【正文】 腺素 、 利多卡因 、 糾酸；心電圖機(jī) 、 治療多種心律紊亂；除顫器 、 起搏器 持續(xù)生命支持 Prolonged LifeSupport G診斷 (Gauge) H低溫 (Hypothermia) I加強(qiáng)治療 (ICU) 胸內(nèi)心臟按壓 ， 止血和治療頭部原因 。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 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。 call 120. 12 Common causes of cardiac arrest PRIMARY: Sudden cessation of heart function Myocardial ischemia Electric shock Drugs,. potassium Secondary Asphyxia,hypoxia,hypercarbia Exanguination Central nervous system failure Metabolic/electrolyte disorders Temperature extremes Toxins Acute anaphylaxis 13 Treatment of cardiac arrest ? Basic Life Support (CPR) Continous of effective Basic Life Support remains important to maintain vital an perfusion assure circulation of lifesaving drugs ? Advanced life support: treats cardiac arrest definitively with drugs, fluids, DC countershock or artificial pacemaker when appropriate 14 Treatment Chain of Survival ? Outof –hospital arrest,several anization promote the idea of “Chain of survival” ? Early recognition/access ? Early CPR ? Early defibrillation ? Early advanced care 及早進(jìn)入急救程序 及早 CPR 及早電除顫 及早進(jìn)一步治療 15 What is CPR? ? Cardiopulmonary 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。 「 C」 =Circulation 人工循環(huán) . 高級(jí)生命支持 （ Advanced Cardiac Life Support,ACLS） 3 BACKGROUND ? Approximately 700,000 cardiac arrests per year in Europe ? Survival to hospital discharge presently approximately 510% ? Bystander CPR vital intervention before arrival of emergency services ? Early resuscitation and prompt defibrillation (within 12 minutes) can result in 60% survival 4 What is Cardiac arrest? ? Cardiac arrest is the cessation of normal circulation of the blood due to failure of the heart to contract effectively during systole. ? if the patient still has a pulse, respiratory arrest (the bined term cardiorespiratory arrest) is also used. ? lack of blood supply results in cell death from oxygen starvation. ? Cerebral hypoxia, or lack of oxygen supply to the brain, causes victims to lose consciousness and stop breathing. ? Cardiac arrest is a medical emergency that, if left untreated, invariably leads to death within seconds to minutes. ? The primary firstaid treatment for cardiac arrest is cardiopulmonary resuscitation. 5 Etiology ? Coronary artery disease (CAD) is the predominant disease process associated with sudden cardiac death in the United Sta