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Scandalo Sanità nella Capitale: Contronotizia

Pubblicato da Dr.Guidalberto Guidi in Primo Soccorso · 9/10/2011 20:50:00
Tags: rianimazionecardiopolmonaremassaggiocardiacoAirwayBreathing
Abbiamo visto tutti le scene raccapriccianti dei pronto soccorso degli ospedali della Capitale e i media si sono scagliati in particolare sul caso di un paziente che viene rianimato “per terra”.

Può sembrare una mostruosità, ma non è così. Giudicare con disprezzo e indignazione questa scena è lecito, ma presuppone una profonda ignoranza in materia sanitaria.

I fondamentali della rianimazione cardiopolmonare (RCP) sono universalmente riconosciuti e sintetizzati nella formula ABC.

A: Airway, cioè pervietà delle vie aeree, che vanno mantenute pervie e libere da vomito, secreto, ecc…

B: Breathing, cioè respirazione, sostituire con “mascherina” o “bocca a bocca” la respirazione e quindil’ossigenazione del sangue.

C: Circolazione, cioè sostituire con il massaggio cardiaco esterno l’azione cardiaca di pompaggi del sangue.

Quindi seguendo i fondamenti della rianimazione cardiopolmonare in caso di arresto cradiaco:

A: Bisogna prima assicurarsi di avere una pervietà delle vie respiratorie, se questa è difficoltosa bisogna intubare il paziente con una cannula oro- o naso-tracheale, per assicurare adeguato passaggio di aria od ossigeno ai polmoni.

B: Bisogna ventilare i polmoni con palloncino Ambu o con respirazione “bocca a bocca”.

C: Bisogna eseguire il massaggio cardiaco esterno per pompare sangue agli organi vitali, primo tra tutti il cervello.

Soffermandoci sul punto C = circolazione: dobbiamo spiegare che per avere un efficace azione meccanica sul cuore che ricominci a pompare sangue negli organi, è necessario comprimere ritmicamente il cuore, tra lo sterno anteriore e la colonna vertebrale posteriormente.

Per ottenere una efficace compressione è essenziale che il piano di appoggio posteriormente alla colonna vertebrale sia rigido e non cedevole, altrimenti l’energia trasmessa allo sterno viene assorbita dal supporto e non sortisce alcuna compressione sul cuore, risultando assolutamente inefficace.

Questa avviene per esempio se il corpo del paziente è adagiato su un materasso o su un letto con rete metallica o una barella di trasporto.

Per questo motivo un rianimatore esperto preferisce adagiare lo sventurato su un piano rigido, possibilmente basso per facilitare la compressione del cuore e sfruttare oltre che la forza delle braccia il peso del corpo del rianimatore come energia necessaria a produrre un efficace pressione sulla cassa toracica.

Ecco quindi che il messaggio mediatico può assumere un altro aspetto: quello di un gesto voluto, consapevole, magari eseguita in condizioni estreme di emergenza, ma con grande competenza nell’intento di salvare una vita.

Altro che mala sanità!

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