心肺复苏术-英文.ppt

CardioPulmonaryResuscitation心肺复苏术 CPR RespiratorydepartmentXiyanwang 王西艳 WhyshouldwelearntheCPR Why Despiteimportantadvancesinprevention cardiacarrestremainsasubstantialpublichealthproblemandaleadingcauseofdeathinmanypartsoftheworld TheestimatedincidenceofEMS emergencymedicalservices treatedout of hospitalcardiacarrestintheChinaisabout35to40 100000persons year Why StudieshaveshowntheimportanceofimmediateCPRfollowedbydefibrillationwithin3 5minutesofsuddenVF VentricularFibrillation cardiacarrestimprovesurvival IncitiessuchasSeattlewhereCPRtrainingiswidespreadanddefibrillationbyEMSpersonnelfollowsquickly thesurvivalrateisabout30 IncitessuchasNewYork withoutthoseadvantages thesurvivalrateisonly1 2 Why Therearemanylivesandlife yearslostbecauseappropriateresuscitationisnotattempted MostofthepublicknowlittleaboutthedetailsofCPR When Cardiacarrest Notbreathingornotmakingsufficientrespiratoryeffortontheirown How C Circulation A Airway B Breathing 2010AmericanHeartAssociationGuidelinesforCardiopulmonaryResuscitationandEmergencyCardiovascularCare Circulation Restorebloodcirculationwithchestcompressions CheckthesafetyoftheentironmentPutthepersononhis herbackonafirmsurface Kneelnexttotheperson sneckandshoulders Circulation Restorebloodcirculationwithchestcompressions 4 Checkthepulseandbreathat5 10seconds count1001 1002 1007 Usetheindexandmiddlefingerstocheckthepulseofcarotidatery themiddleofanterioredgesernocleidomastoid Airway Cleartheairway Putyourfaceneartheperson smouthandlookforthechestmotionatthesametime LookforchestmotionListenfornormalbreathsoundsFeelfortheperson sbreathonyourcheekandear Ifthepersonisn tbreathingnormally beginartificialrespiration 5 Starttheemergencyresponsesystem suchasphone120 catchAED automaticexternaldifibrillator Circulation Restorebloodcirculationwithchestcompressions 6 Placetheheelofonehandoverthecenteroftheperson schest betweenthenipples Placeyourotherhandontopofthefiesthand Keepyourelbowsstraightandpositionyourshouldersdirectlyaboveyourhands Circulation Restorebloodcirculationwithchestcompressions 7 StartCPR Useyourupperbodyweightsasyoupushstraightdownonthechestatadepthofatleast5 6cm Pushhardatarateofabout100 120compressionsaminute Airway Cleartheairway Opentheperson sairway Putyourpalmontheperson sforeheadandgentlytilttheheadback Withtheotherhand gentlyliftthechinforwardtoopentheairway Breathing Breathfortheperson mouth to mouthbreathing mouth to nosebreathingifthemouthisseriouslyinjuredorcan tbeopend mouth to maskbreathing whenoutsidehospitalyoumaynotgiveartificialbreathingifyoudon twant Breathing Breathfortheperson Withtheairwayopen pinchthenostrilsshutformouth to mouth mouth to mask breathingandcovertheperson smouthwithyours makingaseal makesurethereisnoleakage Breathing Breathfortheperson Thirtychestcompressionsfollowedbytworescuebreathsisconsideredonecycle 1or2rescuer Checkthecaroidpulseandchestmotionevery5cycles ContinueCPRuntiltherearesignsofmovementoremergencymedicalpersonneltakeover Breathing Breathfortheperson Ifanadultvictimwithspontaneouscirculation giverescuebreathsatarateofabout1breathevery5to6seconds orabout10to12breathsperminute AED Checkthythm ifshockablegive1shock andimmediatelystartCPR whennotshockable immediatelystartCPR2 Checkthythmevery5cycles continueCPRuntilthepatienthassignsofcirculation Defibrillation Ventricularfibrillationiscommoninadultsnon traumaticcardiacarrest 2 Earlierdefibrillationidimportantforsurvival 3 Thechanceforsurvivaldecline7 10 everyminutelaspe 4 Bedefibrillatedattheearliestpossiblemoment Pointsforattention Ensuringchestcompressionsofadequaterate Ensuringchestcompressionsofadequatedepth Allowingfullchestrecoilbetweencompressions Minimizinginterruptionsinchestcompressions Avoidin