20 10 美国 心 脏协 会 心肺复苏及心血管急救指 南 摘 要 目录 针对所有施救者的主要问题 1 非专业施救者成人心肺复苏 3 医务人员基础生命支持 5 电击治疗 9 心肺复苏技术和装置 12 心血管病高级生命支持 13 急性冠状动脉综合症 17 中风 18 儿科基础生命支持 18 儿科高级生命支持 20 新生儿复苏 22 伦理学问题 24 培训 实施和团队 25 急救 26 总结 28
Mary Fran Hazinski, RN, MSN Leon Chameides, MD Robin Hemphill, MD, MPH Ricardo A. Samson, MD Stephen M. Schexnayder, MD Elizabeth Sinz, MD Brenda Schoolfield Michael R. Sayre, MD Marc D. Berg, MD Robert A. Berg, MD Farhan Bhanji, MD John E. Billi, MD Clifton W. Callaway, MD, PhD Diana M. Cave, RN, MSN, CEN Brett Cucchiara, MD Jeffrey D. Ferguson, MD, NREMT-P Robert W. Hickey, MD Edward C. Jauch, MD, MS John Kattwinkel, MD Monica E. Kleinman, MD Peter J. Kudenchuk, MD Mark S. Link, MD Laurie J. Morrison, MD, MSc Robert W. Neumar, MD, PhD Robert E. O Connor, MD, MPH Mary Ann Peberdy, MD Jeffrey M. Perlman, MB, ChB Thomas D. Rea, MD, MPH Michael Shuster, MD Andrew H. Travers, MD, MSc Terry L. Vanden Hoek, MD, 2010 American Heart Association
2010 (AHA) (CPR) (ECC) 2010 10 2010 1 2 3 2010 50 4 2010 2010 1 2010 (BLS) 2005 2005 (1) 2005 (2) (EMS) (3) 2010 2010 100 100 5 4 5 5 1 2010 2 3 2010 ILCOR 2010 29 356 36 2010 2010 277 411 2010 1 2010 1
L A Y R E S C U E R A D U LT C P R (30:2) 2010 1 100 6 8 1 8 10 A-B-C C-A-B 2010 A-B-C C-A-B 2010 (VF) (VT) A-B-C C-A-B 30 18 2 (AED) AED AED 5 2010 5 1 A-B-C 1 1. 2. 3. 4. 5. 32
H E A LT H C A R E P R O V I D E R B L S 2 2010 2 无反应且没有呼吸或不能正常呼吸 ( 仅仅是喘息 ) 启动急救系统 开始心肺复苏 拿到除颤器 C-A-B A-B-C 30 2 100 100 4 5 5 (*) * 2010 Hands-Only AED 用力按压 快速按压 检查心律 / 如有必要, 开始除颤 每 2 分钟重复 1 次 版权所有 2010 美国心脏协会 30 2 AED 20052005 2005 2010 43
C-A-B A-B-C* 2010 2005 2 30 2 30 2 30 * 2010 30 2 2005 2 100 C-A-B 2 100 * 2010 100 2005 100 (ROSC) AED 2 * 2010 5 2005 4 5 5 4 2010 4
2010 AED 10 10 AED C-A-B A-B-C 30 2 100 100 4 5 5 (*) 2010 AED AED 2005 2010 2005 2010 5
2010 2010 2005 2005 2010 2005 * 2010 AED 2005 2005 2005 2008 2010 6
2005 AED AED 10 AED C-A-B A-B-C* 2010 2010 2005 2 30 2 30 2 30 * 2010 30 2 C-A-B 2 100 * 2010 100 2005 100 AED 4 2 * 2010 5 2005 4 5 5 4 2010 2005 2010 7
1 * 10 C-A-B 100 5 ¹ ³ 5 ¹ ³ 4 2 10 30:2 1 2 30:2 15:2 2 6 8 1 8 10 () 1 AED AEDAPCPRHCP * 2010 2005 2005 2010 1 8
2010 2005 AED AED AED 1 3 AED 2010 AED2010 AED EMS 2005 2005 AED AED EMS AED AED 2010 2005 AED 3 AED 2010 AED 1 8 AED AED AED1 AED AED 2005 1 8 AED AED AED AED 4 J/kg 9 J/kg 2010 2005 AED AED AED AED/ AED AED 1½ 3 3 2010 9
2005 1½ 3 4 5 30 1 1 3 2010 2005 (ILCOR) 2010 1 3 3 1 3 1 2010 2005 200 J ROSC 120 200J 2010 2 4 J/kg 2 J/kg 4 J/kg 10 J/kg 2005 2 J/kg 4 J/kg 2 J/kg 18% 50% 9 J/kg 2010 2005 10
2010 - --- AED 2005 AED -- -- - 2005 2010 -- 2005 2.5 2005 8 AED 2010 120 200 J 200J 50 J 100 J 2005 100 200 J 100 120 J 80% 85% 2005 100 200 J 2010 100 J QRS 2010 11
2005 2005 2010 2010 2005 2010 2005 2010 2010 2005 2 (AutoPulse ) 4 12
2010 (ACLS) (PEA)/ QRS 2010 (PETCO 2 ) 3A 3B 3 mm Hg 50 37.5 25 12.5 0 A. (PETCO 2 ) mm Hg PETCO 2 mm Hg 50 37.5 25 12.5 0 CPR ROSC B. PETCO 2 mm Hg 8 10 100 PETCO 2 12.5 mm Hg PETCO 2 12.5 25 mm Hg (ROSC) ROSC PETCO 2 40 mm Hg 2010 13
4 2005 (CO 2 ) 2005 PETCO 2 PETCO 2 PETCO 2 PETCO 2 2010 4 2005 2005 14
2005 2005 (ALS) 2010 2010 / 2010/ (PALS) / QRS QRS 2005 QRS QRS (IV) 20102010 3 (PCI) 2005 2005 2005 / 2010 15
3 2010 94% (FIO 2 ) 94% 100% - (PaO 2 ) 80 500 mm Hg 100% FIO 2 94% 2005 94% 99% 2010 2,3 5 100% - (PaO 2 ) ~80 500 mmhg 94% 100% 3 1. 2. / 3. (ACS) 4. 5. 16
2010 / (PCI) 2005 2005 15 2010 AHA/ ACC ST (STEMI) ST (STEMI) STEMI (ED) 12 STEMI 12 2000 12 12 (PCI) PCI (PCI) STEMI STEMI PCI 2010 17
/ 2010 94% 2005 90% 6 94% STEMI (UA)/ STEMI 1 (rtpa) (ASA)/AHA 3 (rtpa) 3 4.5 IV rtpa 3 3 4.5 IV rtpa IV rtpa D EMS C-A-B A-B-C 4 5 <90 mm Hg 18
10 AED AED AED AED C-A-B A-B-C 2010 C-A-B A-B-C 30 15 2 2005 2 (C-A-B) C-A-B 18 30 2 2010 4 5 2005 X 4 5 2010 2005 C-A-B 2010 10 10 2005 10 2010 AED 2010 AED AED AED 2005 1 8 AED AED 2010 19
L A Y R E S C U E R A D U LT C P R AED AED / 2 2 4 J/kg 2 J/kg 2005 4 J/kg 4 J/kg 10 J/kg 94% 100% QRS >0.08 >0.09 2010 13 3A 13 3B 2005 / PETCO 2 PETCO 2 10 15 mm Hg PETCO 2 PETCO 2 2010 2 4 J/kg 2 J/kg (VF) 4 J/kg 10 J/kg 2005 2 J/kg 4 J/kg 20
2010 94% FIO 2 94% 100% PaO 2 80 500 mm Hg 100% FIO 2 94% 2005 2005 94% 99% PaO 2 FIO 2 PaO 2 5 2010 Fontan Fontan / Glenn 2005 2005 2010 (ECMO) 2010 QRS >0.09 QRS 2005 QRS >0.08 QRS 6 4 QRS >0.09 QRS 4 16 0.1 PALS >0.09 QRS 0.01 QRS 2010 2005 2005 2010 2005 2010 21
L A Y R E S C U E R A D U LT C P R 2010 32 C 34 C (VF) 32 C 34 C 2005 32 C - 34 C 12 24 2010 / 50 2005 2005 2010 2005 2010 37 39 2010 3 2005 2005 A-B-C 3:1 2010 3 22
2010 100% 2005 100% 60% 10 90% 2010 2005 100 / 2010 2005 : 2010 2005 2010 3:1 (15:2) 2005 3:1 90 30 120 3:1 15:2 2010 36 2005 36 33.5 C 34.5 C 18 2010 23
2010 1 2010 2005 10 10 / (OHCA) 2010 AED AED 2005 40% 60% 2010 72 2005 33 meta 3 24
72 24 N20 3-2 N20 2010 2 AED AED AED 2010 25
2010 2 2 2010 2010 2010 2010 AED 2010 AED AED AED 2010 (AHA) (ARC) 2010 2010 / 30 (ILCOR) ILCOR 26
H E A LT H C A R E P R O V I D E R B L S 2010 / 2010 / 2010 2005 2010 2005 2010 2005 2010 20102010 2005 2005 2010 / 18% 35% 2010 2010 2005 2010 2010 27
201 40 70 mmhg 55 70 mmhg 2005 2005 2010 4% 6% 30 20 2010 2005 2010 / 2005 Kouvenhouven Jude Knickerbocker 50 4 1. Field JM, Hazinski MF, Sayre M, et al. Part 1: Executive Summary of 2010 AHA Guidelines for CPR and ECC. Circulation. In press. 2. Hazinski MF, Nolan JP, Billi JE, et al. Part 1: Executive Summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. In press. 3. Nolan JP, Hazinski MF, Billi JE, et al. Part 1: Executive Summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. In press. 4. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA. 1960;173:1064-1067. 5. Kilgannon JH, Jones AE, Shapiro NI, et al. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA. 2010;303:2165-2171. 6. Surawicz B, Childers R, Deal BJ, et al. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram, Part III: Intraventricular Conduction Disturbances. Circulation. 2009;119:e235-e240. 28
有关美国心脏协会的其他计划的详细信息 请访问 www.heart.org/cpr 美国心脏协会 7272 Greenville Avenue Dallas, Texas 75231-4596 U.S.A. www.heart.org KJ-0880 10/10 ZH-CN