【正文】 lmonary resuscitation (CPR) CPR is a bination of rescue breathing and chest pressions delivered to victims thought to be in cardiac arrest. When cardiac arrest occurs, the heart stops pumping blood. CPR can support a small amount of blood flow to the heart and brain to “buy time” until normal heart function is restored.. 16 Treatment of cardiac arrest CPR ? Basic life support (CPR) ? A: Airway ? B: Breathing ? C: Circulation ? D: defibrilation 17 Basic Life Support —Airway ? 1. Clear the airway Quick inspection of the mouth and throat may reveal a blocked airway. the patient should be placed on his/her back on a firm surface. tilting the head, lifting the chin will lift the tongue away from the back of the mouth, opening the airway. ? In the possibility of a neck injury, lifting the chin or jaw may be enough to stabilise the airway。 ? If foreign body is lodged in the oropharynx, the Heimlich maneuver is performed. 18 BLSairway 19 Basic Life Support —breathing ? Proper check of the patient39。s respiration : After opening the victim‘ s airway, breathing effort is checked, detecting any of the following signs: ? feeling the airflow on the cheek ? hearing the airflow ? feeling the chest rise and fall ? seeing the chest rise and fall 20 Basic Life Support —breathing ? This is done for 10 seconds. ? If the victim is breathing, he/she is placed on the side (in the recovery position). More time is now available to call for help. ? If the victim is absence of breathing effort, artificial respiration is menced. mouthtomouth respiration may be used. 21 Basic Life Support —breathing ? mouthtomouth respiration The head of the patient is tilted backward. The rescuer closes the patient39。s nose with one hand, while lifting the chin with her other hand to keep the mouth open.. ? Initially, two rescue breaths are given. Conventional ventilation techniques during singleresponder CPR require the lungs to be inflated twice in succession every 30 chest pressions. 22 Bag –mask ventilator 23 Mechanical ventilation A definitive airway will be established by the placement of an endotracheal tube which is attached to a mechanical ventilation. 24 Basic Life Support —circulation ? To check for a pulse place your fingers on the victim‘ s neck and slide them to the side until you find a groove in the neck above the carotid artery. Check for pulse for no more than ten seconds. ? Pulse can also be found in the wrists and the ankles, although in an emergency situation there is not usually time to check for pulse here. (In patients with a low blood pressure, the pulse may disappear in the wrists and ankles, and can only be felt in the neck or femoral arteries.) On infants it can be found on the inside of the upper arm. 25 Basic Life Support —circulation ? If there is no circulation: Begin chest pressions ? Chest pression is based on the assumption that cardiac pression allows the heart to maintain a pump function by sequential filling and emptying of its chambers, with petent valves maintaining forward direction of flow. The palm of one hand is placed ? Send a bystander to call for help using the emergency telephone number. 26 ? In some places, including the UK and the United States, some experts no longer advise laypersons to assess the carotid pulse because it wastes time and studies have shown it leads to an incorrect conclusion in up to 50% of cases. Instead they remend looking for other visible signs of circulation. Health professionals are still advised to perform a carotid pulse check, taking no more than 10 seconds, whilst also checking the other signs of a circulation. 27 Begin chest pressions ? Place the victim on their back on a firm surface. (a soft surface will render the pression pletely useless). ? Kneel next to the victim39。s chest. ? Remove, open or cut the patient‘ s excess clothes. (doing CPR through a thin clothing is acceptable). ? Place your hands directly above the sternum, one on top of the other, two fingers‘ width (45cm) above the point where the lower ribs meet. To avoid injuring ribs, only the heel of your hand should touch the chest. (The American Heart Association suggests using the CPR landmark described as, in the center of the chest, between the nipples.) ? Shift your weight forward on your knees until your shoulders are directly over your hands. 28 Begin chest pressions: ? Keeping your elbows locked straight, repeatedly bear down and then e up, bear down and e up. You must depress the chest of an average adult about 2 inches (45cm) with each pression. It is important to release pletely after each chest pression. ? Compress the chest about 100 times every minute. To get the right speed and rhythm, count out loud as you do the pressions, saying 1, 2, 3, 4, 5, 1, 2, 3, 4, 5, 1, 2, 3, 4, 5. Try to press and release for equal periods of time. ? After each 30 pressions, give the victim 2 rescue breaths, p182 ? Return to the victim39。s chest and put your hands in the