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1、Cardiopulmonary Resuscitation (CPR),教学大纲要求,掌握心跳骤停的诊断； 掌握基础生命支持的内容和方法； 掌握进一步生命支持的主要内容和方法； 熟悉导致心跳骤停的常见原因； 熟悉心脑后期生命支持的治疗原则；,Vital Organ Function,Oxygen Supply,Sufficient Oxygenated Blood,Sufficient Oxygen,Blood,Good circulation,Insufficient or cease of Oxygen supply,Vital organ ischemia or death,Hypoxi
2、a,Low CBV or Desaturation,Circulation problem,Ventilation,Airway,Hemorrhage or Hb abnormal,Cardiac Pump,hemodynamics,microcirculation,Definition of Cardiac Arrest -Clinical Death,Medical emergency with absent or inadequate contraction of the left ventricle of the heart that immediately causes bodywi
3、de circulatory failure. The signs and symptoms include loss of consciousness; rapid shallow breathing progressing to apnea (absence of breathing); profoundly low blood pressure (hypotension) with no pulses that can be felt over major arteries; and no heart sounds. Cardiac arrest is one of the greate
4、st of all medical emergencies. Within several minutes, there is lack of oxygen (tissue hypoxia), leading to multiple organ injury. Unless cardiac arrest is quickly corrected, it is fatal.,Ventilation,Airway,Hemorrhage or Hb abnormal,Cardiac Pump,Hemodynamics,microcirculation,Cardiac Arrest,Tissue Hy
5、poxia,Breathing,Brain ischemia,Ventilation,Airway,Hemorrhage or Hb abnormal,Hemodynamics,microcirculation,Cardiac Arrest,Heart,MI,arrhythmia,Heart failure,reflex,Summery of Mechanisms of CA,Reduction of Coronary Blood Flow Critical Cardiac Arrhythmia Absent of inadequate Contraction of the Left Vent
6、ricle Severe Reduction of Cardiac Return Volume,Cardiac Arrest,Brain ischemia,Signs of Cardiac Arrest,Unconscious,Dilated Pupils,No pulse,BP o/o,Cyanosis,No Breathing,No bleeding,No SPO2,无脉性室速,Pulseless,VT,室颤,VT,无脉性电活动,Pulseless,Electrical,Activity,心室停搏,Asystole,Pulseless,VT,VF,Pulseless,Electrical,
7、Activity,Asystole,ECG Patterns of Cardiac Arrest,Cardio-Pulmonary Resusitation,An emergency procedure in which the heart and lungs are made to work by manually compressing the chest overlying the heart and forcing air into the lungs. CPR is used to maintain circulation when the heart stops pumping,
8、usually because of disease, drugs, or trauma. An emergency procedure consisting of external cardiac massage and artificial respiration; the first treatment for a person who has collapsed and has no pulse and has stopped breathing; attempts to restore circulation of the blood and prevent death or bra
9、in damage due to lack of oxygen,The factors most related to poor outcome from cardiac arrest,long arrest time before CPR prolonged ventricular fibrillation without definitive therapy inadequate coronary and cerebral perfusion during cardiac massage. rapid application of closed chest compression and
10、early defibrillation,Early Access Early CPR Early Defibrillation Early Advanced Care,Chain of Survival for Adults,Chain of Survival for Children,Prevention of Arrest Early and Effective Bystander CPR Rapid Activation of the EMS Early Advanced Life Support,Basic Life Support (RABC),Objectives: to del
11、iver oxygenated blood to vital organs Response (consciousness) Airway Control Ventilation (Breathing) Chest Compression,Help! Help ! Help!,Initial steps of CPR,Unresponsive?,Open airway,Check breathing (10s),Breathing,Check Pulse (10s),Circulation present ?,EAR,yes,Chest compression,no,Shake and sho
12、ut,Head tilt/chin lift,Look, listen and feel,Two effective breaths,Signs of circulation,Check signs of circulation every 2min,Call for help and AED,Adult BLS Healthcare Provider Algorithm:. Boxes bordered with dotted lines indicate actions or steps performed by the healthcare provider but not the la
13、y rescuer.,BLS,BLS,Open Airway,Why open airway is important? CA may be caused by airway blockage Unconscious patients tend to have airway obstructed by posterior displacement of the tongue or epiglottis due to the decrease of muscle tone decreased tone of the genioglossus muscle (颏舌肌） in particular
14、It is essential to provide adequate respiration for victims (functional respiration),Normal airway vs Obstructed airway,How to Open Airway?,Tilt the head back- head tilt (dont do this if cervical spine injury is suspected) Lift the jaw-chin lift Jaw thrust (First Choice if cervical spine injury is s
15、uspected) Clear the airway (very important for infant),Open Airway,Jaw Thrust,Head Tilt-Chin Lift,Oropharyngeal Airways OPA,Nasopharyngeal Airways NPA,Breathing,Signs and symptoms of respiratory emergencies?,Breathing is :,Too fast or too slow Irregular Too shallow or too deep Noisy or rasping,Perso
16、n is :,Struggling or gasping for air Becoming tired from trying to breathe Semi-conscious Dizzy or anxiety Lips, ears and fingernails bluish Abnormal chest movement Air cannot be felt moving out of mouth or nose,In out-of-hospital or hospital ward settings, initial airway control and ventilation usually are accomplished by mouth-to-mouth or mouth-to-mask techniques. 10-12/min with pulse 8-10/min without pulse Vt=400-500ml in an adult (amount to produce visible chest lifting) A deliberate pause is incorporated after every 30th chest compression,
