Cardio

Pulmonary

Resuscitation心肺復蘇術(shù)(CPR)RespiratorydepartmentXiyanwang(王西艷)Cardio

Pulmonary

Resuscitation1WhyshouldwelearntheCPR?WhyshouldwelearntheCPR?2Why?Despiteimportantadvancesinprevention,cardiacarrestremainsasubstantialpublichealthproblemandaleadingcauseofdeathinmanypartsoftheworld.TheestimatedincidenceofEMS(emergencymedicalservices)-treatedout-of-hospitalcardiacarrestintheChinaisabout35to40/100000persons/year.Why?Despiteimportantadvances3Why?StudieshaveshowntheimportanceofimmediateCPRfollowedbydefibrillationwithin3-5minutesofsuddenVF(VentricularFibrillation)cardiacarrestimprovesurvival.

?IncitiessuchasSeattlewhereCPRtrainingiswidespreadanddefibrillationbyEMSpersonnelfollowsquickly,thesurvivalrateisabout30%.

?IncitessuchasNewYork,withoutthoseadvantages,thesurvivalrateisonly1-2%.Why?Studieshaveshowntheimp4Why?Therearemanylivesandlife-yearslostbecauseappropriateresuscitationisnotattempted.MostofthepublicknowlittleaboutthedetailsofCPR.Why?Therearemanylivesand5When?●Cardiacarrest●NotbreathingornotmakingsufficientrespiratoryeffortontheirownWhen?●Cardiacarrest6How?

●C(Circulation)●A(Airway)

●

B(Breathing)

--2010AmericanHeartAssociationGuidelinesforCardiopulmonaryResuscitationandEmergencyCardiovascularCareHow?●C(Circulation7Circulation:RestorebloodcirculationwithchestcompressionsCheckthesafetyoftheentironmentPutthepersononhis/herbackonafirmsurface.Kneelnexttotheperson’sneckandshoulders.Circulation:Restorebloodci8Circulation:Restorebloodcirculationwithchestcompressions4.Checkthepulseandbreathat5-10seconds(count1001.1002…..1007)Usetheindexandmiddlefingerstocheckthepulseofcarotidatery(themiddleofanterioredgesernocleidomastoid)Circulation:Restorebloodci9Airway:CleartheairwayPutyourfaceneartheperson’smouthandlookforthechestmotionatthesametime(

Lookforchestmotion

Listenfornormalbreathsounds

Feelfortheperson’sbreathonyourcheekandear)●Ifthepersonisn’tbreathingnormally,beginartificialrespiration.5.Starttheemergencyresponsesystem,suchasphone120、catchAED（automaticexternaldifibrillator）…..

Airway:Cleartheairway10Circulation:Restorebloodcirculationwithchestcompressions6.Placetheheelofonehandoverthecenteroftheperson’schest,betweenthenipples.Placeyourotherhandontopofthefiesthand.Keepyourelbowsstraightandpositionyourshouldersdirectlyaboveyourhands.Circulation:Restorebloodci11Circulation:Restorebloodcirculationwithchestcompressions7.StartCPR:Useyourupperbodyweightsasyoupushstraightdownonthechestatadepthofatleast5-6cm.Pushhardatarateofabout100-120compressionsaminute.Circulation:Restorebloodci12Airway:CleartheairwayOpentheperson’sairway.

●Putyourpalmontheperson’sforeheadandgentlytilttheheadback.

●Withtheotherhand,gentlyliftthechinforwardtoopentheairway.

Airway:CleartheairwayOpe13Breathing:Breathfortheperson

●mouth-to-mouthbreathing

●mouth-to-nosebreathingifthemouthisseriouslyinjuredorcan’tbeopend.

●mouth-to-maskbreathing

●whenoutsidehospitalyoumaynotgiveartificialbreathingifyoudon’twant.

Breathing:Breathfortheper14Breathing:BreathforthepersonWiththeairwayopen,pinchthenostrilsshutformouth-to-mouth(mouth-to-mask)breathingandcovertheperson’smouthwithyours,makingaseal.(makesurethereisnoleakage)Breathing:Breathfortheper15Breathing:BreathforthepersonThirtychestcompressionsfollowedbytworescuebreathsisconsideredonecycle.(1or2rescuer)Checkthecaroidpulseandchestmotionevery5cyclesContinueCPRuntiltherearesignsofmovementoremergencymedicalpersonneltakeover.=30:2:Breathing:Breathfortheper16Breathing:BreathforthepersonIfanadultvictimwithspontaneouscirculation,giverescuebreathsatarateofabout1breathevery5to6seconds,orabout10to12breathsperminuteBreathing:Breathfortheper17AEDCheckthythm:ifshockablegive1shock,andimmediatelystartCPR.whennotshockable,immediatelystartCPR2.Checkthythmevery5cycles,continueCPRuntilthepatienthassignsofcirculation.AEDCheckthythm:ifshockable18DefibrillationVentricularfibrillationiscommoninadultsnon-traumaticcardiacarrest.2.Earlierdefibrillationidimportantforsurvival.3.Thechanceforsurvivaldecline7-10%everyminutelaspe.4.Bedefibrillatedattheearliestpossiblemoment.DefibrillationVentricularfib19Pointsforattention?Ensuringchestcompressionsofadequaterate?Ensuringchestcompressionsofadequatedepth?Allowingfullchestrecoilbetweencompressions?Minimizinginterruptionsinchestcompressions?AvoidingexcessiveventilationPointsforattention?Ensurin20Remember:

●Timeislife!

●Early