cardiopulmonary cerebral resuscitation guidelines毕业论文翻译.docx

cardiopulmonary cerebral resuscitation guidelines毕业论文翻译.docx

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cardiopulmonarycerebralresuscitationguidelines毕业论文翻译

2010cardiopulmonarycerebralresuscitationguidelines

[Abstract]purposeofthisarticle,acomprehensiveanalysisofcardiopulmonarycerebralresuscitationrescuemeasures,includingtherecoveryoftheorderofdefibrillationtherapy,theroutineuseofepinephrine,chestpressingandholdingdoesnotrecommendtheroutineuseofatropine,sodiumbicarbonateapplicationsandrespiratorystimulants,theapplicationofnaloxone,thetreatmentofheadcoolingandhibernationtherapy,effectivelyimprovethesuccessrateofcardiopulmonarycerebralresuscitation.

[Keywords:

]CardiopulmonarycerebralresuscitationclinicalobservationCardiopulmonaryCerebralResuscitationclinicaloneofthethornyissuesinthepastfewdecades,madeaseriesoffruitfulprogress,butrecoverysuccessrateisstilllowerandlowersurvivalrate,inrecentyears,withtherelevantanimalstudiesandclinicaltreatment,thesuccessrateofcardiopulmonarycerebralresuscitationhasbeengreatlyimproved.

1,thelatestprogressoftherecoveryorder2010AHACPRandECCguidelinesforadultandpediatricpatients（includingchildrenandinfants,exceptforneonatalbasiclifesupport（intheorderoftheBLSfromthe“ABC”（airway,artificialventilation,chestpressto“CAB”（chestcompressions,airway,artificialventilationchanges.guiderecommendedthischangeforthefollowingreasons:

1.1thevastmajorityofcardiacarrestpatientsareadults.Arrestintheheartofallagesstoppedinpatientswiththehighestsurvivalrateofthosewitnessesintheheartofarrest,initialrhythmisVForpulselessVTpatients.Inthesepatients,theinitialpartoftheCPRcriticalchestcompressionsandearlydefibrillation.

1.2inABCorder,whentherescueropenairwayformouthtomouthresuscitation,findtheprocessofprotectiveequipment,orassemblyofventilationequipment,chestcompressionsareoftendelayed.ChangetheCABorderassoonaspossibletostartchestcompressions.ventilationdelaytimecanbeshortenedtoonlycompletethetimeofthefirstroundofchestcompressions.

1.3lessthan50%ofthecardiacarrestpatientshavebeenwitnessesofCRP,theremaybemanyreasons,butoneobstacletotheABCorder,whichistherescuerfoundtheinitialoperationisthemostdifficult,theopenairRoadandartificialrespiration.thebeginningoftheimplementationofchestcompressionsmaybeabletoensurethatmorecardiacarrestpatientsreceiveCPRtreatment,thosewhoareunableorunwillingtoimplementartificialrespirationrescuertocompleteatleastchestcompressionoperation.

1.4medicalstafffirstaidprocedureschangeaccordingtothemostlikelyreasonforcardiacarrestisreasonable.Forexample,ifapatientsuddenlyfell,whenthesceneisonlyonemedicalstaff,themedicalstaffmaythinkthatpatientswithsuddenVFtypecardiacarrest;Oncetherescuerconfirmedthatthepatientunconscious,nobreathingoronlysighingbreathing,therescuermustimmediatelyactivatetheemergencyresponsesystem,gettheAEDdefibrillation,andCPRoperation.newborns,themostlikelyreasonforcardiacarrestcausedbyrespiratoryfactors,resuscitationproceduresshouldbeABCorder,unlesstheknownreasonscaused.

2,defibrillationoftreatment2010AHACPRandECCguidelinesupdatethelatestdataofabnormalrapidrhythmoftheapplicationofcardiacpacinginpatientswithbradycardiaandelectricalcardioversionanddefibrillationtherapy.ConfigurationAEDpublicplacesoutsidethehospitalchainofsurvivaloftheemergencysystemcrucialinordertoimprovecardiacarrestpatientsthemaximumchanceofsurvivalinthefirstperiodofcardiacarrest,thethreekindsofbehaviorisessential:

toactivatethesystem,theimplementationoftheoperationoftheinstrumentofCPRanddefibrillation.

InforalongtimeCPRbeforedefibrillationcanimprovecardiacarrestsurvivalrateofpatientswithalong-termfocusofattention.Earlystudieshaveshownthatintogive1.5to3minutesofCPRbeforedefibrillationcanimprovebeforethearrivaloftheEMScontinuedfor>4-5minutesofcardiacarrestsurvivalrate,however,tworecentrandomizedcontrolledclinicaltrialshaveshownthatdefibrillationbeforegiveCPRdoesnotimproveprognosis.scenemorethantwoortworescuers,CPRmustpreparethedefibrillator.

VFtogive1-defibrillationprogramhasnotchanged.EvidencesuggeststhatevenveryshortCPRinterruptionisharmful.Therefore,therescuemustbeasshortaspossibletostopthepressandgivetheintervalbetweendefibrillationtogivedefibrillationimmediatelyaftertherestartCPR.

Inthepast10years,thebiphasicwaveformdefibrillationprovedmoreeffectivethanmonophasicwaveformdefibrillationelectricalcardioversionanddefibrillation.However,noclinicaldatatocomparebetweenthebiphasicdefibrillationefficacy.thereisnoresearchtoconfirmthedifferentwaveformdefibrillatorisagradualincreaseindefibrillationenergyorfixedsubsequentdefibrillationenergymoreefficiently.However,ifhigherenergycanbeappliedinthehand,theymayconsidertheinitialdefibrillationenergycaneffectivelyterminatethearrhythmia.

Inthepast5-10years,withclinicaltrialscomparisonofbiphasicandmonophasicwaveformcardioversionofatrialfibrillationefficacy.Theeffectiveenergyofelectricalcardioversionofatrialfibrillationwithwaveform-specific,generalvolatilityinalreadyinthe120-200J,dependingonthemanufactureroftheelectricdefibrillator,atrialfibrillationelectricalcardioversionrecommendedinitialbiphasicenergyisdevelopedaccordingtothemanufacturer’srecommended,evenifthe120-200J.Iftheinitialelectricalcardioversionisunsuccessful,complexThelawshouldbegraduallyincreasedenergymonophasicwaveformdefibrillator,adultatrialfibrillationelectricalcardioversion,theinitialenergyshouldbe200J,ifnotsuccessfulcardioversion,shouldbegraduallyincreasedenergy.

3,theroutineuseofepinephrinedonotrecommendroutineuseofatropine,epinephrineisCPRdrugofchoice,@receptorexcitatoryeffectsmaypromotevascularpressorresponsetoaorticdiastolicpressure,andpromoterestorationofspontaneouscirculation.Generaluse-adrenaline1mg,repeatedintravenousinjection,thatis,beforetherestorationofspontaneouscirculation,thereshouldbenolimitsontheamountisnolongerrecommendedinthetreatmentofpulselesscardiacelectricalactivity（PEA）/cardiacstoppedroutineuseofatropinerecommendtheuseofadenosine,becauseitisnotonlysafe,butalsointheundifferentiated,rules,asingletype,wideQRStachycardiaintheearlytreatmentforbothtreatmentanddiagnosistohelp.ShareFreepaperDownloadCenterhttp:

//4,2010guidemakeitclearifbystanderswithoutCPRtraining,canprovideonlyCPRchestcompressions.ie“Pressfirmly,quicklypressthepressinthechestcenter,untilithastakenpossessionofbyprofessionalrescuewell-trainedrescuepersonnelshouldbeatleastforthoserescuedchestcompressions.withartificialrespiration,theratioofcompressionsandbreathinginaccordancewith30:

2.beforereachingtheemergencyroom,therescueshouldcontinueCPR.correctimplementationofthechestexternalcardiacmassage:

acontinuousrhythmofpressuretopressthelowersternum1/3,byincreasingintrathoracicpressureorsqueezetheheartgeneratebloodflowandbloodcirculationtothelungs,accompaniedbyartificialventilation,oxygendeliverytothebrainandothervitalorgansuntilthroughthedefibrillation/cardioversion.pressthefrequencyshouldbeatleast100timesperminute.singleordoublerecovery,30:

2compressions:

breathingtheratiooftheCPRprocess,externalcardiacmassageandartificialrespirationshouldbecoordinatedrecoverytobeaccompaniedbytheCPRprocess,bloodflowtoproducechangesinintrathoracicpressure（thoracicpumpmechanismordirectcardiaccompression（cardiacpumpmechanism.presscanproduce60mmHg-80mmHgarterialpressure,diastolicbloodpressureisverylow,rarelymorethan40mmHg,meancarotidarterypressureandcardiacoutputisonly1/3ofthenormalcardiacoutput,pressureunderthebreastboneatleast5cmdepth,torelaxafterthepalmofyourhandDonotleavethechestwall,pressingthefrequencyshouldbeatleast100timesperminute,press:

respirationratioof30:

2,accordingtothepressuretobeuniform,nottoomuch,aftereachpressmustbecompletelyrelievethepressure,chest,backtothenormalposition,pressandrelaxationequaltothetimerequiredtopresstherhythm,thefrequencycannotbeneglectedfastandslow.

5,ontheapplicationofsodiumbicarbonateinCPRbasicdrugs,isusefulintheory,haveusedintheclinicalroutinecarriedoutmetabolicacidosiscanbereducedduetothecessationofrespirationandcirculation,theventricularfibrillationthreshold,reducingmyocardialcontractileforce,andreducevasomotorfunctionthroughtheinhibitionofcatecholamineactivityandtheactivityoftheenzymesystem,butalsocausecelldamagethroughtheactivationoflysosomalenzymes,buttherearedifferentviewsontheapplicationofsodiumbicarbonateinrecentyearsthathaveanadverseeffectontherecovery:

adilationofbloodvesselstoreduceaorticdiastolicpressure,whilereducingtheroleofvasopressors,andoxygendissociationcurvetothelefttoincreasethehypoxia2,3toincreaseintracellularacidosis（PCO2increasedbyincreasedmyocardialoxygendebt,promotionofanaerobicmetabolism,inhibitionofcardiaccontractilityandconduction.6causecoronaryvasoconstriction,andmyocardialbloodfurtherreducethehighsodiumblood