Cardiopulmonary resuscitationWord文档下载推荐.docx
- 文档编号:17631267
- 上传时间:2022-12-07
- 格式:DOCX
- 页数:11
- 大小:73.43KB
Cardiopulmonary resuscitationWord文档下载推荐.docx
《Cardiopulmonary resuscitationWord文档下载推荐.docx》由会员分享,可在线阅读,更多相关《Cardiopulmonary resuscitationWord文档下载推荐.docx(11页珍藏版)》请在冰豆网上搜索。
guidelines,CPRinvolveschestcompressionsatleast5
cm(2
in)deepandatarateofatleast100perminuteinanefforttocreateartificialcirculationbymanuallypumpingbloodthroughtheheartandthusthebody.Therescuermayalsoprovidebreathsbyeitherexhalingintothesubject'
smouthornoseorusingadevicethatpushesairintothesubject'
slungs.Thisprocessofexternallyprovidingventilationistermed
artificialrespiration.Currentrecommendationsplaceemphasisonhigh-qualitychestcompressionsoverartificialrespiration;
asimplifiedCPRmethodinvolvingchestcompressionsonlyisrecommendedforuntrainedrescuers.
CPRaloneisunlikelytorestarttheheart.Itsmainpurposeistorestorepartialflowofoxygenatedbloodtothe
brainand
heart.Theobjectiveistodelay
tissuedeath
andtoextendthebriefwindowofopportunityforasuccessfulresuscitationwithoutpermanent
braindamage.Administrationofanelectricshocktothesubject'
sheart,termeddefibrillation,isusuallyneededinordertorestoreaviableor"
perfusing"
heartrhythm.Defibrillationiseffectiveonlyforcertainheartrhythms,namely
ventricularfibrillation
or
pulselessventriculartachycardia,ratherthanasystole
pulselesselectricalactivity.CPRmaysucceedininducingaheartrhythmthatmaybeshockable.Ingeneral,CPRiscontinueduntilthepatienthasa
returnofspontaneouscirculation
(ROSC)orisdeclared
dead.
Contents
[hide]
∙1
Medicaluses
∙2
Methods
o2.1
Standard
o2.2
Compressiononly
o2.3
ProneCPR
o2.4
Pregnancy
o2.5
Other
∙3
Effectiveness
∙4
Pathophysiology
∙5
Complications
∙6
Adjunctdevices
o6.1
Timingdevices
o6.2
Manualassistdevices
o6.3
Automaticdevices
o6.4
Mobileapps
∙7
Prevalence
o7.1
ChanceofreceivingCPR
o7.2
ChanceofreceivingCPRintime
∙8
Societyandculture
o8.1
Portrayedeffectiveness
o8.2
StageCPR
o8.3
Self-CPRhoax
o8.4
CPRlearnedfrommoviesandtelevision
o8.5
Hands-OnlyCPRportrayedasmorepalatableversion
∙9
History
∙10
AdministeringCPRtoanimals
∙11
Seealso
∙12
References
∙13
Externallinks
Medicaluses[edit]
CPRisindicatedforanypersonunresponsivewithnobreathingorbreathingonlyinoccasional
agonal
gasps,asitismostlikelythattheyarein
cardiacarrest.[1]:
S643
Ifapersonstillhasa
pulse
butisnotbreathing(respiratoryarrest)
artificialrespirations
maybemoreappropriate,but,duetothedifficultypeoplehaveinaccuratelyassessingthepresenceorabsenceofapulse,CPRguidelinesrecommendthatlaypersonsshouldnotbeinstructedtocheckthepulse,whilegivinghealthcareprofessionalstheoptiontocheckapulse.[2]
Inthosewithcardiacarrestdueto
trauma
CPRisconsideredfutilebutstillrecommended.[3]
Correctingtheunderlyingcausesuchasa
pneumothorax
pericardialtamponade
mayhelp.[3]
Methods[edit]
CPRtechniqueasdemonstratedonadummy.
CPRtraining:
CPRisbeingadministeredwhileasecondrescuerpreparesfor
defibrillation.
In2010,the
AmericanHeartAssociation
and
updatedtheirCPRguidelines.[1]:
S640[4]
TheimportanceofhighqualityCPR(sufficientrateanddepthwithoutexcessivelyventilating)wasemphasized.[1]:
S640
Theorderofinterventionswaschangedforallagegroupsexcept
newborns
from
airway,breathing,chestcompressions(ABC)
tochestcompressions,airway,breathing(CAB).[1]:
S642
Anexceptiontothisrecommendationisforthosebelievedtobeina
respiratoryarrest
(drowning,etc.).[1]:
ThemostimportantaspectofCPRare:
fewinterruptionsofchestcompressions,asufficientspeedanddepthofcompressions,completelyrelaxingpressurebetweencompressions,andnotventilatingtoomuch.[5]
Standard[edit]
Auniversalcompressiontoventilationratioof30:
2isrecommendedbytheAHA.[6]:
8
Withchildren,ifatleast2trainedrescuersarepresentaratioof15:
2ispreferred.[6]:
Innewbornsarateof3:
1isrecommendedunlessacardiaccauseisknowninwhichcasea15:
2ratioisreasonable.[1]:
S647
Ifanadvancedairwaysuchasan
endotrachealtube
laryngealmaskairway
isinplace,artificialventilationshouldoccurwithoutpausesincompressionsatarateof8–10perminute.[7]
Therecommendedorderofinterventionsischestcompressions,airway,breathingorCABinmostsituations,[1]:
withacompressionrateofatleast100perminuteinallgroups.[6]:
Recommendedcompressiondepthinadultsandchildrenisatleast5
inches)andininfantsitis4centimetres(1.6
in).[6]:
Asof2010the
ResuscitationCouncil(UK)
stillrecommendsABCforchildren.[8]
Asitcanbedifficulttodeterminethepresenceorabsenceofapulse,thepulsecheckhasbeenremovedforlayprovidersandshouldnotbeperformedformorethan10secondsbyhealthcareproviders.[6]:
Inadults,rescuersshouldusetwohandsforthechestcompressions,whileinchildrentheyshoulduseone,andwithinfantstwofingers(indexandmiddlefingers).[9]
Compressiononly[edit]
Compression-only(hands-onlyorcardiocerebralresuscitation)CPRisatechniquethatinvolveschestcompressionswithout
artificialrespiration.[1]:
Itisrecommendedasthemethodofchoicefortheuntrainedrescuerorthosewhoarenotproficientbecauseitiseasiertoperformandinstructionsareeasiertogiveoveraphone.[1]:
S643[6]:
8[10]
Inadultswithout-of-hospital
cardiacarrest,compression-onlyCPRbythelaypublichasahighersuccessratethanstandardCPR.[10]
Theexceptionsarecasesof
drownings,
drugoverdose
andarrestinchildren.Childrenwhoreceivecompression-onlyCPRhavethesameoutcomesasthosehavingreceivednoCPR.[1]:
S646
Themethodofdeliveringchestcompressionsremainsthesame,asdoestherate(atleast100perminute).Itishopedthattheuseofcompression-onlydeliverywillincreasethechancesofthelaypublicdeliveringCPR.[11]
Asperthe
AmericanHeartAssociation,thebeatofthe
BeeGeessong"
Stayin'
Alive"
providesanidealrhythmintermsofbeatsperminutetouseforhands-onlyCPR.[12]
Onecanalsohum
Queen'
s"
AnotherOneBitesTheDust"
whichisexactly100beats-per-minuteandcontainsamemorablerepeatingdrumpattern.[13]
Forthosewithnoncardiacarrestandpeoplelessthan20yearsofage,standardCPRissuperiortocompression-onlyCPR.[14][15]
ProneCPR[edit]
Simultaneousmaintenanceofbloodcirculationandventilationcanbeobtainedbycompressingthebackifthevictimisinproneposition,byturningtheheadtothesideandcompressingtheback.Duetothehead'
sbeingturned,theriskofvomitingandcomplicationscausedby
aspirationpneumonia
issignificantlyreduced,andthemethodmeansthepatientcontinuestogetairintotheirlungswithouttheneedformouth-to-mouthrespiration.[16]
Pregnancy[edit]
During
pregnancy
whenawomanislyingonherback,the
uterus
maycompressthe
inferiorvenacava
andthusdecreasevenousreturn.[3]
Itisthereforerecommendedthattheuterusbepushedtothewoman'
sleft;
ifthisisnoteffective,eitherrollthewoman30°
orhealthcareprofessionalsshouldconsideremergency
Caesareansection.[3]
Other[edit]
Interposedabdominalcompressionsmaybebeneficialinthehospitalenvironment.[17]
Thereisnoevidenceofbenefitpre-hospitalorinchildren.[17]
Internalcardiacmassageismanualsqueezingoftheexposedheartitselfcarriedoutthroughasurgical
incision
intothe
chestcavity,usuallywhenthechestisalreadyopenforcardiacsurgery.
Effectiveness[edit]
TypeofArrest
ROSC
Survival
Source
WitnessedIn-HospitalCardiacArrest
52%
19%
[18]
UnwitnessedIn-HospitalCardiacArrest
33%
8%
Out-of-HospitalCardiacArrestOverall
59%
10%
[19]
UnwitnessedOut-of-HospitalCardiacArrest
21%
4%
WitnessedOut-of-HospitalCardiacArrest
41%
15%
Witnessedand"
Shockable"
withBystanderCPR
53%
37%
BystanderCompression-only
Resuscitation
-
13%
[20]
BystanderConventionalCPR
CPRservesasthefoundationofsuccessfulcardiopulmonaryresuscitation,preservingthebodyfor
defibrillation
advancedlifesupport.Eveninthecaseofa"
non-shockable"
rhythm,suchas
PulselessElectricalActivity
(PEA)wheredefibrillationisnotindicated,effectiveCPRisnolessimportant.Usedalone,CPRwillresultinfewcompleterecoveries,thoughtheoutcomewithoutCPRisalmostuniformlyfatal.[21]
StudieshaveshownthatimmediateCPRfollowedbydefibrillationwithin3–5minutesofsudden
VF
cardiacarrestdramaticallyimprovessurvival.IncitiessuchasSeattlewhereCPRtrainingiswidespreadanddefibrillationbyEMSpersonnelfollowsquickly,thesurvivalrateisabout20percentforallcausesandashighas57percentifawitnessed"
shockable"
arrest.[22]
IncitiessuchasNewYork,withoutthoseadvantages,thesurvivalrateisonly5percentforwitnessedshockablearrest.[23]
Compression-onlyCPRmaybelesseffectiveinchildrenthaninadults,ascardiacarrestinchildrenismorelikelytohavea
non-c
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- Cardiopulmonary resuscitation