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心肺复苏术(CPR)

(2012-11-14 20:50:05) 下一个

The ABCs of CPR (cardiopulmonary resuscitation)

For child and adult
      
Compressions with breaths:

1. Check for responsiveness by tap and shout.

2. If no response, ask call 911 or send for AED. If you are alone, call after 5 cycles/2min in child; call immediately in adult.

3. Check breathing: looking for chest fall and down, listening for breathing

4. Position: Hard flat surface with barrier device

5. Airway (open airway): head tilt (back) with hand on forehead, and chin lift with two fingers.


6. Breathing: Give 2 Slow Breaths

7. Circulation: (Moving, talking, breathing), Check Carotid Pulse

8. If circulation present but no breathing , only applies to HCP: Give Rescue Breaths; 

9.  If breathing present but victim unconscious with no signs of Spinal Cord Injury, Place in recovery position.

10. No breathing and Circulation: (Child)30 compressions and 2 breaths for one man; 15 compressions and 2 breaths for two men; (Adult)30:2 one man or two men (total five cycles).

11. Speed/Depth of Compressions: (Child)100 compressions/minute, 1/3 depth; (Adult) 100compressions/minute, 1.5-2 inches
     

Conscious Choking (if unconscious do CPR)
1.  Abdominal Thrust, No finger sweep
I2.  f unconscious, to do CPR

 Trauma
1. No head tilt, Use Jaw Thrust instead


For Infant (0-1 years)
     
Compressions with breaths:
1. Check for responsiveness by tapping bottom of foot.

2. If no response, ask call 911. If you are alone, call after 5 cycles/2min in child;

3. Position: Hard flat surface with barrier device

Airway (open airway): head tilt (back) with hand on forehead, and chin lift with two fingers. (Sniffing position)

5. Breathing: 2 Slow Puffs

6. Circulation: (Moving, talking, breathing), Check Brachial Pulse

7. If circulation present but no breathing , only applies to HCP: Give Rescue Breaths

8.  If breathing present but victim unconscious with no signs of Spinal Cord Injury, Place in recovery position.

9. No breathing and Circulation: 30 compressions and 2 breaths for one man; 15 compressions and 2 breaths for two men; (two fingers in the middle of heart slightly compression, just below the bone base line)

10. Speed/Depth of Compressions: 100 compressions/minute, 1/3 depth; 
     

Conscious Choking (if unconscious do CPR)
1. 5 back blows and 5 chest thrust
2. If unconscious, to do CPR
          
Trauma
1. No head tilt, Use Jaw Thrust instead


Rescue Breaths
1. Give oxygen, Interval 1-2-3-4-5 counts, and squeeze oxygen bag (five cycles
      with compressions)
2.  Infant head is against saver chest. When give oxygen, the chest should rises.
3.  Adult and child lay down to the flat surface
4. Chest recoil naturally when compression

Mouth to Mouth     
Completely cover mouth with your mouth, close nose with your two fingers


CPR with AED operation
1. Continue to do CPR
2. When AED come, Power on-Pad on-Clear skin (for analysis to process)-shut shock button  
3. About child pad, one is in the front, one is in the back.

When charged, the device instructs the user to ensure no one is touching the victim and then to press a button to deliver the shock. Human intervention is usually required to deliver the shock to the patient, to avoid the possibility of accidents. After the shock is delivered, the device will either instruct the user to commence CPR, or will continue to monitor the heart rhythm of the patient to determine if another shock is necessary.

Many AED units have an 'event memory', which store the ECG of the patient along with details of the time the unit was activated and the number and strength of any shocks delivered. Some units also have voice recording facilities, to monitor the actions taken by the personnel, to ascertain if these had any impact on the survival outcome. All this memorized data can be either downloaded to a computer, or printed out, so that the providing organization or responsible body (such as a coroner) can see the effectiveness of both CPR and defibrillation on the patients’ heart.
AEDs available to the public may be semi-automatic or fully automatic. Fully automatic units are likely to have few buttons, often activating as soon as the case is opened, and possibly just one button to shock, or in some cases, this will be performed automatically. The user has no input in to the operation of the unit, apart from attaching the pads, and following the prompts. Health care professionals, and other trained persons, may use a Semi-Automatic defibrillator, which is likely to have an ECG readout display, and the possibility to override the rhythm analysis software. This allows trained personnel to give a higher standard of care, shocking at specific times in the cycle.

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