We had the BLS+AED training for 140 students at one grade of Tuma Saito-shi Miyazaki-ken high school for 2days on 24th and 26th July 2017.Staff are 15 firefighters from Sato fire department,a doctor from Independent administrative corporation Saitokoyu medical center (the owner of this site)、3 office worker,2 teacher and a school nurse from Tuma highschool.
In addition to the conventional techniques of artificial respiration and chest compression using a resuscitation doll, we also performed chest compression using Scoman 2.
Among the 90 minutes of practical skills, slides of "Important life that can only be saved by you" and "Self-examination example of being able to save life on May 25, 2008 using the AED at the tennis court" were also viewed.
I show this trainning below.
（The women is changing, can you tell what changes ?）
（A：the mouth and eyes change.）
１
The mechanism of the heart
First, let's look at the normal heart movement and electrocardiogram.
The heart moves regularly by the flow of weak electricity to send blood to the whole body.
Electricity from the right atrium travels through the wall of the heart, moving the four chambers in order and sending blood.
The electrocardiogram shows this flow of electricity in a graph, and we can check whether the heart is operating normally.
What does a bad heart look like? In the case of myocardial infarction, the blood vessels that is essential for the heart are clogged with blood, as shown in the video below.
If the blood vessels that flow to the right and left are blocked, the heart's movement becomes very poor.。
Blood flow is worse due to a blood clot.
The blood clot is gone and the blood flow is good
This heart got better by PCI (Percutaneous Coronary Angioplasty)。
When we have haert deseases or we have hard excersise without knowi心If we have a heart disease, or if we suddenly exercise hard without knowing that your heart is bad, we might have an “arrhythmia” that causes the heart rhythm to change.The ventricular fibrillation is hard to cure.
At this time, electricity does not flow well, and the heart is quivering. Do you see the heart moving like a caterpillar? As you can see, the heart is moving finely. In this case,blood does not come out well . The electrocardiogram will also be irregular and jagged.
AED is located where many people come such as schools, atations, and department stores。
Anyone an use AED.
The Ministry of Health, Labor and Welfare issued a notice to the prefectural governors saying "About the use of automatic external defibrillators (AED) by non-medical personnel"on July 1, 2004.
This clarified that there is no precondition, and even if the general public receives an electric shock using an AED, the illegality will not be questioned.
We, the general public, are now able to save lives using the AED.。
3)
How to use AED
。Let's learn how to use AED through the case that life was saved outside by AED
the interview video
（On September 9 , 2008 (Emergency Day),NHK miyazaki broadcast the event happened on May 25, 2008 ）
Please see the change of the electrocardiogram stored in real AED.
After cardiac arrest, it is an electrocardiogram when I put on an electrode of AED.
This is a wave pattern of the ventricular fibrillation.
Please see waveform at the age of 00:01:10.
This is the wave pattern which I defibrillated just after that in AED.
At 00:01:19 that is nine seconds later from a wave pattern of the ventricular fibrillation
It is changed to a wave pattern called the ventricular tachycardia.
The ventricular tachycardia is the state that left ventricle moves frequently.
It is different from the fibrillation and is the state that a pulse conflicts with subtly.
It is the evidence that recovered.
This wave pattern is the normalcy that an atrium and ventricle move.
In this, I woke up.
4)
The case ＡＥＤ cannot be used
The figure below shows the electrocardiogram, which is a single line. Medically, it is called asystole. There is no electricity from the heart.
Unfortunately, AED is not effective in this condition.。
（Normal electrocardiogram）
When the AED does not give defibrillation instructions but gives voice instructions to continue artificial respiration and chest compressions, What is the case?？
The case the electrocardiogram is almost normal as the asystole
（There is a case that an electrocardiogram is nomal but the patient does't have the blood pressure.）
Caution
When the AED does not direct defibrillation,
Continue mechanical ventilation and chest compressions
Until the emergency team arrives, or the patient comes to move by himself.
The place to press is the middle of the line connecting the left and right nipples (red dot in the left photo) Oppress.。
Place the base of the palm on the red dot. On top of that, put the other palm.。
At this time, the five fingers should be slightly bent. This will reduce the chance of breaking your ribs
As you can see in the animation below, straighten your arms and push the chest downwards with your waist as the fulcrum. Push down the chest 4-5 cm.
You better to push about 100〜120 times per minute.
The cardiopulmonary resuscitation is considered to be two times of artificial respiration about 30 times of chest compression, but the artificial respiration is strong in resistance, and it is recommended what only chest compression performs when there are not a motivation and knowledge.
※Some case that let you clog up is excluded in a drowned person, throat.
I should do what or tell that I report 119.
I can save you while receiving the instruction of the expert on the telephone.
I do it in a speaker mode without hanging up as I am apt to be confused in the case of emergency and will hear even anything!
The press is important, but after pressing, keep the palm on your chest until the next compression. Please see the movement of the heart in the animation below. Please play the animation slowly with the direction key on the right.。
By pressing on the sternum, blood in the heart is sent out to the whole body. Blood will return to the left and right ventricles when you stop pushing.
Blood flows from the right ventricle to the lungs and from the left ventricle to the body. Blood returns from the body to the right ventricle and from the lungs to the left ventricle.
Press the right arrow key and watch the movement slowly. You can see the chest compressions and the movement of blood in the heart.
If artificial respiration is possible, What are the advantages of it ?
Chest compression moves blood from the right ventricle to both lungs. When oxygen is sent to the blood in the lungs by artificial respiration, the blood is rich in oxygen. When chest compressions are stopped, oxygenated blood travels from the lungs to the left ventricle. Next, when chest compressions are performed, blood is carried from the left ventricle into the body and brain. This prevents the brain from lack of oxygen.
When there is no breathing, first give artificial respiration twice, with or without body movement. After that, when there is physical activity and there is no breathing, the breathing and exhalation confirmation are repeated once every 5 seconds.
When there is no movement, 30 sets of chest compressions and 2 sets of artificial respiration are repeated.
It is difficult to tell if there is physical activity. If you cannnot see,start chest compressions immediately.
When artificial respiration is not possible, continue chest compressions at a rate of 100 times per minute. When you are tired, immediately replace it with another person.
Where should the blood from the heart go? Where is the most important place?
The answer is the Brain
It's a shame if you're resuscitated and your breathing and circulation return, but you're unconscious. The chest is compressed to ensure sufficient blood flow to the brain so that the brain remains intact.。
This wave pattern is the normalcy that an atrium and ventricle move.
