would Seem what can threaten the newborn within the walls of a home? He also is not able to move still plainly. Nevertheless children of the first month of life quite often become the victims of tragic accidents. One of them - asthma, or as his physicians call, asphyxia. What to do in such situation and whether it is possible to prevent it?
of the Reason of asphyxia
Asphyxia - the asthma caused by a sdavleniye of airways, closing of their gleam with slime, food, a sdavleniye of a neck, thorax and stomach and leading to oxygen starvation and excess accumulation of carbon dioxide in fabrics and cages of an organism that threatens with heavy disorders of activity of nervous system, breath and blood circulation.
this state can be caused In the newborn generally by two reasons:
- of Existence of an external obstacle for free breath : the diaper which is hung up on a bed handrail, or a blanket corner can fall on a child`s face; the baby can bury or “creep“ under a blanket when he uneasily sleeps or when wakes up. It is necessary to tell about presence at newborns of an unconditioned reflex of crawling: the child lies on a stomach and if to it under a foot something firm gets (a side of a bed, a pelenalny table), then the kid is capable to make a start legs from a subject and to make the creeping movements, raising and moving buttocks forward. At the same time the head, shoulders and hands passively move ahead on a surface. Complication in the strings of a blanket cover, a bumper which are low hung up on a bed rattles also can become the asthma reason. Long laces from caps, pacifiers, jeweler chains can be twisted around the child`s neck, causing in him the asthma which is complicated by efforts of the kid to be exempted from them. Joint dream in one bed of the kid and parents and furthermore - the joint dream of the baby in one bed with elder brothers, sisters is dangerous from too - for possible asthma of the newborn. It can unintentionally be covered with the head, press a face of the kid to the body. It is also dangerous to put to bed the kid on a bed with a hydromattress. The baby can appear between her motionless parts and a mobile mattress. It is not necessary to trust too the senior children care of the newborn. They can care for younger too zealously: it is excessive to wrap up it, to cover with a blanket or to feed the child with the food which is not suitable it on age, for example, to share with it cookies, especially if the baby cries. Hit of foreign matters in airways (most often it is food masses during the vomiting, vomiting) is
- the reason of accidents. Especially it is dangerous to the premature, weakened children at whom all protective reflexes are still insufficiently developed. At such kids it can occur during a dream, without emergence of characteristic cough as protective reaction when the organism tries to be exempted from a foreign matter.
External symptoms of asphyxia
At the kid observes motive concern, a poperkhivaniye, the child gasps for air, there can be a squeezed muffled crying (but happens that children do not cry and by that do not draw attention to themselves). There can be sounds which not peculiar are earlier rattling, whistling - so-called stridorozny breath, a hoarse voice or its total absence, unexpected, pristupoobrazny cough, short wind, retraction of supraclavicular poles, intercostal intervals, a stomach, the scared eyes, the formation of a large amount of saliva which is speeded up, and then the slowed-down heartbeat, the weakened breath. Cyanosis (bluish coloring) of the person, extremities, bodies, loss of consciousness, a spasm, full muscular relaxation, lack of reflexes are characteristic of asthma.First aid
In such critical situation of time for expectation of medical care is not present
, and it is necessary to count first of all on himself.
- Ask the people who are a row to call “ambulance“, and do not spend on it invaluable time. Release to the child airways: take off a diaper, a blanket from a face, clean the objects squeezing a neck, wipe the food masses which were srygnut by the child from a face. Try to suck away a rubber pear for enemas contents (food masses) from a mouth and a nose. The mouth can be exempted from possible alien objects the finger which is wrapped up by a napkin, a scarf. If the child cries, rattles, coughs, so airways are partially passable. The kid should help to clear the throat, turn the child headfirst, to clap between shovels or pressing a spoon on a language root, to cause an emetic reflex. It is possible even, having taken the child for legs, to turn him headfirst and to slap several times on a back. It is also possible to simulate cough sharp compression by brushes from lateral faces of the lower part of a thorax and it to try to push out a subject. In most cases these actions happen enough for pushing out of a foreign matter.
But do not try to grasp fingers the subject which got stuck in a throat, - so you can push it further away and cause reflex respiratory standstill .If these actions of success did not bring
- , the child does not cry, does not breathe, skin color remains cyanotic, pulse and heartbeat is not found, it is necessary to start resuscitation actions: to artificial respiration and indirect massage of heart which are carried out at the same time. Note time when you began them.
First of all needs to be put the child on a back on a plain rigid surface (a table, a floor, the earth), and under shovels to put a diaper, the clothes rolled in the form of the roller. Then the head of the victim will be thrown back and language will not sink down, interfering with passing of air to airways. After this child it is necessary to undress, having cleaned all squeezing clothes.
Reanimation is begun with of an artificial respiration . At newborns it is carried out both to a nose, and to a mouth at once. Previously having made a superficial breath, densely capture a mouth or the child`s nose the mouth and make a short exhalation approximately that volume of air which can be located at you in a mouth, but it is no more as inhalation of all “adult“ volume of lungs can lead to a rupture of lungs of the child. There is a criterion of efficiency of an artificial respiration - - the excursion (movement) of a thorax of the victim similar to breath. But you watch that at inhalation of air at the child cheeks were not blown out: it demonstrates that air does not get into lungs and the help is inefficient. Check whether densely your lips clasp a nose or the victim`s mouth, whether the head is rather thrown back and whether language corks airways, whether everything foreign matters are removed from a mouth. Press lips to a child`s face more densely, once again throw back the head or in addition exempt a mouth from foreign matters. At children about one year the frequency of inflations is approximately equal 20 1 minute.
of Note . It is the simplest to find a pulsation in the newborn on a big fontanel, and also on a humeral artery: take away a hand of the child from a body and turn palm up. In an average third of a shoulder on inside index and average fingers grope pulse between two muscles. To check pulse on a carotid, on a neck at newborns difficult from - that a neck still short, and skin on it has numerous folds.
to check heartbeat, it is necessary to put the palm on a thorax of the kid, on area of the left mammary gland. If you manage to feel heartbeat, but there is no pulse on arteries, then warm activity is considered insufficient and resuscitation actions are necessary. Such actions are necessary also in the absence of heartbeat.
After each breath indirect massage of heart .needs to find
On a thorax of the kid a point which it is necessary to press. Reference point such is - it settles down on width of one finger below the line which is mentally carried out between nipples on the left edge of a breast (approximately in its lower third).
to Children about one year needs to be pressed sharply this point two fingers - index and average, at the same time hands should be disciplined perpendicular to the victim`s body, in elbows not to bend, efforts have to be made only by hands, but not all over, that is it is impossible to transfer the weight of the body to hands not to injure the child`s edge.the Thorax of the child should clasp
with both hands (thumbs lie on the specified area) and to vigorously squeeze it. Frequency of pressings on a thorax at newborns - 120 times a minute. Remember that when performing an artificial respiration massage of heart is interrupted that it did not hinder the respiratory movements of a thorax.
Criterion of efficiency of indirect massage of heart - emergence of pulse on a big fontanel and large vessels (see. above). Therefore, carrying out reanimation, approximately once a minute check existence of a pulsation. In case the pulsation was restored, indirect massage should be stopped, and to continue an artificial respiration before restoration of independent breath. If pulse is absent, continue reanimation further and every minute control pulse. Sometimes to define pulse can be difficult from - for small fillings of vessels or as a result of a mistake by search of a point of a fumbling of pulse. Therefore 3 - 5 minutes later indirect massage of heart and an artificial respiration is recommended to be interrupted and on external signs to establish existence of independent heartbeat, spontaneous breath, the size of pupils. Narrow pupils is a sign of restoration of work of a brain.you have to achieve
of What as a result of all resuscitation actions? Restoration of vital activity, i.e. emergence of independent breath, pulsation, heartbeat, narrowing of pupils and their reaction to light, changes of skin color with pale, cyanotic on pink.
Then the child should take to hospital for comprehensive inspection, especially if asphyxia developed during the vomiting or vomiting. The food masses which got into bronchial tubes from a stomach is sour at the expense of gastric juice and by that is hostile environment for a gentle mucous membrane of airways, leading to its damage, an inflammation. Most likely, the sanatsionny bronkhoskopiya (introduction to bronchial tubes of the optical apparatus which allows to examine bronchial tubes and if necessary to carry out their washing), the roentgenogram will be in that case carried out and antibiotics are appointed.If when rendering the resuscitation help heartbeat and breath are not restored by
, and pupils remain wide, then indirect massage of heart and an artificial respiration should be continued before arrival of “ambulance“ or before warm and respiratory activity. The decision on the termination of reanimation is made by the doctor.
to increase time of life of a cerebral cortex at activity violation, during the first moments after loss of consciousness impose the child`s head with something cold (a hot-water bottle, bottles with cold water, ice from the refrigerator, the package of the frozen vegetables frozen by meat etc.) .If at any stage of reanimation at the child vomiting began
, turn it sideways, a finger clear a mouth of emetic masses, again lay on a back and continue revival.Prevention of asphyxia
- After each feeding to the child should give to
the chance to otrygnut the air swallowed with food. For this purpose it is necessary to take it some time vertically and at all not to put right after feeding. Some children (especially premature or weakened) can belch repeatedly, already being in a bed. For prevention of inhalation of contents turn the head of the baby always on one side. If vomiting frequent and plentiful, then it is a reason for the address to the doctor. by
- Choosing children`s bed linen and clothes, the preference should be given to goods without various zavyazochek, tesemochek, etc. Instead of a children`s blanket it is possible to use a special envelope for a dream, not to use too big “adult“ blankets. It is possible to use special mesh blankets for babies. should not leave to
- for a long time the senior children of one about the newborn, hoping for their maturity and judiciousness, and also to put to sleep the baby in one bed with them. And the joint dream in one bed with parents from the point of view of possible asphyxia is not safe.
- the Joint dream can also be risk factor of suffocation of the kid. Though many young mothers put with themselves in a bed of kids, nevertheless the dream in a parental bedroom, but not in a parental bed will be optimum. Put a crib end-to-end to the, lower a lateral lattice. On the one hand, it will ensure safety of the kid, with another - you will be in close proximity to the child and you should not jump at night several times. It will be convenient to you to feed at night the baby, and then, without rising, to shift it in a bed. >
- For prevention of asphyxia it is preferable to li to stack the child serially on one, on other flank as in provisions on a back and on a stomach there are some shortcomings.
Scientific revealed a certain interrelation between the child`s dream on a stomach and increase in frequency of emergence of the syndrome of sudden children`s death (SSCD). So the sudden death of the child of the first year of life (especially the first is called - the fourth month) for the obscure reasons, against full health, is more often in night and hours at dawn. Do not help to explain the reasons of this phenomenon neither detailed studying of medical history of the kid, nor results of pathoanatomical research. So far only the factors influencing sudden death on which it is possible to allocate children of risk group are specified and to hold for them preventive events. However in situation on a stomach gases from the blown-up stomach of the baby depart easier, back muscles become stronger, the correct position of coxofemoral joints is formed. And if you do not risk to put the kid to bed on a stomach at night, then can quite make it in the afternoon when the child is under your control. But also the minuses are in the family way on a back. In this position of the child, suffering from vomiting and vomiting, can choke with emetic masses. And at an underdeveloped bridle language also easily can sink down.in conclusion we will note
that it is always necessary to think of safety of the baby. It is very defenseless and can help itself(himself) unless calling surrounding with crying.