心肺復(fù)蘇.英文班精選文檔

1、master the methods of early recovery 1familiar with the late recovery and recovery treatment summary resuscitation： all the measures taken to save lives 。 cardiopulmonary resuscitation,cpr： for respiratory and circulatory arrest taking emergency measures, including artificial respiration and cardiac

2、 massage. cardiopulmonary cerebral resuscitation,cpcr： the brain function recovery, the whole process of reversal of clinical death cpcr key factor to success ： early recovery started 4 minutes later, the late recovery started within 8 minutes the steps of cpcr three stepsa: recognition b:airwayc:br

3、eathingd:circulation a: ensure airway unobstructedb: oxygenc: assessment of vital signsd: differential diagnosisa: artificial airway b: evaluation of the adequacy of ventilationc: establish vein channel, use intravenous drug d: to find the causebasic life support main task:（ rapid and effective） res

4、toring blood perfusion and oxygen supply) abc: a. keep the airway unobstructed b .effective artificial respiration c .effective artificial cycle artificial respiration and cardiac massage is the main measures of early recovery.the artificial respiration: recognition of breathing (listen to the air,

5、look at the chest) the relief of airway obstruction (clear secretions) the artificial respiration (manual, instrument method)determine spontaneous breathing methods: keep ear close to the mouth and nose eyes observe thoracic uplift or not at the same time listen to breath sounds time is not more tha

6、n 5 seconds make patients lie on your back on the solid flat (ground) keep respiratory tract unobstructed, removal and keep head position properly 仰頭抬頸法 仰頭舉頦法 抬舉下頜法b:breathing mouth to mouth / nose breathing (the most suitable for on-site resuscitation) simple mask respirator tracheal intubationmout

7、h-to-mouth resuscitation method : start 3 4 times in a row, after blowing once every five seconds. take a deep breath every time . the patient can be exhaled gas himself. notice ： avoiding excessive ventilation and decreasing cardiac output inspiratory time should be greater than 1 seconds tidal vol

8、ume 500 600ml frequency: adult 10 12 times /min children 18-20 /min infants with 30-40 /min start ventilation frequency: 2 consecutive or 5 times thoracic raised as a symbol of effective artificial respiration cardiac compression is a method trough indirect or direct cardiac massage to form a tempor

9、ary artificial cycle.cardiac compression definition type asystoleventricular fibrillationelectromechanical dissociation the cause primary: coronary ischemia, electric shocks, anesthetic overdose, visceral traction, high potassium secondary: alveolar hypoxia, airway obstruction, acute massive blood l

10、oss. diagnosis mind suddenly lose, call for no response; no artery pulse, blood pressure measurement is less than, cant hear heart sounds; no spontaneous breathing a) corectasisfour “no”：consciousnessrespirationheart soundsarterial pulseasystoleventricular fibrillation心肌纖維快速不規(guī)則顫動(dòng)心肌纖維快速不規(guī)則顫動(dòng)(不同步快速收縮不

11、同步快速收縮)ecg: qrs波群消失，代波群消失，代之以振幅與頻率極不規(guī)則之以振幅與頻率極不規(guī)則的顫動(dòng)波，頻率的顫動(dòng)波，頻率200500次次/分分electromechanical dissociation, emd 緩慢無效的心室自主節(jié)律 ，qrs波群寬而畸形，低振幅，2030次/分以下2.cardiac compression1) rapid diagnosis of cardiac arrest2) chest compression: note:lying in the plane r:c: 2:30, children 2:15 p/r（time） 1:1(2) operation

12、 method:胸外心臟按壓胸外心臟按壓 artificial circulationmechanism: press sternal lower 1/3 increase intrathoracic pressure (thoracic pump) or direct compression of the heart (heart), the blood flow to the lungs and other organs effective indication:touch pulse, the pupil becomes smallgradually, red lip, autonomo

13、us respiration position: lie on your back on the solid flat (ground) .the head is not higher than the heart the press position: the finger to touch the costal margin, move toward the midline, into the ribs and sternum.up to 4cm (two fingers) 4）open chest compression,occ indications: the longer time

14、of cardiac arrest or ecc is not valid for more than 10 minutes. the existence of intrathoracic conditions, such as bleeding, pericardial tamponade, tension pneumothorax. the thoracic or spinal deformity with heart displacement the multiple external defibrillation is invalid forvf or vt cardiac arres

15、t occurred in operation, especially to open chest surgery advantage. provide near normal mbf (myocardial blood flow) and cbf (cerebral blood flow,) is beneficial to the recovery of spontaneous circulation and protection of brain disadvantages: high technology and conditions, there is the possibility

16、 of infectionopen chest compression,occ methods: open the chest, direct compression of the heart by hand 80 times frequency characteristic. 1 myocardial blood flow and brain blood flow increased 2 animal experiments that can improve survival rate 3 be in hospital, arrest 25 is invalid severe chest t

17、rauma, thoracic deformity,pericardial tamponade should open chest compressions（二）（二）advanced life support,als 1 the management of respiratory tract with spontaneous breathing: mouth airway (nose) no autonomous respiration: tracheal intubation or incision of trachea 2 monitoring ecg, bp (the best rec

18、ord), blood gas analysis (pao2 60mmhg ;paco2 36 40mmhg), urine volume, specific gravity, cvp. 3 drug treatment objective: to stimulate the recovery of heart beat and enhance myocardial contractility, prevention and treatment of arrhythmia, adjust the acidbase imbalance, fluid and electrolyte replace

19、ment.medication objective: excitation of cardiac autonomic rhythms and enhance myocardial contractility, prevention and treatment of arrhythmia, adjust the acidbase imbalance, fluid and electrolyte replacement, when recovery the medication must be quickly and accurately. injection way: the intraveno

20、us injection (preferred); intratracheal injection (injection be diluted to10ml); the intracardiac injection (complicationscommonly used drugs1） catecholamine and adrenergicep（epinephrine）: first choicedose ：0.51mg once ，或0.01 0.02mg/kg repeated every 5 minutesne： a significant increase in mbf.cbf th

21、e incidence of arrhythmia is higher after defibrillation isopropyl epinephrine and dobutamine mainly excite receptor, mbf does not increase after the selection 2) sodium bicarbonate according to the results of blood gas analysis , correct acute acidosis when the base excess (seb) above -10mmol/l, ap

22、plication of sodium bicarbonatesodium bicarbonate(mmol/l)sbe weight （kg）46. fluid therapy in the process of cpr low blood volume is not conducive to the recovery and autonomous rhythm stability, reduces the sensitivity of vasoactive drugs.expansion of crystal fluid, the appropriate colloid, generall

23、y without blood transfusion.the cvp is maintained at 10 15 mmhg. 4. ventricular fibrillation and defibrillation defibrillation time: vf/vt sudden, defibrillation within 30 seconds of other should be cpr at least 2 minutes (give epinephrine pre-) method： external defibrillation adult: 360 j; children

24、 with 2-4j/kg thoracic defibrillation adult 20 80j;5 50j children indications: vf/vt electrical cardioversion; the medication invalid （supraventricular ）(50j) ventricular heartbeat tachycardia (50j) atrial flutter (25j)external defibrillation左側(cè)第五肋間腋前線左側(cè)第五肋間腋前線胸骨右緣第二肋間胸骨右緣第二肋間5. heart pacemaker （restoration of spontaneous rhythm, but must rely onisoproterenol to maintain normal heart rate）（三）（三）post-resuscitation treatment,prt prolonged life support,pls objective: prevention and treatment of multiple organ failure and hypoxic brain injury maintain good respi