OCR Text |
Show scene of the accident or in the transportation vehicle. This, as well as the suitable positioning of the unconscious person ( lateral position and as much as possible simultaneous low positioning of the upper part of the body and head with fixation through straps over the hip to the stretcher and the sled) should avoid renewed blocking of access to the larynx ( keeping open the breathing passages). This practically eliminates the penetration of water, blood, vomit, or foreign bodies into the deeper breathing passages ( so- called aspiration) with the danger of suffocation or subsequent pneumonia. Often it is not possible permanently to keep the air passages clear in this manner ( transportation, restless patient). In this case, the auxiliary aid of an oropharyngeal tube ( airway - resusitube) introduced into the throat will help to keep the air passage clear, both during resuscitation and after normal breathing has been restored. Time must not be lost unnecessarily with suction attempts, which in any event are indicated only in certain cases with obvious obstruction of the respiratory passages. Much more important is the immediate starting of respiration if the spontaneous respiration of the patient has become superficial or has ceased altogether. While awaiting the arrival of the respiration equipment, which should permit one helper to administer adequate and effortless breathing for hours, an attempt should be made to ventilate the lungs without the use of auxiliary equipment. For this, mouth- to- mouth resuscitation is best. This is started immediately as soon as the rescuer has access to the head of the patient, while the other members of the rescue team dig out the buried body. Breathing into the mouth is also possible if the victim lies in a lateral or abdominal position. If the insufflation meets resistance, the head- jaw position must be improved by overextending; it is also possible that the air passages are blocked by snow or other foreign bodies. This necessitates an inspection and cleaning out of the pharyngo- oral space. Artificial respirtation without open air passages is pointless. The first puffs of breath are often decisive. Therefore, the victim is respirated; immediately at least 10 times in quick succession with the mouth before a more normal and slower rhythm of about 10 to 12 breaths per minute is started. In order to avoid direct contact with the victim, a handkerchief, a few layers of surfical gauze, or any other piece of textile which is permeable to air may be placed over the nose and mouth of the victim. The possibility of mechanical injury is always present in an avalanche victim. The rescue team should exercise special care to check for the possibility of neck fracture before manipulating the patient to clear the air passages and begin resuscitation. If a neck fracture appears possible, traction is permissible, but flexing of the neck should be minimized. If breathing has stopped, resuscitation must begin in any case, but with great care if neck injuries are suspected. Resuscitation already started without the aid of auxiliary equipment can become more effective and less troublesome for the attendant by the use of respiration equipment. In the case of simple bag or sac equipment, breathing takes place by insufflation of air into the lungs. The important advantage 58 |