CardioPulmonaryResuscitation心肺復(fù)蘇術(shù)(CPR) Respiratory department Xiyan wang(王西艷),Why should we learn the CPR?,Why?,Despite important advances in prevention, cardiac arrest remains a substantial public health problem and a leading cause of death in many parts of the world. The estimated incidence of EMS(emergency medical services)-treated out-of-hospital cardiac arrest in the China is about 35 to 40/ 100 000 persons / year.,Why?,Studies have shown the importance of immediate CPR followed by defibrillation within 3-5 minutes of sudden VF (Ventricular Fibrillation) cardiac arrest improve survival. In cities such as Seattle where CPR training is widespread and defibrillation by EMS personnel follows quickly, the survival rate is about 30%. In cites such as New York, without those advantages, the survival rate is only 1-2%.,Why?,There are many lives and life-years lost because appropriate resuscitation is not attempted. Most of the public know little about the details of CPR.,When?, Cardiac arrest Not breathing or not making sufficient respiratory effort on their own,How?, C ( Circulation ) A ( Airway ) B ( Breathing ),- 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care,Circulation: Restore blood circulation with chest compressions,Check the safety of the entironment Put the person on his/her back on a firm surface. Kneel next to the persons neck and shoulders.,Circulation: Restore blood circulation with chest compressions,4.Check the pulse and breath at 5-10 seconds(count 1001.1002.1007) Use the index and middle fingers to check the pulse of carotid atery( the middle of anterior edge sernocleidomastoid),Airway: Clear the airway,Put your face near the persons mouth and look for the chest motion at the same time ( Look for chest motion Listen for normal breath sounds Feel for the persons breath on your cheek and ear) If the person isnt breathing normally, begin artificial respiration. 5.Start the emergency response system,such as phone 120、catch AED（automatic external difibrillator）.,Circulation: Restore blood circulation with chest compressions,6. Place the heel of one hand over the center of the persons chest, between the nipples. Place your other hand on top of the fiest hand. Keep your elbows straight and position your shoulders directly above your hands.,Circulation: Restore blood circulation with chest compressions,7.Start CPR:Use your upper body weights as you push straight down on the chest at a depth of at least 5-6 cm. Push hard at a rate of about 100 -120 compressions a minute.,Airway: Clear the airway,Open the persons airway. Put your palm on the persons forehead and gently tilt the head back. With the other hand, gently lift the chin forward to open the airway.,Breathing: Breath for the person, mouth-to-mouth breathing mouth-to-nose breathing if the mouth is seriously injured or cant be opend. mouth-to-mask breathing when out side hospital you may not give artificial breathing if you dont want.,Breathing: Breath for the person,With the airway open, pinch the nostrils shut for mouth-to-mouth(mouth-to-mask) breathing and cover the persons mouth with yours, making a seal.(make sure there is no leakage),Breathing: Breath for the person,Thirty chest compressions followed by two rescue breaths is considered one cycle.(1 or 2 rescuer) Check the caroid pulse and chest motion every 5 cycles,Continue CPR until there are signs of movement or emergency medical personnel take over.,Breathing: Breath for the person,If an adult victim with spontaneous circulation , give rescue breaths at a rate of about 1 breath every 5 to 6 seconds, or about 10 to 12 breaths per minute,AED,Check thythm:if shockable give 1 shock,and immediately start CPR. when not shockable, immediately start CPR 2.Check thythm every 5 cycles,continue CPR until the patient has signs of circulation.,Defibrillation,Ventricular fibrillation is common in adults non-traumatic cardiac arrest. 2. Earlier defibrillation id important for survival. 3. The chance for survival decline 7-10% every minute laspe. 4. Be defibrillated at the earliest possible moment.,Points for attention, Ensuring chest compressions of adequate rate Ensuring chest compressions of adequate depth Allowing full chest recoil between compressions Minimizing interruptions in chest compressions Avoiding excessive ventilation,Remember: Time is life! Early CPR can improve survival.,Survival chain(five steps) In hospital (prevention-ERS-CPR-defrillation-ALS) Outside of hospital (ERS-CPR-defrillation-BLS-ALS),Thank you !,