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1、CardioPulmonaryResuscitation心肺复苏术(CPR)Respiratory departmentXiyan wang(王西艳)Why should we learn the CPR?Why?lDespite important advances in prevention, cardiac arrest remains a substantial public health problem and a leading cause of death in many parts of the world.lThe estimated incidence of EMS(eme
2、rgency medical services)-treated out-of-hospital cardiac arrest in the China is about 35 to 40/ 100 000 persons / year.Why?lStudies have shown the importance of immediate CPR followed by defibrillation within 3-5 minutes of sudden VF (Ventricular Fibrillation) cardiac arrest improve survival. In cit
3、ies such as Seattle where CPR training is widespread and defibrillation by EMS personnel follows quickly, the survival rate is about 30%. In cites such as New York, without those advantages, the survival rate is only 1-2%.Why?lThere are many lives and life-years lost because appropriate resuscitatio
4、n is not attempted.l Most of the public know little about the details of CPR. When? Cardiac arrest Not breathing or not making sufficient respiratory effort on their ownHow? C ( Circulation ) A ( Airway ) B ( Breathing ) - 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation
5、and Emergency Cardiovascular CareCirculation: Restore blood circulation with chest compressions1.Check the safety of the entironment2.Put the person on his/her back on a firm surface.3.Kneel next to the persons neck and shoulders.Circulation: Restore blood circulation with chest compressions4.Check
6、the pulse and breath at 5-10 seconds(count 1001.1002.1007)Use the index and middle fingers to check the pulse of carotid atery( the middle of anterior edge sernocleidomastoid)Airway: Airway: Clear the airwayClear the airwayPut your face near the persons mouth and look for the chest motion at the sam
7、e time ( Look for chest motion Listen for normal breath sounds Feel for the persons breath on your cheek and ear) If the person isnt breathing normally, begin artificial respiration. 5.Start the emergency response system,such as phone 120、catch AED（automatic external difibrillator）. Circulation: Res
8、tore blood circulation with chest compressions6. Place the heel of one hand over the center of the persons chest, between the nipples. Place your other hand on top of the fiest hand. Keep your elbows straight and position your shoulders directly above your hands.Circulation: Restore blood circulatio
9、n with chest compressions7.Start CPR:Use your upper body weights as you push straight down on the chest at a depth of at least 5-6 cm. Push hard at a rate of about 100 -120 compressions a minute.Airway: Airway: Clear the airwayClear the airway1.Open the persons airway. Put your palm on the persons f
10、orehead and gently tilt the head back. With the other hand, gently lift the chin forward to open the airway. Breathing: Breathing: Breath for the personBreath for the person mouth-to-mouth breathing mouth-to-nose breathing if the mouth is seriously injured or cant be opend. mouth-to-mask breathing w
11、hen out side hospital you may not give artificial breathing if you dont want. Breathing: Breathing: Breath for the personBreath for the person1.With the airway open, pinch the nostrils shut for mouth-to-mouth(mouth-to-mask) breathing and cover the persons mouth with yours, making a seal.(make sure t
12、here is no leakage)Breathing: Breathing: Breath for the personBreath for the person2.Thirty chest compressions followed by two rescue breaths is considered one cycle.(1 or 2 rescuer)3.Check the caroid pulse and chest motion every 5 cyclesContinue CPR until there are signs of movement or emergency me
13、dical personnel take over.= 30 : 2:Breathing: Breathing: Breath for the personBreath for the personIf an adult victim with spontaneous circulation , give rescue breaths at a rate of about 1breath every 5 to 6 seconds, or about 10 to 12 breaths per minuteAED AED 1.Check thythm:if shockable give 1 sho
14、ck,and immediately start CPR. when not shockable, immediately start CPR2.Check thythm every 5 cycles,continue CPR until the patient has signs of circulation.Defibrillation Defibrillation 1.Ventricular fibrillation is common in adults non-traumatic cardiac arrest.2. Earlier defibrillation id importan
15、t for survival.3. The chance for survival decline 7-10% every minute laspe.4. Be defibrillated at the earliest possible moment.Points for attention Points for attention Ensuring chest compressions of adequate rate Ensuring chest compressions of adequate depth Allowing full chest recoil between compr
16、essions Minimizing interruptions in chest compressions Avoiding excessive ventilationRemember: Time is life! Early CPR can improve survival.Survival chain(five steps)Survival chain(five steps)In hospital(prevention-ERS-CPR-defrillation-ALS)Outside of hospital (ERS-CPR-defrillation-BLS-ALS)Thank you !
