"公众心肺复苏"的成功规律分析和抢救预案制定

目的探究"公众心肺复苏"成功完成心肺脑复苏的规律,提出"公众心肺复苏白金10 min预案"。 方法选择2005年至2015年全国重大医疗保障现场、公共场所、比赛场所等空间和笔者在执行院外抢救任务中,发生呼吸心跳骤停且经心肺复苏(CPR)抢救成功的16例患者(男性13例,女性3例),统计分析患者性别、年段龄,发生呼吸心跳骤停的时间、场所、诱/病因,实施CPR的第一施救者身份,抢救的开始时间、方法、后续治疗衔接时间以及抢救结果等信息。 结果患者分布：儿童6例,中年1例,青年6例,老年2例。发生呼吸心跳骤停的场所：运动赛场或公园8例,游泳池或山庄2例,其他公共场所6例。诱因或病因：溺水和窒息6例,运动4例,心源性3例,触电2例,外伤1例。第一施救者：目击者7例(其中家人1例),医护人员6例,救护员3例。抢救方法：采用徒手CPR 15例,背跑式CPR 1例,使用自动体外除颤仪(AED)3例。所有患者平均在1 min(54.36±45.46)s]内开始接受胸外按压,与进一步救治的衔接时间为(7.13±2.66)min,初步抢救过程均在8～10 min内完成。除例5后期出现并发症死亡,余患者均未遗留明显脑损害症状。 结论在"公众心肺复苏"领域,成功复苏的核心是贯彻现场抢救的立即执行和专业抢救的迅速衔接。制定"公众心肺复苏白金10 min预案"应具体要求施救者在发现情况的1 min内开始胸外按压,7 min内有后续或专业性抢救措施,抢救不以转运为目的而更应进行合理转运。

Analysis of successful rule of public cardiopulmonary resuscitation and establishment of rescue plan

ObjectiveTo study the success of "public cardiopulmonary resuscitation(CPR)" , and put forward the "platinum ten minutes plan of public CPR" . MethodsIn the past 10 years from the major security, public places, competition venues and condition that the author execute task out of hospital, 16 successful cases of CPRwere analyzed using the information collected, the occurrence time, sex, age, place of occurrence, breathing and heartbeat stop, the first aid status, the beginning time of the rescue, the rescue, the time of the connection, the result, etc. Results16 cases, (13 vs 3 were male vs female), 7 cases were middle and young, 6 cases of children, 2 cases of old people, 8 case of international sports competition and garden , 2 case of swimming pool, villa 6, cases of other public places. Accidental causes: drowning and suffocation in 6 cases, 4 cases of sports, accident in 3 cases, 2 cases of electric shock, 1 cases of trauma. The first reaction was: 7 witnesses (1 of the family), 6 medical personnel, 3 ambulance. Rescue response time: From the discovery of the situation, the judge after the chest compression began to (54.36±45.46 )s(immediately press 30 seconds) seconds. Rescue methods: 15 cases with CPR, 1 cases with back running CPR , and 3 cases with AED. And the professional connection time is 7.13±2.66 mins . These are completed in 8-10 within minutes. In addition to 5 cases of late complications of death. The other did not leave a clear brain damage. ConclusionIn the field of CPR the golden 4 mins concept needs to be improved; public CPR of "platinum ten minutes plan" is: immediately began, the rapid convergence, that is within 1 minutes to start the chest press, follow-up (AED) or professional rescue within 7 minutes; we want more accurate and more scientific dissemination of first aid theory and philosophy.