心肺脑复苏急救中的护理配合

心跳骤停是指各种急性原因导致心脏突然失去有效的供血能力,意味着机体开始进入临床死亡[1].心肺脑复苏(Cardiopulmonary Cerebral Resuscitation,CPCR)是针对心脏骤停所采取的一切抢救措施,与心肺复苏( Cardiopulmonary Resuscitation,CPR)相比,CPCR不仅能促进循环功能和呼吸功能的恢复,更重要的是促进脑复苏,使患者恢复社会行为能力[2].临床过程中,大部分心脏骤停最早都是由护理人员发现的,所以CPCR急救中的护理配合显得十分必要.一般先采取CPR对患者的生命体征进行抢救,尽快恢复循环和呼吸功能,并同时进行脑功能的保护,因此,护理人员一定要熟练掌握并不断更新CPCR有关知识与技术,以最有效的方式实施复苏[3].     

心肺复苏成功急救中的医护配合

目的:探讨护理配合在心肺复苏术(CPR)对心脏骤停(CA)患者抢救中的重要性.方法:回顾性分析2006年11月至2009年10月我科抢救心脏骤停患者234例中CPR成功的35例的临床资料.结果:复苏成功35例中转入ICU科27例,放弃治疗5例,收住心内科2例,入手术室急诊手术1例.结论:复苏过程中医护密切配合,分秒必争地抢救,可提高复苏成功率,降低死亡率.     

基层医院急诊科心肺脑复苏的院内急救

目的：探讨基层医院心、肺、脑复苏的院内急救护理最佳配合。方法对本院2010年5月～2013年5月19例心肺脑复苏成功患者的急救与护理配合进行回顾性分析。结果19例患者经瞬间评估判断、畅通气道、人工呼吸、胸外心脏按压、电击除颤、合理给药、脑部降温等急救措施的实施,复苏成功。结论积极有效的急救护理配合是保证复苏成功的关键。     

心肺脑复苏的护理

随着现代复苏术的飞速发展 ,心肺复苏不仅仅针对心搏呼吸骤停的患者 ,而开始注重围心搏骤停期患者的评估救治与护理 ,因此在心肺脑复苏 (ＣＰＣＲ)中群体的力量至关重要。一、护士在ＣＰＣＲ中的作用护士常是最早接触心搏骤停患者的第一人 ,因此 ,护士必须熟练掌握ＣＰＣＲ的基础生命支持 (ＢＬＳ)操作步骤 ,才能在抢救中准确配合救治 ,护士要具备专业水准及应急能力 ,在评估病情、开放气道、人工呼吸、人工循环、除颤、建立静脉道路、气管插管等方面起到积极的作用。在万分紧急的情况下 ,繁多复杂的复苏措施 ,总得一件一件去做 ,必有主次、…     

心肺脑复苏急救99例的医护配合

目的：探讨护士如何配合医生实施心肺脑复苏术,以提高急救水平。方法：对洛阳市第三人民医院急诊科近年来心搏呼吸骤停患者心肺脑复苏资料进行分析。结果：99例中复苏成功率39.39%（39/99）。其中0-4 min成功率57.78%（26/45）;4-6 min成功率32.35%（11/34）;6-8 min成功率12.5%（2/16）。结论：医护紧密配合,尽早构筑完整的生命链,才能提高抢救成功率。     

护士在心肺脑复苏配合中应注意的几个问题

心肺脑复苏 (ＣＰＣＲ)是抢救心搏骤停的急救措施 ,也是护理人员配合抢救治疗研究的热点问题。护士是ＣＰＣＲ各项急救技术实施中不可缺少的角色。为提高复苏成功率、降低死亡率 ,多年的经验教训告诉我们 ,护士在ＣＰＣＲ配合中应注意以下几个问题。1.给氧 :心搏、呼吸停止 ,人体内氧储备在数分钟内耗尽 ,机体处于严重缺氧状态。因此 ,尽早给氧以利于心跳的恢复和循环的维持。可以采取给纯氧、用面罩加压呼吸、气管插管等措施 ,以加强通气、改善换气、提高氧分压、纠正低氧血症。2 .选择最佳给药途径 :在ＣＰＣＲ中 ,要使药物在循环中迅速达…     

心肺脑复苏的急救护理

近年据文献报道，临床上合并3个脏器衰竭患者死亡率高达79％～85％，累积4个以上脏器衰竭患者的死亡率可达100％。因此在临床抢救治疗护理过程中，必须严密监测生命体征，特别是心肺脑复苏的护理期间，除了保持呼吸道通畅实施气管插管，维持其呼吸功能外，一旦心电监测确定患者处于心室颤动状态，应立即进行非同步直流电除颤。等病情稍脱离危险期后仍应持续认真细致地观察病情动态变化。现将心肺脑复苏的急救护理方法报告如下。     

提高心肺复苏后的脑复苏率

随着心肺复苏术的普及和进展,心跳呼吸骤停的复苏率大有提高,但仍有相当的存活患者并发神经系统损害,不能恢复正常生活,致使心肺脑复苏的成功率仍较低.故心肺复苏中及复苏后脑复苏就成为复苏成功的关键之一.     

心肺复苏后肺水肿的诊断及急诊处理

目的：探讨心肺复苏后肺水肿的诊断及急诊处理。方法：回顾性分析10例心肺复苏后肺水肿的临床表现及治疗情况。结果：6例经治疗后好转出院,其中1例遗留严重的缺氧性脑病转上级医院,1例自动出院,3例并发多脏器功能衰竭治疗无效死亡。结论：心肺复苏后肺水肿起病急,病情凶险,急诊医生应加强对该病的认识,及时正确的处理,呼吸的支持是抢救成功的关键。     

Cardiac arrest in the Emergency Department: a report from the National Registry of Cardiopulmonary Resuscitation

BACKGROUND: Little is known about cardiac arrests (CA) in the Emergency Department (ED). The objective of this study was to determine the characteristics of ED CAs. METHODS: 60,852 adult, in-patient CA events in the National Registry of Cardiopulmonary Resuscitation were included. Multiple regression analysis compared ED CA with those occurring in the ICU, telemetry, or general floors. Subgroup analysis examined traumatic vs. non-traumatic ED CA and ED CA occurring after a successful pre-hospital resuscitation (recurrent) vs. primary ED event. RESULTS: In multivariate analysis, ED location predicted improved survival to discharge (OR 0.74, 95%CI [0.67-0.82]). ED CAs had higher survival to discharge rates (ED 22.2, ICU 15.5, Tele 19.8, Floor 10.8, p<0.0001), better cerebral performance category scores (ED 1.59, ICU 1.73, Tele 1.96, Floor 1.69, p<0.0001), and shorter post-event length of stays (ED 8.6, ICU 17.5, Tele 16.5, Floor 14.2 days, p<0.0001) than other locations. Recurrent ED CAs were less likely to survive to discharge (10.1% vs. 24.6%, p<0.0001) than primary events. Trauma-related ED CAs had a lower survival to discharge rate (7.5% vs. 23.8%, p<0.0001), were less likely to be caused by an arrhythmia (23.6% vs. 32.5%, p<0.0008), and more likely to be preceded by hypotension or shock (41.6% vs. 29.0%, p<0.0001) than non-trauma ED events. CONCLUSIONS: ED CAs have unique characteristics, and better survival and neurologic outcomes compared to other hospital locations. Primary ED CAs have a better chance of survival to discharge than recurrent events. Traumatic ED CAs have worse outcomes than non-traumatic CA.     

气道管理在急诊科心肺复苏患者维持治疗中的应用

目的:探讨气道管理在急诊科心肺复苏患者维持治疗中的应用效果.方法:选取2012年1月1日～2020年5月1日接受维持治疗的急诊科心肺复苏患者300例作为研究对象,采用随机数字表法将其分为观察组和对照组各150例.对照组给予常规护理干预,观察组在对照组基础上给予气道管理;比较两组抢救时间、插管时间、入住ICU时间、血气指...     

气管内紧急心脏起搏抢救心跳骤停的临床应用

目的:探讨紧急床边气管内心脏起搏在心肺复苏中的成功率。方法:对50例心跳骤停患者紧急行改良气管导管插管,插管成功后即行气管内心脏起搏。结果:50例中41例有起搏信号,起搏成功率为82%,28例临床有效,临床有效率为56%,其中21例复苏成功,复苏成功率为42%。结论:紧急床边气管内心脏起搏设备、操作简单,不影响胸外按压和进行其它急救措施,是抢救心跳骤停的一种有效措施。     

心肺脑复苏中联合应用肾上腺素血管升压素氨茶碱的疗效

目的：评价心肺脑复苏时联合应用肾上腺素、血管升压素和氨茶碱的疗效。方法：57例心跳骤停患者随机分为两组，肾上腺素标准剂量组29例（对照组），联合应用肾上腺素、血管升压素、氨茶碱组28例（治疗组）。分别观察各组自主心律、循环、呼吸、意识恢复情况，并据此评价为显效、有效、无效。结果：对照组、治疗组总有效率分别为41．38％、71．4％；治疗组的心肺脑复苏成功率明显高于对照组，同时治疗组的自主循环恢复时间明显少于对照组。结论：联合应用肾上腺素、血管升压素、氨茶碱进行心肺脑复苏的成功率明显高于单独应用标准剂量的肾上腺素。     

Cardiac arrest patients in the emergency department-National Hospital Ambulatory Medical Care Survey, 2001-2007

Aim of the study

Few studies have focused on the full complement of cardiac arrest cases seen in hospital emergency departments (ED). The aims of our study were to describe cardiac arrest visits in the ED by using a nationally representative sample of U.S. adults.

Methods

ED data from the 2001–2007 National Hospital Ambulatory Medical Care Survey (NHAMCS) were analyzed. Cardiac arrest visits were considered to be those with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code of 427.5 as the primary diagnosis.

Results and conclusions

From 2001 to 2007, adults in the U.S. made an estimated 600,729,000 ED visits. Of those, 1,001,000 (0.17%) had a primary diagnosis of cardiac arrest. The majority of patients with such visits were dead on arrival or died in the ED (74.0%). The mean age for cardiac arrest visits was 66.7 years (95% confidence interval [CI], 64.6–68.8 years). Women had a lower rate of cardiac arrest visits than men (age-adjusted odds ratio [AOR], 0.6; 95% CI, 0.5–0.8), and the privately insured (AOR, 0.4; 95% CI, 0.2–0.7) and those with government insurance (AOR, 0.5; 95% CI, 0.3–0.9) had a lower proportion of cardiac arrest ED visits than uninsured persons. In addition, increasing age was a significant predictor of cardiac arrest visits. Cardiac arrest visits did not vary significantly by race, geographic region, or metropolitan statistical area. ED visits classified as cardiac arrest represent 1 in 600 visits and these visits differ by age, sex, payment source, and arrival time at the ED.