心肺復蘇術 英文參考課件

Cardio

Pulmonary

Resuscitation心肺復蘇術(CPR)RespiratorydepartmentXiyanwang(王西艷)1

Cardio

Pulmonary

ResuscitationWhyshouldwelearntheCPR?2WhyshouldwelearntheCPR?2Why?Despiteimportantadvancesinprevention,cardiacarrestremainsasubstantialpublichealthproblemandaleadingcauseofdeathinmanypartsoftheworld.TheestimatedincidenceofEMS(emergencymedicalservices)-treatedout-of-hospitalcardiacarrestintheChinaisabout35to40/100000persons/year.3Why?DespiteimportantadvancesWhy?StudieshaveshowntheimportanceofimmediateCPRfollowedbydefibrillationwithin3-5minutesofsuddenVF(VentricularFibrillation)cardiacarrestimprovesurvival.

?IncitiessuchasSeattlewhereCPRtrainingiswidespreadanddefibrillationbyEMSpersonnelfollowsquickly,thesurvivalrateisabout30%.

?IncitessuchasNewYork,withoutthoseadvantages,thesurvivalrateisonly1-2%.4Why?StudieshaveshowntheimpWhy?Therearemanylivesandlife-yearslostbecauseappropriateresuscitationisnotattempted.MostofthepublicknowlittleaboutthedetailsofCPR.5Why?TherearemanylivesandWhen?●Cardiacarrest●Notbreathingornotmakingsufficientrespiratoryeffortontheirown6When?●Cardiacarrest6How?

●C(Circulation)●A(Airway)

●

B(Breathing)

--2010AmericanHeartAssociationGuidelinesforCardiopulmonaryResuscitationandEmergencyCardiovascularCare7How?●C(CirculationCirculation:RestorebloodcirculationwithchestcompressionsCheckthesafetyoftheentironmentPutthepersononhis/herbackonafirmsurface.Kneelnexttotheperson’sneckandshoulders.8Circulation:RestorebloodciCirculation:Restorebloodcirculationwithchestcompressions4.Checkthepulseandbreathat5-10seconds(count1001.1002…..1007)Usetheindexandmiddlefingerstocheckthepulseofcarotidatery(themiddleofanterioredgesernocleidomastoid)9Circulation:RestorebloodciAirway:CleartheairwayPutyourfaceneartheperson’smouthandlookforthechestmotionatthesametime(

Lookforchestmotion

Listenfornormalbreathsounds

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

10Airway:Cleartheairway10Circulation:Restorebloodcirculationwithchestcompressions6.Placetheheelofonehandoverthecenteroftheperson’schest,betweenthenipples.Placeyourotherhandontopofthefiesthand.Keepyourelbowsstraightandpositionyourshouldersdirectlyaboveyourhands.11Circulation:RestorebloodciCirculation:Restorebloodcirculationwithchestcompressions7.StartCPR:Useyourupperbodyweightsasyoupushstraightdownonthechestatadepthofatleast5-6cm.Pushhardatarateofabout100-120compressionsaminute.12Circulation:RestorebloodciAirway:CleartheairwayOpentheperson’sairway.

●Putyourpalmontheperson’sforeheadandgentlytilttheheadback.

●Withtheotherhand,gentlyliftthechinforwardtoopentheairway.

13Airway:CleartheairwayOpeBreathing:Breathfortheperson

●mouth-to-mouthbreathing

●mouth-to-nosebreathingifthemouthisseriouslyinjuredorcan’tbeopend.

●mouth-to-maskbreathing

●whenoutsidehospitalyoumaynotgiveartificialbreathingifyoudon’twant.

14Breathing:BreathfortheperBreathing:BreathforthepersonWiththeairwayopen,pinchthenostrilsshutformouth-to-mouth(mouth-to-mask)breathingandcovertheperson’smouthwithyours,makingaseal.(makesurethereisnoleakage)15Breathing:BreathfortheperBreathing:BreathforthepersonThirtychestcompressionsfollowedbytworescuebreathsisconsideredonecycle.(1or2rescuer)Checkthecaroidpulseandchestmotionevery5cyclesContinueCPRuntiltherearesignsofmovementoremergencymedicalpersonneltakeover.=30:2:16Breathing:BreathfortheperBreathing:BreathforthepersonIfanadultvictimwithspontaneouscirculation,giverescuebreathsatarateofabout1breathevery5to6seconds,orabout10to12breathsperminute17Breathing:BreathfortheperAEDCheckthythm:ifshockablegive1shock,andimmediatelystartCPR.whennotshockable,immediatelystartCPR2.Checkthythmevery5cycles,continueCPRuntilthepatienthassignsofcirculation.18AEDCheckthythm:ifshockableDefibrillationVentricularfibrillationiscommoninadultsnon-traumaticcardiacarrest.2.Earlierdefibrillationidimportantforsurvival.3.Thechanceforsurvivaldecline7-10%everyminutelaspe.4.Bedefibrillatedattheearliestpossiblemoment.19DefibrillationVentricularfibPointsforattention?Ensuringchestcompressionsofadequaterate?Ensuringchestcompressionsofadequatedepth?Allowingfullchestrecoilbetweencompressions?Minimizinginterruptionsinchestcompressions?Avoidingexcessiveventilation20Pointsforattention?EnsurinRemember:

●Timeislife!

●EarlyCPRcanimprovesurvival.21Remember:21Survivalchain(fivesteps)Inhospital(prevention-ERS-CPR-defrillation-ALS)Outsideofhospital(ERS-CPR-defrillation-BLS-ALS)22Survivalchain(fivesteps)22Thankyou!23Thankyou!23Cardio

Pulmonary

Resuscitation心肺復蘇術(CPR)RespiratorydepartmentXiyanwang(王西艷)24

Cardio

Pulmonary

ResuscitationWhyshouldwelearntheCPR?25WhyshouldwelearntheCPR?2Why?Despiteimportantadvancesinprevention,cardiacarrestremainsasubstantialpublichealthproblemandaleadingcauseofdeathinmanypartsoftheworld.TheestimatedincidenceofEMS(emergencymedicalservices)-treatedout-of-hospitalcardiacarrestintheChinaisabout35to40/100000persons/year.26Why?DespiteimportantadvancesWhy?StudieshaveshowntheimportanceofimmediateCPRfollowedbydefibrillationwithin3-5minutesofsuddenVF(VentricularFibrillation)cardiacarrestimprovesurvival.

?IncitiessuchasSeattlewhereCPRtrainingiswidespreadanddefibrillationbyEMSpersonnelfollowsquickly,thesurvivalrateisabout30%.

?IncitessuchasNewYork,withoutthoseadvantages,thesurvivalrateisonly1-2%.27Why?StudieshaveshowntheimpWhy?Therearemanylivesandlife-yearslostbecauseappropriateresuscitationisnotattempted.MostofthepublicknowlittleaboutthedetailsofCPR.28Why?TherearemanylivesandWhen?●Cardiacarrest●Notbreathingornotmakingsufficientrespiratoryeffortontheirown29When?●Cardiacarrest6How?

●C(Circulation)●A(Airway)

●

B(Breathing)

--2010AmericanHeartAssociationGuidelinesforCardiopulmonaryResuscitationandEmergencyCardiovascularCare30How?●C(CirculationCirculation:RestorebloodcirculationwithchestcompressionsCheckthesafetyoftheentironmentPutthepersononhis/herbackonafirmsurface.Kneelnexttotheperson’sneckandshoulders.31Circulation:RestorebloodciCirculation:Restorebloodcirculationwithchestcompressions4.Checkthepulseandbreathat5-10seconds(count1001.1002…..1007)Usetheindexandmiddlefingerstocheckthepulseofcarotidatery(themiddleofanterioredgesernocleidomastoid)32Circulation:RestorebloodciAirway:CleartheairwayPutyourfaceneartheperson’smouthandlookforthechestmotionatthesametime(

Lookforchestmotion

Listenfornormalbreathsounds

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

33Airway:Cleartheairway10Circulation:Restorebloodcirculationwithchestcompressions6.Placetheheelofonehandoverthecenteroftheperson’schest,betweenthenipples.Placeyourotherhandontopofthefiesthand.Keepyourelbowsstraightandpositionyourshouldersdirectlyaboveyourhands.34Circulation:RestorebloodciCirculation:Restorebloodcirculationwithchestcompressions7.StartCPR:Useyourupperbodyweightsasyoupushstraightdownonthechestatadepthofatleast5-6cm.Pushhardatarateofabout100-120compressionsaminute.35Circulation:RestorebloodciAirway:CleartheairwayOpentheperson’sairway.

●Putyourpalmontheperson’sforeheadandgentlytilttheheadback.

●Withtheotherhand,gentlyliftthechinforwardtoopentheairway.

36Airway:CleartheairwayOpeBreathing:Breathfortheperson

●mouth-to-mouthbreathing

●mouth-to-nosebreathingifthemouthisseriouslyinjuredorcan’tbeopend.

●mouth-to-maskbreathing

●whenoutsidehospitalyoumaynotgiveartificialbreathingifyoudon’twant.

37Breathing:BreathfortheperBreathing:BreathforthepersonWiththeairwayopen,pinchthenostrilsshutformouth-to-mouth(mouth-to-mask)breathingandcovertheperson’smouthwithyours,makingaseal.(makesurethereisnoleakage)38Breathing:BreathfortheperBreathing:BreathforthepersonThirtychestcompressionsfollowedbytworescuebreathsisconsideredonecycle.(1or2rescuer)Checkthecaroidpulseandchestmotionevery5cyclesContinueCPRuntiltherearesignsofmovementoremergencymedicalpersonneltakeover.=30:2:39Breathing:BreathfortheperBreathing:BreathforthepersonIfanadultvictimwithspontaneouscirculation,giverescuebreathsatarateofabout1breathevery5to6seconds,orabout10to12b