心肺复苏改版 路人也能轻易施救

目前,美国心脏协会公布了“2010版心肺复苏与心血管急救指导摘要”,其中有两处较为重要的改动：心肺复苏步骤由过去公众熟知的ABC（开放气道一人工呼吸一胸外按压）调整为CAB（胸外按压一开放气道人工呼吸）;未经急救培训的民众实施单纯胸外按压,也可提供有效的心肺复苏。     

走出误区 更有效地实施心肺复苏

正心肺复苏通过按压和通气给予患者心脑重要脏器一定的供血和供氧,辅以电除颤等技术,从而可能起死回生,是现代医学伟大的进步之一。它是抢救心脏骤停的唯一方法。如何让更多普通人掌握心肺复苏技术,拯救更多的生命,是急救普及的重要内容之一。然而对于如何识别心脏骤停、什么时候开始实施心肺复苏,却存在很多的认识误区。何时开始实施心脏复苏误区一:不做人工呼吸,只做胸外按压没有用面对越来越多的心脏骤停患     

便携式野战—Ⅰ型心肺复苏器

前言目前心肺复苏一般采用徒手胸外心脏按压及口对口人工呼吸方式进行,存在医务人员劳动强度大,通气、按压效果不够确实,易造成胸肋骨骨折,搬运途中无法持续进行按压和人工呼吸等缺点,目前已有的电动、气动心肺复苏器需要在有电力或高压氧气瓶的场所才能使用。便携式野战心肺复苏器的研制成功,较好地解决了上述问题。     

便携式野战——Ⅱ型心肺复苏器

目前心肺复苏一般采用徒手胸外心脏按压及口对口人工呼吸方式进行,存在医务人员劳动强度大,通气、按压效果不佳,易造成胸骨、肋骨骨折,搬运途中无法持续进行心脏按压和人工呼吸等缺点;已有的电动,气动心肺复苏器需要在有电力或高压氧气瓶     

萨勃心肺复苏机在急诊的临床使用分析简

目的：观察心肺复苏机对心脏停搏患者的救治效果。方法：分析80例使用萨勃心肺复苏机和78例采用人工胸外按压心肺复苏的患者,比较两种方法患者的血压、脉搏、血氧饱和度、肋骨骨折发生率,比较两组患者的心肺复苏成功率、心跳恢复时间及存活率。结果：萨勃心肺复苏机心肺复苏组生理参数优于人工按压组,复苏成功率较人工按压组高,并发症发生率低于人工胸外按压组。结论：萨勃心肺复苏机在维持患者生理参数稳定、减少并发症方面效果优于传统人工心肺复苏,建议普及使用。     

心肺复苏的影响因素分析

目的分析心肺复苏的影响因素，为临床治疗提供依据。方法回顾性分析2008年5月至2009年4月笔者所在医院收治的46例心肺复苏患者的临床资料。结果两组患者的年龄、胸外按压开始时间及持续时间、电除颤开始时间、人工呼吸开始时间比较，均有显著性差异。结论临床医师应掌握心肺复苏的影响因素，积极实施抢救措施，提高心肺复苏成功率。     

胸外心脏按压频率对心肺复苏影响的观察及护理体会

目的:探析胸外心脏按压频率对心肺复苏影响的观察及护理体会。方法:选取自2012年1月至2013年1月在本院进行心脏骤停治疗的患者37例作为普通组,本组患者的治疗的按压频率为每分钟80-100,选取自2012年1月至2015年12月在本院进行心脏骤停治疗的患者65例作为实验组,本组患者的治疗的按压频率为每分钟100-120,比较分析两组患者的抢救成功率以及患者对护理的满意度。结果:普通组37例心脏骤停患者经每分钟80-100的心肺按压抢救成功13例,成功率为35.14%,实验组65例心脏骤停患者经每分钟100-120心肺按压抢救成功51例,成功率为78.46%;普通组与实验组患者对护理的满意度分别为67.57%、90.77%。以上两组的数据对比,组间差异显著,存在统计学意义(P0.05)。结论:胸外心脏按压频率不同,心肺复苏的成功率也不一样,经研究发现每分钟100-120的心脏按压频率更有利于病患的抢救,并且提高患者对治疗的满意度,值得临床推广。     

自动式胸外心脏按压仪在院前急救中的应用

目的探讨自动式胸外心脏按压仪在院前急救中的应用效果。方法回顾性分析2020年1—12月台山市人民医院收治的40例院前心搏骤停患者的抢救情况。按照胸外按压的方式将患者分成对照组和试验组,各20例。对照组进行徒手胸外心脏按压,试验组使用自动式胸外心脏按压仪,并按照心肺复苏的急救指南进行相应急救,比较两组心脏复苏效果。结果试验组在按压10、15、30 min时有效胸外按压指征出现率高于对照组,差异有统计学意义(P<0.05);试验组心肺复苏时间长于对照组,自主循环恢复(ROSC)率高于对照组,差异有统计学意义(P<0.05)。结论采用自动式胸外心脏按压仪替代徒手胸外心脏按压,可获得更为理想的心肺复苏效果,尤其是在超长心肺复苏中具有优势。     

除颤心电监护仪对心肺复苏成功率的影响

随着科学技术的发展，越来越多的医疗仪器应于临床，使临床诊疗工作更加科学、有效。为了探究除颤心电监护仪这一电技术仪器在心脏骤停第一时间内对心肺复苏成功率的影响。我们用进口除颤心电监护仪对34例心脏骤停患者进行电击除颤，并与单纯人工通气加胸外心脏按压及药物复苏组进行比较，其结果报道如下。     

心肺复苏诊疗技术及给药途径探析

心肺复苏(CPR)是抢救生命基本的关键技术和方法,影响心肺复苏成功的关键因素是能否快速地识别心脏骤停.心肺的复苏是一般生命支持是开放气道、人工呼吸、判断病人有无脉搏和有效的心脏按压以及除颤.心肺复苏的高级生命支持是建立高级气道、优选给药途径和合理用药.     

Guidelines for revised cardiopulmonary resuscitation--basic life support

Basic life support(BLS) does not require any special instruments or drugs, and its skills can be understood and performed easily by the lay person. The main goal of cardiopulmonary resuscitation(CPR) for the victims of cardiac pulmonary arrest(CPA) is not only restoration of cardiopulmonary function but also return to their previous life. An early bystander CPR plays a pivotal role to achieve this target. When encountering an unconscious person, emergency medical systems(EMS) such as calling 119 must be activated immediately. As the next step, cardiopulmonary condition status has to be determined after assurance of airway patency. When there are no signs of breathing or pulse, BLS consisting of artificial respiration and/or chest compression must be started immediately and continued until EMS staffs arrive. In this article, the details of the revised guidelines for BLS by the American Heart Association are described. Current CPR education for pre- or early post-graduate medical students in our institution is reported.     

心肺复苏器的应用及展望简

心肺复苏器是有望替代传统人工胸外按压的器材,正逐步应用于现场急救和临床抢救工作当中。本文介绍了胸外按压泵机制的理念沿袭、不同心肺复苏器设计的理论依据和国内外常见心肺复苏器的使用方法及特点;同时对心肺复苏器的发展趋势和改进方向进行了展望。以期为心肺复苏器更有效地应用于临床抢救中提供有益借鉴和推广。     

Telemedicine and cardiopulmonary resuscitation: the value of video-link and telephone instruction to a mock bystander

We evaluated cardiopulmonary resuscitation (CPR) performed by persons with no previous experience on a resuscitation dummy. Subjects were randomized into four groups, one of which had no instruction. The other three groups were instructed for 3 min in mock CPR by a supervisor using a telephone, a video-link, or directly in person. They were compared with a group which had had previous CPR training. The main outcome measures were the number of correct ventilations, chest compressions and compressions with correct hand position. Video-link instruction was associated with significantly higher median scores for all three outcome measurements (P < 0.05), whereas telephone instruction and previous CPR training were associated with higher scores on only one, namely ventilations (P < 0.05). Video-link instruction was comparable with direct observer instruction. There was no significant difference between previously trained subjects and the intervention groups. Video-link instruction can produce significant improvements in the quality of CPR in mock resuscitations for persons with no resuscitation training.     

手动胸外按压复苏仪的研制

本文阐述了一种便携式手动胸外按压复苏仪的研制过程。该装置以国际心肺复苏指南为标准,根据正负压心肺复苏术原理设计而成,主要由真空吸盘、压力弹簧、硬件电路、按压手柄以及指针组件等构成。该装置体积小,操作简单,能够提供稳定的按压频率和按压/通气比提示音,并且能够显示按压力度,能辅助非专业急救人员为心脏骤停患者实施心肺复苏急救。     

《2015美国心脏学会心肺复苏与心血管急救指南(更新版) 》儿童基础生命支持部分解读

2015年10月公布了最新的《2015美国心脏病协会心肺复苏及心血管急救指南(更新版)》(以下简称为《2015更新》)。本指南采用了新的系统性审查流程和新的建议级别(COR)及证据水平(LOE)。同时,对其中儿童基础生命支持(PBLS)部分的内容,也进行了调整。为了加强儿科医务人员的心肺复苏(CPR)急救技能的掌握,笔者拟简要介绍《2015更新》中,关于PBLS部分的主要更新内容,包括：①明确PBLS的适用人群;②重申胸外按压-开放气道-人工通气(C-A-B)的CPR操作顺序;③提供新的专业人员单人和多人施救流程;④限定胸外按压深度：青少年不超过6 cm;⑤建议按压频率为100～120次/min;⑥比较传统CPR与单纯胸外按压式CPR的优势与劣势;⑦强调高质量的CPR等,旨在提高临床对患儿进行CPR的成功率及患儿生存率。     

心脏停搏患者应用便携式胸腔按压机复苏效果观察

目的:探讨MCC便携式心肺复苏机对心脏停搏患者进行心肺复苏的效果.方法:选择2011年5月~2012年4月25例心脏停搏患者进抢救室后遵医嘱应用便携式心肺复苏机实施心脏胸外按压,代替人工手动按压,进行复苏抢救.同比2010年5月~2011年4月急诊抢救心脏停傅患者22例,采用传统徒手心肺复苏,做为对照组.MCC便携式心肺复苏机按压频率100次/min,按压深度范围为38mm-50mm.传统徒手心肺复苏按心肺复苏原则操作.统计复苏成功率.结果:两组病例在性别、年龄、心脏停搏时间及病因等方面无统计学差异.患者经过机械心肺复苏,成功7例(28%),MCC便携式心肺复苏机成功率明显提高传统徒手心肺复苏.在MCC组没有一例肋骨骨折.结论:跟徒手心肺复苏相比MCC便携式心肺复苏机是安全的,有效的,它提供了一个新的CPR选择.     

Corpuls cpr resuscitation device generates superior emulated flows and pressures than LUCAS II in a mechanical thorax model

The provision of sufficient chest compression is among the most important factors influencing patient survival during cardiopulmonary resuscitation (CPR). One approach to optimize the quality of chest compressions is to use mechanical-resuscitation devices. The aim of this study was to compare a new device for chest compression (corpuls cpr) with an established device (LUCAS II). We used a mechanical thorax model consisting of a chest with variable stiffness and an integrated heart chamber which generated blood flow dependent on the compression depth and waveform. The method of blood-flow generation could be changed between direct cardiac-compression mode and thoracic-pump mode. Different chest-stiffness settings and compression modes were tested to generate various blood-flow profiles. Additionally, an endurance test at high stiffness was performed to measure overall performance and compression consistency. Both resuscitation machines were able to compress the model thorax with a frequency of 100/min and a depth of 5 cm, independent of the chosen chest stiffness. Both devices passed the endurance test without difficulty. The corpuls cpr device was able to generate about 10–40% more blood flow than the LUCAS II device, depending on the model settings. In most scenarios, the corpuls cpr device also generated a higher blood pressure than the LUCAS II. The peak compression forces during CPR were about 30% higher using the corpuls cpr device than with the LUCAS II. In this study, the corpuls cpr device had improved blood flow and pressure outcomes than the LUCAS II device. Further examination in an animal model is required to prove the findings of this preliminary study.     

A new method without reference channels used for ventricular fibrillation detection during cardiopulmonary resuscitation

Ventricular fibrillation (VF) is observed as the initial rhythm in the majority of patients suffering from sudden cardiac arrest. It is vitally important to accurately recognize the initial VF rhythm and then implement electrical defibrillation. However, artifacts produced by chest compression during cardiopulmonary resuscitation (CPR) make the VF detection algorithms utilized by current automated external defibrillators (AEDs) unreliable. CPR must be traditionally interrupted for a reliable diagnosis. However, interruptions in chest compression have a deleterious effect on the success of defibrillation. The elimination of the CPR artifacts would enable compressions to continue during AED VF detection and thereby increase the likelihood of resuscitation success. We have estimated a model of this artifact by adaptively incorporating noise-assisted multivariate empirical mode decomposition (NA-MEMD) and least mean squares (LMS) and then removing the artifact from the corrupted ECGs. The simulation experiment indicated that the CPR artifact could be accurately modeled without any reference channels. We constructed a BP neural network to evaluate the results. A total of 372 VF and 645 normal sinus rhythm (SR) ECG samples were included in the analysis, and 24 CPR artifact signals were used to construct corrupted ECGs. The results indicated that at different SNR levels ranging from 0 to ?12 dB, the sensitivity and specificity were always above 95 and 80 %, respectively.     

胸腹交替按压心肺复苏装置的研制

本文介绍一种用于心脏、呼吸骤停时进行抢救的胸腹交替按压心肺复苏医疗装置。利用市电为能源，采用机械呼吸和体外胸腹交替按压复苏技术，即＂压胸－压腹－压胸＂方式交替进行，并每五次按压时，给肺充气一次。具有复苏成功率高，防止复苏过程中病人出现胃部胀气。且能随时调节按压频率、深度、充气比和充气时间，满足临床各种情况的需求。为各医院临床新型急救设备。