2010心肺复苏和心血管急救指南CPR2010培训资料.ppt

——更新与亮点;版本：2010AHA心肺复苏和心血管急救指南为基础，参考2010ERC心肺复苏指南 发布时间：相差两天——竞争无处不在 ;;基本生命支持部分的改变 高级生命支持中药物使用的改变 低温治疗 复苏后综合征的处理 生存链的变化*;;● Lay rescuers begin CPR if the adult victim is unresponsive and not breathing normally (ignoring occasional gasps) without assessing the victim’s pulse. ● Following initial assessment, rescuers begin CPR with chest compressions rather than opening the airway and delivering rescue breathing. ● All rescuers, trained or not, should provide chest compressions to victims of cardiac arrest. A strong emphasis on delivering high-quality chest compressions remains essential: push hard to a depth of at least 2 inches (5 cm) at a rate of at least 100 compressions per minute, allow full chest recoil after each compression, and minimize interruptions in chest compressions. ● Trained rescuers should also provide ventilations with a compression-ventilation ratio of 30:2. ● EMS dispatchers should provide telephone instruction in chest compression-only CPR for untrained rescuers.;病人无反应 无正常呼吸;按压优先于通气;BLS——compression（按压）;BLS——compression（按压）;BLS——compression（按压）;高质量的胸外按压：4点 用力按压：深度——至少5cm（2005年指南4-5cm） 快速按压：频率——至少100次/分*(ERC2010 100-120bpm) 两个 at least 完全回复：每一次按压后必须让胸廓完全复位 尽可能减少按压中断;BLS——opening the airway;BLS—判断呼吸*;;要不要先清除口腔内异物？;BLS—Rescue breathing;ERC2010：持续1秒，给足够的潮气量使患者胸廓抬起，要避免过快和用力吹气。无论口对口呼吸还是面罩通气，通气时有无给氧均如此。连续2次呼吸时间不超过5秒;按压：通气比 成人：30:2 儿童院外复苏、非专业人员复苏：30:2，专业人员复苏：15:2 ;具体情况具体分析： ;BLS—Compression-only;BLS—气道梗阻的处理;;对于双相除颤/电复律，自粘电极板与手持金属电极板一样安全有效 单相波电复律时，手持电极板更合适 电极板的size8cm 除颤器的选择：双相波比单相波更有效;能量的选择：双相截断指数波形：150-200焦耳，单相波：360焦耳;除颤：第二次及以后能量？;. Place the ?rst electrode pad in the mid-axillary line just below the armpit. Place the second electrode just below the right collarbone (clavicle).;除颤过后，立即按压;● The use of capnography to confirm and continually monitor tracheal tube placement and quality of cardiopulmonary resuscitation (CPR). ● More precise guidance on the control of glucose in adults with sustained return of spontaneous circulation. Blood gluco