复旦大学临床医学专业：《内科学》课程教学资源（课件讲义，双语版）心肺复苏（黄培志）

Cardiopulmonary Resuscitation Peizhi huang Zhongshan Hospital

Cardiopulmonary Resuscitation Peizhi Huang Zhongshan Hospital

Diagnosis of cardiac and respiratory arrest Raditional methods 1 Carotid pulse check by lay rescuers LoSS of consciousness 3.Pupil dilation 4. Respiratory arrest

Diagnosis of cardiac and respiratory arrest Traditional methods : 1. Carotid pulse check by lay rescuers 2. Loss of consciousness 3. Pupil dilation 4. Respiratory arrest

Guideline 2000 Elmination of the pulse check for lay rescuers Evaluate for signs of circulation in 10 seconds breathing s coughing movement in response to rescue breath

Guideline 2000 • Elimination of the pulse check for lay rescuers • Evaluate for signs of circulation in 10 seconds breathing , coughing , movement in response to rescue breath

Assess for a pulse Time is too longer Accurate rate 750 Sensibitity 90 Specificity 600

Assess for a pulse •Time is too longer •Accurate rate 75 % • Sensibitity 90% • Specificity 60%

Rate of false- positive(40%0)- Results Pulseless Pulse Mistakenly loss the saving opportunity

Rate of false- positive(40%) Results Pulseless Pulse Mistakenly loss the saving opportunity

Rate of false-negative(10 % Results Pulse Pulseless Unnecessarily do cPr

Rate of false-negative (10 %) Results Pulse Pulseless Unnecessarily do CPR

Electrocardiogram changes of Cardiac arrest VEntricular fibrillation A flat line or only atrial wave Pulseless Electrical Activity, PEa

Electrocardiogram changes of Cardiac arrest • Ventricular fibrillation • A flat line or only atrial wave • Pulseless Electrical Activity, PEA

The chain of survival Early access Early CPR Early Defibrillation Early advanced life support x patient with Coma immediately do CPr not clear obstructed airways at first)

The chain of Survival • Early access • Early CPR • Early Defibrillation • Early advanced life support * patient with Coma （ immediately do CPR ， not clear obstructed airways at first）

Basic life support the first ABCD o Airway Breathing B o Circulation C Defibrillation D

Basic Life Support --- the first ABCD • Airway A • Breathing B • Circulation C • Defibrillation D

△ Tray Tilt the head backwards o Liit the jaw Open the mouth Clearing obstructed airways from choking Subdiaphragmatic abdominal thrust (Heimlich maneuver)

Airway • Tilt the head backwards • Lift the jaw • Open the mouth • Clearing obstructed airways from choking • Subdiaphragmatic abdominal thrust (Heimlich maneuver)