《黄培志－心肺复苏》.pptVIP

Cardiopulmonary Resuscitation Peizhi Huang Zhongshan Hospital Diagnosis of cardiac and respiratory arrest Traditional methods : 1. Carotid pulse check by lay rescuers 2. Loss of consciousness 3. Pupil dilation 4. Respiratory arrest Guideline 2000 Elimination of the pulse check for lay rescuers Evaluate for signs of circulation in 10 seconds breathing , coughing , movement in response to rescue breath Assess for a pulse Rate of false- positive(40%)  Results Pulseless Pulse Mistakenly loss the saving opportunity Rate of false-negative (10 %) Results Pulse Pulseless Unnecessarily do CPR Electrocardiogram changes  of Cardiac arrest Ventricular fibrillation A flat line or only atrial wave Pulseless Electrical Activity, PEA The chain of Survival Early access Early CPR Early Defibrillation Early advanced life support * patient with Coma （ immediately do CPR ， not clear obstructed airways at first） Basic Life Support --- the first ABCD Airway A Breathing B Circulation C Defibrillation D Airway Tilt the head backwards Lift the jaw Open the mouth Clearing obstructed airways from choking Subdiaphragmatic abdominal thrust (Heimlich maneuver) Breathing Mouth to mouth or mouth to nose Mouth to oropharyngeal tube Mouth to shield Mouth to mask(compressing the cricoid cartilage in order to decrease gastric distention and prevent gastric reflu) Bag-mask ventilation challenged endotracheal intubation – resuscitation’s “gold standard” Circulation —external chest compression High-frequency（100 compressions per min） aortic pressure ↑myocardial perfusion pressure↑ cardiac outputs ↑ rise survival rate Reduce interrupted co