Medical intervention can save a person who has fallen into a state of clinical (reversible) death. The patient will have only a few minutes before death, so those nearby are obliged to provide him with emergency first aid. Cardiopulmonary resuscitation(CPR) is ideal in this situation. It is a set of measures to restore respiratory function and circulatory systems. Not only rescuers, but also ordinary people nearby can provide assistance. The reason for holding resuscitation measures become characteristic clinical death manifestations.
Cardiopulmonary resuscitation is a set of primary methods of saving a patient. Its founder is famous doctor Peter Safar. He was the first to create correct algorithm actions emergency care to the victim, which is used by most modern resuscitators.
Execution base complex to save a person is necessary when identifying clinical picture characteristic of reversible death. Its symptoms are primary and secondary. The first group refers to the main criteria. This:
The voiced indicators can be identified by examining the patient:
Secondary symptoms vary in severity. They help ensure the need for pulmonary-cardiac resuscitation. Get acquainted with additional symptoms clinical death can be found below:
Basic form of cardiopulmonary resuscitation is performed by nearby people in order to save the patient’s life. An extended version of assistance is provided by resuscitators. If the victim has fallen into a state of reversible death due to a long course of pathologies that have depleted the body and cannot be treated, then the effectiveness and expediency of rescue methods will be in question. Usually leads to this terminal stage development oncological diseases, severe deficiency internal organs and other ailments.
There is no point in resuscitating a person if there are visible injuries that are incomparable to life against the background of a clinical picture of characteristic biological death. You can see its symptoms below:
Drying and noticeable clouding of the cornea after death is called the "floating ice" symptom due to its appearance. This sign is clearly visible. The "cat's eye" phenomenon is determined by light pressure on the sides eyeball. The pupil contracts sharply and takes the shape of a slit.
The rate at which the body cools depends on the ambient temperature. Indoors, the decrease occurs slowly (no more than 1° per hour), but in a cool environment everything happens much faster.
Cadaveric spots are a consequence of the redistribution of blood after biological death. Initially, they appear on the neck from the side on which the deceased was lying (front on the stomach, back on the back).
Rigor mortis is the hardening of muscles after death. The process begins with the jaw and gradually covers the entire body.
Thus, it makes sense to perform cardiopulmonary resuscitation only in the case of clinical death, which was not provoked by serious degenerative changes. Its biological form is irreversible and has characteristic symptoms, so people nearby will only need to call an ambulance for a team to pick up the body.
The American Heart Association regularly provides advice on how to help better effective assistance sick people. Cardiopulmonary resuscitation according to new standards consists of the following stages:
The procedure for performing cardiopulmonary resuscitation is compiled according to the recommendations of the American Heart Association. For convenience, it has been divided into specific phases entitled in English letters"ABCDE". You can see them in the table below:
| Name | Decoding | Meaning | Goals |
|---|---|---|---|
| A | Airway | Restore | Use the Safar method. Try to eliminate life threatening violations. |
| B | Breathing | Carry out artificial ventilation lungs | Perform artificial respiration. Preferably using an Ambu bag to prevent infection. |
| C | Circulation | Ensuring blood circulation | Perform an indirect massage of the heart muscle. |
| D | Disability | Neurological status | Assess vegetative-trophic, motor and brain functions, as well as sensitivity and meningeal syndrome. Eliminate life-threatening failures. |
| E | Exposure | Appearance | Assess the condition of the skin and mucous membranes. Stop life-threatening disorders. |
The voiced stages of cardiopulmonary resuscitation are compiled for doctors. To ordinary people If you are near the patient, it is enough to carry out the first three procedures while waiting for an ambulance. WITH correct technique implementation can be found in this article. Additionally, pictures and videos found on the Internet or consultations with doctors will help.
For the safety of the victim and the resuscitator, experts have compiled a list of rules and advice regarding the duration of resuscitation measures, their location and other nuances. You can find them below:
Time to make a decision is limited. Brain cells are rapidly dying, so pulmonary-cardiac resuscitation must be carried out immediately. There is only no more than 1 minute to make a diagnosis of “clinical death”. Next, you need to use the standard sequence of actions.
An ordinary person without medical education has only 3 techniques available to save the life of a patient. This:
Specialists will have access to defibrillation and direct cardiac massage. The first remedy can be used by a visiting team of doctors if they have the appropriate equipment, and the second only by doctors in the intensive care unit. The sound methods are combined with the administration of medications.
Precordial shock is used as a replacement for a defibrillator. It is usually used if the incident happened literally before our eyes and did not take more than 20-30 seconds. Algorithm of actions this method next:
If the pulse cannot be felt, then it is necessary to move on to massage the heart muscle. The method is contraindicated for children whose age does not exceed 8 years, since the child may suffer even more from such a radical method.
Indirect form of cardiac muscle massage is compression (squeezing) chest. This can be done using the following algorithm:
When performing cardiac massage in children, it is necessary to take into account the following nuances:
If the procedure turns out to be effective, the patient will develop a pulse, the skin will turn pink and the pupillary effect will return. It must be turned on its side to avoid tongue sticking or suffocation by vomit.
Before carrying out the main part of the procedure, you must try the Safar method. It is performed as follows:
If there is no result, you must immediately proceed to artificial ventilation. Without the use of special devices, it is performed according to the instructions below:
To avoid infection of the rescuer or patient, it is advisable to carry out the procedure through a mask or using special devices. Its effectiveness can be increased by combining it with indirect cardiac massage:
The heart muscle is massaged directly only in a hospital setting. Often resort to this method in case of sudden cardiac arrest during surgical intervention. The technique for performing the procedure is given below:
The essence of defibrillation is the use of a special device (defibrillator), with which doctors apply current to the heart muscle. This radical method is indicated for severe forms of arrhythmia (supreventricular and ventricular tachycardia, ventricular fibrillation). They provoke life-threatening disruptions in hemodynamics, which often lead to fatal outcome. If the heart stops, using a defibrillator will not bring any benefit. In this case, other resuscitation methods are used.
Enter special drugs performed by doctors intravenously or directly into the trachea. Intramuscular injections are ineffective, so they are not carried out. The following medications are most commonly used:
Other medications, including antiarrhythmic drugs, are used as appropriate. After the patient’s condition improves, they will be kept under observation in the intensive care unit for a certain period of time.
Consequently, cardiopulmonary resuscitation is a set of measures to recover from the state of clinical death. Among the main methods of providing assistance are artificial respiration and indirect cardiac massage. They can be performed by anyone with minimal training.
In newborns, massage is performed in the lower third of the sternum, with one index finger at the level of the nipples. Frequency - 120 per minute. Inhalations are carried out according to general rules, but the volume of the cheek space (25-30 ml of air).
In children under 1 year of age, clasp the chest with both hands and press the front of the sternum with your thumbs, 1 cm below the nipples. The depth of compression should be equal to 1/3 of the height of the chest (1.5-2 cm). Frequency - 120 per minute. Inhalations are carried out according to general rules.
In children under 8 years of age, massage is performed on a hard surface with one hand in the lower half of the sternum to a depth of up to 1/3 of the height of the chest (2-3 cm) with a frequency of 120 per minute. Inhalations are carried out according to general rules.
The CPR cycle in all cases consists of alternating 30 compressions with 2 breaths.
Features of CPR for drowning.
Drowning is a type of mechanical asphyxia resulting from water entering the respiratory tract.
Necessary:
observing personal safety measures, remove the victim from under the water;
clear oral cavity from foreign bodies (algae, mucus, vomit);
during evacuation to the shore, holding the victim’s head above the water, perform artificial respiration according to the general rules of cardiopulmonary resuscitation using the “mouth to mouth” or “mouth to nose” method (depending on the experience of the rescuer);
on the shore, call an ambulance to prevent complications that arise after drowning as a result of water, sand, silt, vomit, etc. entering the lungs;
warm the victim and monitor him until the ambulance arrives;
in case of clinical death - cardiopulmonary resuscitation.
Features of CPR in case of electric shock.
If you suspect that a person has been exposed to electric current, be sure to:
compliance with personal safety measures;
stopping the impact of current on a person;
calling emergency services and monitoring the victim;
in the absence of consciousness, place in a stable lateral position;
in case of clinical death - perform cardiopulmonary resuscitation.
The entry of foreign bodies into the upper respiratory tract causes a violation of their patency for the supply of oxygen to the lungs - acute respiratory failure. Depending on the size of the foreign body, obstruction may be partial or complete.
Partial airway obstruction– the patient breathes with difficulty, his voice is hoarse, he coughs.
call emergency services;
execute first Heimlich maneuver(if coughing is ineffective): fold the palm of your right hand into a “boat” and apply several intense blows between the shoulder blades.
Complete obstruction of the airway– the victim cannot speak, breathe, cough, skin quickly acquire a bluish tint. Without assistance, he will lose consciousness and cardiac arrest will occur.
First aid:
if the victim is conscious, perform second Heimlich maneuver– standing from behind, grab the victim, clasp your hands in the epigastric region of the abdomen and perform 5 sharp compressions (pushes) with the ends of your fists from bottom to top and front to back under the diaphragm;
if the victim is unconscious or there is no effect from previous actions, perform third Heimlich maneuver - lay the victim on his back, apply 2-3 sharp pushes (not blows!) with the palmar surface of the hand in the epigastric region of the abdomen from bottom to top and from front to back under the diaphragm;
In pregnant and obese people, the second and third Heimlich maneuvers are performed in the area of the lower 1/3 of the sternum (in the same place where chest compressions are performed).
In children under 1 year of age, the heart is located relatively lower in the chest than in older children, so the correct position for indirect massage hearts - one finger width below the interpapillary line. The resuscitator should apply pressure with 2-3 fingers and shift the sternum to a depth of 1.25-2.5 cm at least 100 times/min. Ventilation is carried out at a frequency of 20 breaths/min. When performing cardiopulmonary resuscitation in children over 1 year of age, the base of the resuscitator’s palm is located on the sternum two fingers’ width above the sternal notch. The optimal compression depth is 2.5-3.75 cm and at least 80 times/min. Ventilation rate - 16 breaths/min.2. The cartilage of the trachea in a child under 1 year of age is soft, which makes it possible for the lumen to collapse due to overextension, especially if cardiopulmonary resuscitation is performed with excessive extension of the neck. In this case, the lumen of the trachea and bronchi may be blocked.
3. The lumen of the oropharynx in children under 1 year of age is relatively smaller due to large sizes tongue and small lower jaw.
4. The narrowest part of the airway in children is at the level of the cricoid cartilage, below the vocal cords.
5. Lower respiratory tract in children they are smaller in size and less developed. The diameter of the lumen of the main bronchus in children under 1 year of age is comparable to that of an average-sized groundnut.
1) oxygenation with 100% oxygen;
2) intensive observation, ECG monitoring;
3) identifying signs of arrhythmia, hypotension and cardiac arrest;
4) puncture of the right ventricle, if auscultation reveals
air;
5) standard cardiopulmonary resuscitation in case of cardiac arrest, since with the help of manual chest compression it is possible to expel the air embolus.
How is the defibrillation procedure different for children?
1. Lower dose: 2 J/kg and, if necessary, further doubling.
2. Smaller electrode area: standard pediatric electrodes have a diameter of 4.5 cm, while those for adults have a diameter of 8.0 cm.
3. Less common use: ventricular fibrillation occurs infrequently in children.
Rigor mortis(rigor mortis) is a thickening and contraction of muscles that occurs as a result of continued post-mortem cell activity with the consumption of ATP, the accumulation of lactic acid, phosphate and the crystallization of salts. On the neck and face, rigor begins after 6 hours, on the shoulders and upper limbs - after 9 hours, on the torso and legs - after 12 hours. Cadaveric spots and rigor - absolute readings to refuse resuscitation, therefore, during the initial examination it is necessary to carefully examine the patient for their detection.
2. The nasogastric tube is not installed.
3. Not assigned medicines necessary in this situation.
4. Periodic evaluation is not carried out breath sounds, pupil size, pulse.
5. Delay in installing an intraosseous or other infusion system.
6. The team leader is overly involved in the procedure he is conducting individually.
7. Roles in the team are distributed incorrectly.
8. Errors in initial assessment the patient's condition (incorrect diagnosis).
9. Lack of control over the correctness of cardiac massage.
10. Cardiopulmonary resuscitation carried out for too long in case of out-of-hospital cardiac arrest.
Not often, but there are such cases: a man was walking down the street, straightly, confidently, and suddenly he fell, stopped breathing, and turned blue. In such cases, people around you usually call an ambulance and wait a long time. Five minutes later, the arrival of specialists is no longer necessary - the person has died. And it is extremely rare that there is a person nearby who knows the algorithm for performing cardiopulmonary resuscitation and is able to apply his actions in practice.
In principle, any disease can cause cardiac arrest. Therefore, listing all those hundreds of diseases that are known to specialists is pointless and there is no need. However, the most common causes of cardiac arrest are:
However, regardless of the reason, the algorithm of actions during cardiopulmonary resuscitation always remains the same.
Movies often show heroes trying to resuscitate a dying person. Usually it looks like this - he runs up to the victim lying motionless positive character, falls to his knees next to him and begins to intensely press on his chest. With all his artistry, he shows the drama of the moment: he jumps over a person, trembles, cries or screams. If the case happens in the hospital, the doctors always say that “he is leaving, we are losing him.” If, according to the scriptwriter's plan, the victim must live, he will survive. However, the chances of salvation in real life such a person does not, since the “reanimator” did everything wrong.
In 1984, Austrian anesthesiologist Peter Safar proposed the ABC system. This complex formed the basis modern recommendations in cardiopulmonary resuscitation, and for more than 30 years this rule has been used by all doctors without exception. In 2015, the American Heart Association released updated guidance for practitioners, which covers all the nuances of the algorithm in detail.
ABC algorithm is a sequence of actions that gives the victim the maximum chance of survival. Its essence is contained in its very name:
Cardiopulmonary resuscitation using the ABC algorithm can be performed by any person, even those without medical education. This is the basic knowledge that everyone should have.
First of all, you should ensure the safety of the victim, without forgetting about yourself. If you remove a person from a car that has been involved in an accident, immediately move them away from it. If there is a fire nearby, do the same. Move the victim to any nearest safe place and proceed to the next step.
Now we need to make sure that the person really needs CPR. To do this, ask him “What is your name?” It is this question that will best attract the attention of the victim if he is conscious, even if clouded.
If he doesn’t answer, encourage him: lightly pinch his cheek, pat him on the shoulder. Do not move the victim unnecessarily, as you cannot be sure of the absence of injuries if you find him already unconscious.
If you are unconscious, check for the presence or absence of breathing. To do this, place your ear to the victim's mouth. The rule “See” applies here. Hear. Touch":
In the movies, they often put their ear to their chest for this. This method is relatively effective only if the patient's chest is completely exposed. Even one layer of clothing will distort the sound and you will not understand anything.
At the same time as checking your breathing, you can check for a pulse. Don't look for it on your wrist: best way pulse detection - palpation carotid artery. To do this, place your index finger and ring finger on the top of the Adam's apple and move them towards the back of the neck until the fingers rest against the muscle that runs from top to bottom. If there is no pulsation, then cardiac activity has stopped and it is necessary to begin saving life.
Attention! You have 10 seconds to check for a pulse and breathing!
The next step is to make sure that there are no foreign bodies in the victim’s mouth. Under no circumstances should you look for them by touch: a person may experience convulsions and your fingers may simply be bitten off, or you may accidentally tear them off. artificial crown tooth or bridge, which will enter the respiratory tract and cause asphyxia. Only those foreign bodies that are visible from the outside and located close to the lips can be removed.
Now attract the attention of others, ask them to call an ambulance, and if you are alone, do it yourself (calling the emergency services is free), and then begin performing cardiopulmonary resuscitation.
Place the person on his back on a hard surface - the ground, asphalt, table, floor. Throw back his head, push the lower jaw forward and open the victim’s mouth slightly - this will prevent the tongue from retracting and allow artificial respiration to be carried out effectively ( triple Safar maneuver).
If you suspect a neck injury or if the person is found already unconscious, limit yourself to only moving your lower jaw and opening your mouth slightly ( double Safar maneuver). Sometimes this is enough for a person to start breathing.
Attention! The presence of breathing is almost one hundred percent evidence that a person’s heart is working. If the victim is breathing, he should be turned on his side and left in this position until doctors arrive. Observe the victim, checking for pulse and breathing every minute.
If there is no pulse, begin external cardiac massage. To do this, if you are right-handed, then place the base of your right palm on the lower third of the sternum (2-3 cm below the conditional line passing through the nipples). Place the base of your left palm on it and interlace your fingers as shown in the figure.
Arms must be straight! Press the victim’s chest with your whole body at a frequency of 100-120 presses per minute. The depth of pressure is 5-6 cm. Do not take long breaks - you can rest for no more than 10 seconds. Allow the chest to fully expand after pressing, but do not take your hands off it.
Most effective method artificial respiration - “mouth to mouth”. To carry it out after a triple or double Safar maneuver, cover the victim’s mouth with your mouth, pinch his nose with the fingers of one hand and exhale forcefully for 1 second. Let the patient breathe out.
The effectiveness of artificial respiration is determined by the movements of the chest, which should rise and fall during inhalation and exhalation. If this is not the case, then the person’s airways are blocked. Check your mouth again - you may see foreign body, which can be extracted. In any case, do not interrupt CPR.
ATTENTION! According to the recommendations of the American Heart Association, you can refuse artificial respiration, since chest compressions provide the body with the minimum necessary air. However, artificial respiration increases the likelihood of positive effect from CPR. Therefore, if possible, it should still be carried out, remembering that the person may be sick infectious disease such as hepatitis or HIV infection.
One person is not able to simultaneously press on the chest and perform artificial respiration, so the actions should be alternated: after every 30 compressions, 2 breathing movements should be performed.
Every two minutes you should stop and check for a pulse. If it appears, pressing on the chest should be stopped.
A detailed algorithm for performing cardiopulmonary resuscitation for adults and adolescents is presented in the video review:
Cardiopulmonary resuscitation is stopped:
Numerous studies show that performing CPR for more than 30 minutes can lead to heart rate. However, during this time the cerebral cortex dies and the person is not able to come to his senses. That is why a half-hour interval has been established during which the victim has a chance of recovery.
IN childhood the more common cause of clinical death is asphyxia. Therefore, it is especially important for this category of patients to carry out the full range of resuscitation measures - both external cardiac massage and artificial respiration.
Please note: if an adult is allowed to be left for very short time In order to call for help, the child must first perform CPR for two minutes, and only then can he leave for a few seconds.
Chest compressions in a child should be performed with the same frequency and amplitude as in adults. Depending on his age, you can press with two or one hand. An effective method for infants is to clasp the baby's chest with both palms, placing the thumbs in the middle of the sternum, and the rest firmly pressed to the sides and back. Pressing is done with the thumbs.
The ratio of clicks and breathing movements for children it can be either 30:2, or if there are two resuscitators - 15:2. In newborns, the ratio is 3 clicks per breathing movement.
Bozbey Gennady Andreevich, emergency physician
Relevance of the topic. Cardiopulmonary syncope (CPS) is a sudden and unexpected cessation of effective breathing or circulation, or both.
Respiratory and circulatory arrest most often occurs in children of the first two years of life, and among them in children of the first five months of life. In children, SIJ is of a polyetiological nature. Most common reasons SIDS are a syndrome sudden death infants, road traffic injury, drowning, upper airway obstruction, respiratory diseases, birth defects development, sepsis, dehydration.
General goal. Improve knowledge and skills in diagnosing and providing emergency care for cardiopulmonary syncope.
Specific goal. Based on complaints, medical history, objective examination data, determine the main signs of an emergency condition, carry out differential diagnosis, provide the necessary assistance.
1. Etiology and pathophysiology of cardiopulmonary syncope.
2. Clinical signs of cardiopulmonary syncope.
3. Tactics of cardiopulmonary resuscitation.
4. Follow-up life support activities.
When preparing for a lesson, you need to familiarize yourself with the basic theoretical issues through the graph-logical structure of the topic, treatment algorithms (Fig. 1, 2), literature sources.
Basic clinical signs cardiopulmonary syncope:
- lack of breathing, heartbeat and consciousness;
- disappearance of the pulse in the carotid and other arteries;
- pale or gray-sallow complexion;
- dilated pupils, lack of reaction to light;
- total hypotension, areflexia.
1. Immediately begin resuscitation measures.
2. Record the time of appearance of signs of clinical death and the beginning of resuscitation measures.
3. Sound the alarm, call assistants and the resuscitation team.
A (Airways)- restoration of airway patency
1. Place the patient’s back on a hard surface (table, floor, asphalt).
2. Mechanically clean the oral cavity and pharynx from mucus and vomit.
3. Slightly tilt your head back, straighten your airways (contraindicated in case of injury cervical spine spine), place a soft cushion under the neck.
4. Move the lower jaw forward and upward to prevent the tongue from sinking and facilitate air access.
B (Breath)- restoration of breathing
1. Start artificial ventilation of the lungs using expiratory methods from mouth to mouth in children over 1 year of age or from mouth to mouth and nose in children under 1 year of age.
2. Cover the patient’s face with a handkerchief or gauze pad.
When breathing from mouth to mouth and nose, the resuscitator with his left hand pulls up the patient’s head, and then, after a preliminary deep breath, tightly covers the child’s nose and mouth with his lips and blows in air. As soon as the chest rises, the air injection is stopped and the patient is allowed to exhale passively.
The procedure is repeated with a frequency equal to the age-related respiratory rate of the patient: in children of the first years of life - 20 per 1 minute, in adolescents - 15 per 1 minute. When breathing from mouth to mouth, the resuscitator covers the patient's mouth with his lips and pinches his nose with his right hand.
With both methods of artificial respiration there is a danger of air entering the stomach, its distension, regurgitation of gastric contents into the oropharynx and aspiration. Using a gastric tube can prevent this.
C (Circulation)- restoration of blood circulation
After 3-4 air insufflations in the absence of a pulse in the carotid artery, it is necessary to begin chest compressions.
The resuscitator selects a hand position appropriate for the child’s age and performs rhythmic chest compressions at the patient’s age-appropriate pulse rate (Table 1). The pressure force should correspond to the elasticity of the chest. Cardiac massage is carried out until the pulse in the peripheral arteries is restored.
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Complications of chest compressions: rib and sternum fractures, pneumothorax, liver rupture, regurgitation of gastric contents and aspiration.
For every two air insufflations, 15 chest compressions should be performed. When both procedures are performed by one resuscitator, you can do 2 inflations in a row, and then 30 chest compressions.
The child’s condition must be re-evaluated 1 minute after the start of resuscitation, and then every 2-3 minutes.
Criteria for the effectiveness of mechanical ventilation and chest compressions:
— assessment of chest movements: depth of breathing, uniform participation of the chest in breathing;
- checking the transmission of massaging movements of the chest by pulse on sleepy and radial arteries;
- increase in blood pressure to 50-70 mm Hg;
- reducing the degree of cyanosis of the skin and mucous membranes;
- narrowing of previously dilated pupils and the appearance of a reaction to light;
- renewal spontaneous breaths and heartbeats.
1. If the heartbeat does not recover, without stopping mechanical ventilation and chest compressions, provide access to peripheral vein and enter i/v:
— 0.1% solution of adrenaline 0.01 ml/kg (0.01 mg/kg)1;
- 0.1% solution of atropine sulfate 0.01-0.02 ml/kg (0.01-0.02 mg/kg).
If necessary, re-administer these drugs intravenously after 5 minutes.
2. Oxygen therapy with 100% oxygen through a face mask or nasal catheter.
3. For ventricular fibrillation—defibrillation.
4. In the presence of metabolic acidosis, administer 4% sodium bicarbonate solution 2 ml/kg (1 mmol/kg) intravenously.
5. In the presence of hyperkalemia, hypocalcemia or overdose calcium blockers administration of a 10% solution of calcium gluconate 0.2 ml/kg (20 mg/kg) is indicated.
Intracardiac administration of drugs is not currently practiced.
Main
1. Berezhnoy V.V., Marushko T.V. The risk of sudden death in children and adolescents // Tauride Medical-Biological Bulletin. - 2009. - T. 12, No. 2(46). - P. 93-99.
2. Order of the Ministry of Health of Ukraine No. 437 dated 08/31/04. About the confirmation of clinical protocols for the provision of medical assistance for difficult conditions in children at the hospital and pre-hospital stages.
3. Gordeev V.I., Aleksandrovich Yu.S., Lapis G.A., Ironosov V.E. Emergency pediatrics prehospital stage.— St. Petersburg: Publication of GPMA, 2003.— P. 172-221.
4. Nagornaya N.V., Pshenichnaya E.V., Chetverik N.A. Sudden cardiac death in children. Risk stratification from the perspective of evidence-based medicine // Tauride Medical and Biological Bulletin. - 2009. - T. 12, No. 2(46).— P. 28-35.
5. Volosovets O.P., Marushko Yu.V., Tyazhka O.V. ta in. Uncomplicated topics in pediatrics: Beg. pos_b. / For ed. O.P. Volosovtsia and Yu.V. Marushko.— Kh.: Prapor, 2008.— 200 p.
6. Snisar V.I., Syrovatko Y.A. Features of cardiopulmonary resuscitation in children // Health of Ukraine. - 2005. - No. 13-14. - P. 27.
7. Uchaikin V.F., Molochny V.P. Emergency conditions in pediatrics: Practical guide.— M.: GEOTAR-Media, 2005.— 256 p.
Additional
1. Volosovets O.P., Savvo M.V., Krivopustov S.P. ta in. Selected nutrition for pediatric cardio-rheumatology / Ed. O.P.Volosovtsia, M.V. Savvo, S.P. Krivopustova.—Kiev; Kharkiv.— 2006.— 246 p.
2. Selbst S.M., Kronan K. Secrets of emergency pediatrics: Trans. from English / Under the general editorship. prof. N.P. Shabalova.— M.: MEDpress-inform, 2006.—480 p.
3. Standards and Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC) // JAMA. - 1992. - 268(16). - pp. 2171-3203.
