heart massage, oxygen will start to run out in the arterial blood, that's the whole point of performing mouth-to-mouth resuscitation at the same time. This gesture is technical and must be carried out by trained first aiders. In a cardiopulmonary resuscitation manoeuvre, the 30/2 is applied, i.e. 30 massages followed by two mouth-to-mouth breaths. You should know that cardiac massage circulates the blood, but that it also has, by itself, a pulmonary ventilation action. So if you're not by first aider, no mouth-to-mouth! The gesture to be made is the continuous cardiac massage to be done until the arrival of the SAMU.
Since May 2007, a decree (decree DEA 2007 attached) allows the use by all of the automatic external defibrillator (AED).
Since cardiac arrest is due to anarchic electrical activity of the heart, the treatment is to "set the record straight", i.e. to induce an electric shock> which will restore normal electrical activity as seen in this short film.
Since this decree, many institutions have equipped themselves with AEDs. They are positioned in high-risk places:either places where more than 250 adults circulate per day (such as stations, shopping centers, stadiums or sports venues – 500 athletes die a year during physical exertion! – , etc.), or very isolated places with long response times for the SAMU (in the mountains, in isolated villages). This is how many cities have equipped themselves with AEDs positioned in public places available to everyone. There's even a cell phone app to obtain the places where public AEDs are located in France.
In our particular case, you have to ask a witness if he knows of an AED available nearby and go get it. On the phone, the SAMU regulator can also tell you the nearest AED if he has a map of the defibrillators installed.
AEDs are very simple devices. to use:you have to open the device, press a button, position the electrodes as shown in this diagram produced by the French Federation of Cardiology and listen to it, because the device gives you the instructions to follow. There are two types of AEDs available. Some are automatic, that is, they will analyze the electrical activity of the heart, make a diagnosis and perform the electric shock automatically; others are semi-automatic, that is to say that when the device considers that it is necessary to perform an electric shock, it will express it by asking that a specific button be pressed which will deliver the shock. What you need to know is that there is no risk for the one who sets up the DEA, all you have to do is listen to the instructions carefully, and before the shock, the DEA invites the people present to move away and not to touch the victim again.
Faced with a sudden death, the crucial problem is the emergency response time. In France, we were late compared to our neighboring countries because before May 2007, any non-rescue citizen had only one reflex:to call the SAMU and above all to do nothing for fear of doing "worse". . However, in the face of this type of discomfort, if we do nothing and wait for the SAMU, which will take between 10 and 30 minutes to intervene, only 2 to 3% of these people who are victims of cardiac arrest will survive. So the worst thing is to do nothing about it while waiting for the SAMU ! So, don't forget the three steps to save a life:roll 15, massage, defibrillate! And do not hesitate to get trained, it only takes a few hours, the Initiation to First Aid (IPS) is free, find out more from the institutions listed below.
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