复旦大学附属中山医院：《内科学》课程教学资源（PPT讲稿）黄培志－心肺复苏 Cardiopulmonary Resuscitation

Cardiopulmonary Resuscitation Peizhi huang Zhongshan Hospital

Cardiopulmonary Resuscitation Peizhi Huang Zhongshan Hospital

Diagnosis of cardiac and respiratory arrest Traclitional 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 Elimination of the pulse check for lay rescuers o Evaluate for signs of circulation in 10 seconds breathing, 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 60

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

Rate of false-positive(40%o) Results Pulseless → Pulse Mista kenly loss the saving opportunity

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

Rate of false-negative(10%o) 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 A o Breathing B o Circulation C Defibrillation D

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

rway Crilt the head back wards Lift the iaw Open the mouth Clearing obstructed airways from choking o 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)