心肺復蘇急救技能應用ApplicationofCardiopulmonaryResuscitation(CPR)FirstAidSkills心肺復蘇急救技能應用ApplicationofCardiopulmonaryResuscitation(CPR)FirstAidSkills心臟病heartdisease高血壓hypertension心肺復蘇急救技能應用ApplicationofCardiopulmonaryResuscitation(CPR)FirstAidSkills溺水drowning觸電electricshock心肺復蘇急救技能應用ApplicationofCardiopulmonaryResuscitation(CPR)FirstAidSkills異物吸入foreignbodyaspiration煤氣中毒gaspoisoning食物藥物中毒foodordrugpoisoning心肺復蘇急救技能應用ApplicationofCardiopulmonaryResuscitation(CPR)FirstAidSkills大腦brain重要器官組織importantorgantissuesv時間就是生命timeisoftheessence心肺復蘇急救技能應用ApplicationofCardiopulmonaryResuscitation(CPR)FirstAidSkills心肺復蘇操作技能CardiopulmonaryResuscitation(CPR)operationalskills黃金4分鐘內Withinthegoldenfourminutes挽救生命避免或減少不幸的發(fā)生SavelivesPreventorreducetheoccurrenceofmisfortunes課程導入Courseimport面對心搏驟停的傷病員Whenfacingacasualtywithcardiacarrest只有一名救護員在現(xiàn)場時Ifthereisonlyonerescueron-site應立即啟動EMSS后開始心肺復蘇。TherescuershouldimmediatelyactivatetheEmergencyEMSSandthenstartcardiopulmonaryresuscitation(CPR).當有兩名救護員在現(xiàn)場時Whentherearetworescuerson-site一名立即實施心肺復蘇，另一名向EMSS求救。OneshouldimmediatelyperformCPR,andtheothershouldcalltheEMSSforhelp.心肺復蘇程序CPR程序CardiopulmonaryResuscitationProcedure(CPRProcedure)IdentificationandJudgment識別判斷評估現(xiàn)場環(huán)境是否安全，做好個人防護。Assesswhethertheon-siteenvironmentissafeandtakepersonalprotectivemeasures.IdentificationandJudgment識別判斷判斷傷病員意識，用雙手輕拍傷病員雙肩。Judgethecasualty'sconsciousness,Gentlypatthecasualty'sshoulderswithbothhands.IdentificationandJudgment識別判斷先生先生，您怎么了，能聽到我說話嗎?What'swrongwithyou,Sir.Canyouhearme?IdentificationandJudgment識別判斷用耳貼近口鼻，未感到有氣流或胸部無起伏，無呼吸或無正常呼吸。Placeyourearclosetothecasualty'smouthandnose.Ifyoudon'tfeelanyairfloworobservenochestmovement,itindicatesthatthecasualtyhasnobreathingornonormalbreathing.IdentificationandJudgment呼叫、求救快來人呀！快來人呀！我是急救員。Comeandgo!Comeandgo!I'manemergencyworker.IdentificationandJudgment呼叫、求救有人暈倒了，幫我取除顫儀，那位先生幫我撥打120。Someonefainted,helpedmegetthedefibrillator,whichgentlemanhelpedmedial120.CPRPosition心肺復蘇體位救護者的位置應處于傷病員的右側。Therescuershouldbepositionedontheright-handsideofthecasualty.CPRPosition心肺復蘇體位傷病員的體位應處于平坦、堅實的表面，仰臥體位。Thecasualtyshouldbeplacedonaflatandfirmsurfaceinasupineposition.CPRPosition心肺復蘇體位如果傷病員處于俯臥位或其他不宜復蘇體位。Ifthecasualtyisinapronepositionorotherpositionsnotsuitableforresuscitation,CPRPosition心肺復蘇體位救護員應在傷病員的一側。therescuershouldbeononesideofthecasualty.CPRPosition心肺復蘇體位將其雙上肢向頭部方向伸直。First,stretchthecasualty'sbothupperlimbsstraighttowardsthehead.CPRPosition心肺復蘇體位將對側小腿放于同側的小腿上，呈交叉狀。Then,placetheopposite-sidelowerlegonthesame-sidelowerleginacrossedposition.CPRPosition心肺復蘇體位救護員再用單手托住傷病員的后頭枕部。Next,therescuerusesonehandtosupportthebackofthecasualty'shead.CPRPosition心肺復蘇體位另一只手放置于其對側腋下。andtheotherhandtoholdtheopposite-sidearmpit.CPRPosition心肺復蘇體位放置雙上肢于身體兩側。Afterthat,placethetwoupperlimbsonbothsidesofthebody.CPRPosition心肺復蘇體位放置雙上肢于身體兩側。Afterthat,placethetwoupperlimbsonbothsidesofthebody.CPRPosition心肺復蘇體位注意Note對懷疑有頸椎受傷的傷病員，翻轉身體時要使其頭頸背部呈軸向轉動，以免損傷脊髓。Forcasualtiessuspectedofhavingcervicalspineinjuries,whenturningthebody,makesurethehead,neck,andbackrotateaxiallytoavoidspinalcordinjury.救護員兩膝分開，與肩同寬，跪于傷病員一側肩部，解開傷病員衣領、領帶、拉鏈及褲帶等束縛。Therescuershouldspreadtheirkneesshoulder-widthapart,kneelbesidethecasualty'sshoulder,andthenundotherestrictiveitemssuchasthecasualty'scollar,tie,zipper,andtrouserbelt.Hands-onlyCardiopulmonaryResuscitation徒手心肺復蘇v成人胸外心臟按壓ChestCompressionsforAdultsHands-onlyCardiopulmonaryResuscitation徒手心肺復蘇確定按壓部位：兩乳頭連線中點(胸骨下1/2處)。Determinethecompressionsite:Themid-pointofthelineconnectingthetwonipples(thelowerhalfofthesternum).Hands-onlyCardiopulmonaryResuscitation徒手心肺復蘇救護員將雙手十指相扣，一手掌根緊貼傷病員胸部按壓位置。Therescuerinterlocksthefingersofbothhandswiththeheelofonehandfirmlyagainstthecompressionsiteonthecasualty'schest.Hands-onlyCardiopulmonaryResuscitation徒手心肺復蘇另一手掌重疊放在此手背上，手指上翹，避免接觸肋骨。Theotherpalmisplacedoverlappingonthebackofthishand,withthefingersliftedupwardstoavoidtouchingtheribs.Hands-onlyCardiopulmonaryResuscitation徒手心肺復蘇身體前傾，兩肘關節(jié)伸直，上肢呈一直線，雙肩夾緊。Leanforward,twoelbowsstraight,straightupperlimbs,shouldersclamped.Hands-onlyCardiopulmonaryResuscitation徒手心肺復蘇肩肘掌軸與傷病員胸骨垂直，挺胸翹臀，以腰為支點垂直向下按壓。elbowsandpalmsperpendiculartothecasualty'ssternum.archthechestandliftthebuttocks,andpressverticallydownwardswiththewaistasthepivot.Hands-onlyCardiopulmonaryResuscitation徒手心肺復蘇按壓深度:5~6cm。Compressiondepth:5-6cm.按壓頻率:100~120次1分，按壓與放松的間隔比為1:1。Compressionfrequency:100-120timesperminute.Theratioofcompressiontimetorelaxationtimeis1:1.按壓中斷時間不超過10秒。Interrupttime:Theinterruptionofcompressionshouldnotexceed10seconds.按壓次數(shù):每次按壓后胸廓完全回彈，放松時手不離開胸壁，連續(xù)按壓30次。Numberofcompressions:Aftereachcompression,thechestwallshouldfullyrecoil.Keepthehandsincontactwiththechestwallduringrelaxation.Perform30consecutivecompressions.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing檢查口腔有無異物，若口中有嘔吐物、活動義齒等，應立即清除。Checkthemouthforforeignobjects,Iftherearevomit,removabledentures,etc.inthemouth,removethemimmediately.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing救護員用一只手的小魚際，使其頭部后仰。Therescuerusesthehypothenarofonehandtopressdownonthecasualty'sforehead,tiltingtheheadbackwards.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing將另一只手的食指和中指放在下頜骨將其向上抬起，開放氣道。Then,placetheindexfingerandmiddlefingeroftheotherhandonthemandibleandliftitupwardstoopentheairway.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing開放氣道的標志:下頜角與同側耳垂的連線與所躺平面成90度。Signofanopenairway:Thelineconnectingtheangleofthemandibleandtheipsilateralearlobeshouldforma90-degreeanglewiththeplaneonwhichthecasualtyislying.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing確保傷病員氣道開放通暢。Ensurethatthecasualty'sairwayisopenandunobstructed.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing救護員用一手捏緊傷病員鼻翼，防止漏氣。Therescuerpinchesthecasualty'snostrilstightlywithonehandtopreventairleakage.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing用口把傷病員的口完全罩住，呈密封狀。Then,completelycoverthecasualty'smouthwiththeirownmouthtoformaseal.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing緩慢吹氣，每次吹氣持續(xù)約1秒，確保吹氣時可見胸廓起伏。Blowairslowly,witheachbreathlastingabout1second,makingsurethatthechestrisesvisiblyduringthebreath.人工呼吸ArtificialRespiration仰頭舉頦法Head-TiltChin-LiftManeuver口對口吹氣Mouth-to-MouthBlowing紗布gauze薄衣物athinpieceofclothing呼吸面巾abreathingtowel提示Tip胸外心臟按壓與人工呼吸比例為30:2Theratioofchestcompressionstoartificialrespirationis30:2.操作胸外心臟按壓，人工呼吸5組循環(huán)后，復蘇評估。Afterperforming5cyclesofchestcompressionsandartificialrespiration,conductaresuscitationassessment.Hands-onlyCardiopulmonaryResuscitation徒手心肺復蘇Hands-onlyCardiopulmonaryResuscitation徒手心肺復蘇患者有脈搏、有呼吸，心肺復蘇成功，送醫(yī)院。Thepatienthadapulseandbreathing,withsuccessfulcardiopulmonaryresuscitationandwassenttothehospital.Indicatorsofsuccessfulcardiopulmonaryresuscitation:心肺復蘇成功的指標：昏迷變淺，出現(xiàn)各種反射；Thepatient'scomabecomesshallowerandvariousreflexesappear.身體出現(xiàn)無意識的掙扎動作；Thebodyshowsunconsciousstrugglingmovements.自主呼吸逐漸恢復；Spontaneousbreathinggraduallyrecovers.觸摸到規(guī)律的頸動脈搏動；Aregularcarotidarterypulsecanbefelt.面色、口唇轉為紅潤；Thecomplexionandlipsturnruddy.雙側瞳孔縮小、對光反射恢復。Thepupilsofbotheyesconstrictandthelightreflexrecovers.RecoveryPosition復原體位患者有脈搏、有呼吸，心肺復蘇成功，送醫(yī)院。Thepatienthadapulseandbreathing,withsuccessfulcardiopulmonaryresuscitationandwassenttothehospital.RecoveryPosition復原體位自主呼吸spontaneousbreathing心跳恢復heartbeatresumeTerminationofCardiopulmonaryResuscitation心肺復蘇終止復蘇操作已達30分鐘以上而傷病員意識、自主呼吸、心跳未恢復;Resuscitationhasbeencarriedoutformorethan30minutes,yetthecasualty'sconsciousness,spontaneousbreathing,andheartbeathavenotrecovered.心電圖波一直呈現(xiàn)直線。Theelectrocardiogramshowsastraightlinecontinuously.StandardsforHigh-qualityCardiopulmonaryResuscitation高質量心肺復蘇的標準心肺復蘇時為保證組織器官的血流灌注，必須實施有效的胸外按壓。Duringcardiopulmonaryresuscitation,toensurebloodperfusionoftissuesandorganseffectivechestcompressionsmustbecarriedout.有效的胸外按壓必須快速、有力。Effectivechestcompressionsmustberapidandforceful.成人按壓頻率100~120次/分，按壓深度5~6cm。Foradults,thecompressionfrequencyis100-120timesperminute.Thecompressiondepthis5-6cm.每次按壓后胸廓完全回彈，按壓與放松比大致相等。Aftereachcompression,thechestwallshouldfullyrecoil,andtheratioofcompressiontorelaxationshouldbeapproximatelyequal.盡量避免胸外按壓的中斷，應避免過度吹氣。Trytoavoidinterruptionsinchestcompressions,Over-ventilationshouldbeavoided.實施心肺復蘇的步驟順序SequenceofCardiopulmonaryResuscitationSteps胸外心臟按壓一開放氣道→人工呼吸。Chestcompressions→Airwayopening→Artificialrespiration.胸外心臟按壓只能在傷病員心臟驟停后才能實施。Chestcompressionsshouldonlybecarriedoutafterthecasualty'scardiacarrest.ImportantTipsonCardiopulmonaryResuscitationOperations有關心肺復蘇操作的重要提示v嚴禁在正常人身上操作練習，這樣可能會導致嚴重后果。Itisstrictlyprohibitedtopracticeonnormalpeople,asthismayleadtoseriousconsequences.實施心肺復蘇的步驟順序SequenceofCardiopulmonaryResuscitationSteps實施心肺復蘇時應將傷病員的領帶、衣扣及皮帶等束縛松開，以免引起內臟損傷。Whenperformingcardiopulmonaryresuscitation,loosenthecasualty'stie,buttons,beltandotherrestrictiveitemstoavoidinternalorgandamage.

胸外心臟按壓的位置、力度必須符合要求。Thepositionandforceofchestcompressionsmustmeettherequirements.ImportantTipsonCardiopulmonaryResuscitationOperations有關心肺復蘇操作的重要提示實施心肺復蘇的步驟順序SequenceofCardiopulmonaryResuscitationStepsImportantTipsonCardiopulmonaryResuscitationOperations有關心肺復蘇操作的重要提示胸外心臟按壓的位置、力度必須符合要求。Thepositionandforceofchestcompressionsmustmeettherequirements.v按壓位置不準確可能導致按壓無效、臟器損傷。Ifthecompressionpositionisinaccurate,itmayleadtoineffectivecompressionandorgandamage.力度過大容易造成肋骨骨折，引起氣胸、血胸；按壓的力度過輕,胸腔壓力小，不足以推動血液循環(huán)。Excessiveforcecaneasilycauseribfractures,leadingtopneumothoraxandhemothorax.按壓的力度過輕,胸腔壓力小，不足以推動血液循環(huán)。Ifthecompressionforceistoolight,thepressureinthechestcavityistoosmalltodrivebloodcirculation.實施心肺復蘇的步驟順序SequenceofCardiopulmonaryResuscitationStepsImportantTipsonCardiopulmonaryResuscitationOperations有關心肺復蘇操作的重要提示有效的胸外心臟按壓才可能產生適當?shù)难貉h(huán)，要求救護員應“有力和快速地按壓”，按壓頻率100~120次每分鐘。Onlyeffectivechestcompressionscangenerateproperbloodcirculation.Rescuersarerequiredto"compressforcefullyandrapidly".Thecompressionfrequencyshouldbe100-120timesperminute.強調連續(xù)按壓的重要性，按壓間斷時間不超過10秒。Emphasizetheimportanceofcontinuouscompressions.Theinterruptiontimeofcompressionsshouldnotexceed10seconds.實施心肺復蘇的步驟順序Sequence