董士民2000年心肺复苏指南PPT课件.ppt

一次更换按压操作者后, 要经历几次新的胸外按压才能达到更换前的循环水平 Hand off time 时间越长,自主循环建立的难度就越大 A： 无CPR，延迟除颤 （0-2%生存率） B：早期CPR，延迟除颤（2-8%） C：早期CPR，早除颤20% D：早期CPR，早除颤， 早ACLS（30%） 除颤 除颤 除颤 ICCM, WT, 11/2000 ICCM, WT, 11/2000 早期除颤增加生存率 每分钟除颤延迟，生存率降低10% SURVIVAL OF OUT- OF-HISPITAL CARDIAC ARREST New York City 1.4% Chicago 2.0% Paris 1.9% Taipei 1.4% —— 河北医科大学第三医院急诊科 AED（自动体外除颤仪）: Automatic External Defibrillator Analysis heart rhythms Dual-function pads Voice and screen prompts Deliver shocks AEDs USED BY POLICE OFFICERS The City of Rochesters Experience Time （min） Survival（%） 6 58 White RD et al : Ann Emerg Med 1996;28:480 河北医科大学第三医院急诊科 AEDs USED BY POLICE OFFICERS Time(min) Survival(%) Paramedics 12 3 Police officers 6 26 2000 International guidedline of Cardiopulmonary Resuscitation 2000 年国际心肺复苏指南介绍 Evidence-Based Guidelines Search for evidence Appraise the quality of each article Determine the level of evidence Class of recommendation —— 河北医科大学第三医院急诊科 Class of Recommendation Class Ⅰ: Excellent, diffidently recommendation Class Ⅱa : Good to very good, acceptable and useful Class Ⅱb: Fair to good , acceptable and useful Class Indeterminate: Preliminary research stage ClassⅢ: Unacceptable, may be harmful —— 河北医科大学第三医院急诊科 Major Changes of the New Guidelines The priority of mechanical ventilation Publicisc as defibrillation programs CPR pharmacology Myocardial pres