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2010 CPR & ECC Guidelines
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Highlights of the 2010 AHA Guidelines for CPR and ECC 2010 年 美國心臟協會 CPR 與 ECC 準則提要
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2010 CPR & ECC Guidelines
1.
Highlights of the
2010 AHAGuidelines for CPR and ECC 2010 年 美國心臟協會 CPR 與 ECC 準則提要 summarized by sun yaichenghttp://decode-medicine.blogspot.com/
2.
高品質 CPR 胸部按壓速率:每分鐘至少
100 次(快速壓) 胸部按壓深度:至少 5 公分 (用力壓) 嬰兒和兒童按壓深度至少為胸部前後徑的 1/3 (嬰兒約為 4 公分,兒童約為 5 公分) 每次按壓後確保完全的胸部回彈 儘量避免中斷胸部按壓 避免過度通氣 單一施救者施行急救時建議之 30:2 按壓吹氣比並未變動 確認高級呼吸道裝置的位置後,可以繼續胸部按壓 (每分鐘至少 100 次) 且不需再配合通氣週期
3.
BLS的順序從 A-B-C變更為 C-A-B
4.
AHA ECC 成人生存之鏈
EMS CPR Defibrillation ALS Post-Cardiac Arrest Care
5.
簡化的成人 BLS 流程
強調胸部按壓 單人施救者的在進行急救人工呼吸前開始胸部按壓 (C-A-B 而非 A-B-C) 單人施救者應以 30 次按壓開始 CPR,而非先進行 2 次通氣,以減少第一次按壓前的延遲 「看、聽和感覺是否有呼吸」已經從流程中移除 未經 CPR 訓練的一般民眾應實施 Hands- Only CPR (單純壓胸 CPR),直到取得 AED 經訓練的施救者如果能執行人工呼吸, 按壓吹氣的比率為 30:2
6.
CPR 金字塔CPR 期間使用團隊作業模式
7.
8.
電擊治療 任何施救者目擊到院前心臟停止,且現場可立即取得 AED,則施救者應以胸部按壓開始
CPR,並儘快使用 AED 建議實施單一電擊,接著立即進行 CPR , 而非連續3次電擊去顫 小兒去顫 初始能量:2 焦耳/公斤 後續能量:至少 4 焦耳/公斤 但不應超過 10 焦耳/公斤或成人最大劑量
9.
同步電擊 Af:初次雙相能量 120-200
焦耳 初次單相能量 200 焦耳 AF:初次能量 50-100 焦耳 (單相或雙相) VT:初次能量 100 焦耳 (單相或雙相)
10.
高級心臟救命術 建議進行量化波形二氧化碳濃度監測(quantitative
waveform capnography),以確認並監控氣管內管位置與 CPR 品質 心臟停止後照護,改善入院心臟停止患者 ROSC 之後的存活率。 治療包括心肺與神經系統方面的維持、低溫治療、PCI、診斷癲癇的EEG ROSC 後,FiO2應調整到 SpaO2 ≧94% 所需的最小濃度
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