心肺骤停与心肺复苏英文教案及讲稿文档格式.docx

1、出 版 社People health publishing company 版次the first edition Oct. 2003教学目的要求1:Recall The definition of Sudden Cardiac Arrest . The clinical symptoms of Sudden Cardiac Arrest The basic steps of CPR for adults.2:Application : Show the complete sequence for 1-rescuer CPR. 难点How to perform all the steps of

2、 CPR in order 重How to perform all the steps of CPR in order外语要求CET- 4教学方法手段Multimedia参考资料Guideline 2005 of CPR and ECG教研室意见 教学组长： 教研室主任： 年 月 日 辅助手段时间分配Good afternoon everybody, today we are going to discuss the SCA and CPCR ,at first let me introduce myself .;At beginning of the class ,we will watch

3、 a short video, please watch it carefully ,there are two questions, What happened and what are they doing? S C A（一）DEFINITIONBut how do we define SCA Sudden Cardiac Arrest ,we also call SCA ,refers to sudden and unexpected loss of heart function ,cease the blood flow form the heart to the rest of th

4、e body , the brain and vital organs lack of blood and oxygen ,If the victim get the propriety medical service immediately ,survival is possible ,if not ,death occurs .because when SCA happens ,loss of heart function ,cease the blood flow from the heart the rest of the body, it causes the brain and t

5、he vital organs lack of the blood and oxygen,Sometimes it occurs suddenly ,comes without warning ,，.it happens unexpected .sometimes it may happened on somebody who is thought in good health situation .（二）cuasesMany diseases may lead to SCA ,like as heart disease , The person who has heart disease h

6、as the higher chances of SCA .See the picture,if the disease can cause Decreased contractility, Arrhythmia ,Lower cardiac output Insufficient Coronary perfusion, then it may lead to SCA .The person who has heart disease has the higher chances of SCA .Studies report ,80% SCA were caused by coronary h

7、eart disease ,And the typical sings on electrocardiogram, we may see the ventricular fibrillation, and ventricular systole, the most common SCA are caused by ventricular fibrillation. Approximately 70%.（三）CLINICAL SIGNS SCA comes suddenly and unexpected, but how can we recognize it .There are six si

8、gns in our text book1.sudden unconsciousness . You palpate the shoulder ,if no response ,you may say the victim in unconsciousness.2.Absence of major artery pulse（ carotid or femoral ）3.No breathing . 4.Pupillary dilation and no pupillary reflex to light5.Heart sound is not obtainable6.Pale and no b

9、lood in the face（四）DIAGONOSISDo we need to collect all the evidences to establish the diagonosis?Here if you see the victim in unconsciousness, you cant palpate the pulse on carotid or femoral ,you can establish the diagnosis SCA .We have discussed that when the victim in SCA , loss of heart functio

10、n ,cease of blood ,the brain and the vital organs lack of blood and oxygen ,What medical service is propriety and can save the life CPCR Here are two concepts , CPR and CPCR .CPR But what the differences between them , the protection of brain,CPR is results from many years clinical experiences and m

11、any medical professionals contributed to it , Peter J Safar , who created mouth to mouth breathing in 1958 , he proposed the A-BC （airway, breathing, circulation） sequence of resuscitation, including the technique of mouth-to-mouth rescue breathing. So he is known as the father of CPR .CPR save many

12、 life ,but the persons who was survival from SCA , but Approximately 10-40% of them suffered obvious non-reverseable brain damage More and more medical professionals pay more attention to the protection of brain function.The becomes CPCR , so the most important difference between CPR and CPCR ,is th

13、e protection of brain .The modern Resuscitation CPR consist of three main elements:Mouth to mouth breathing Chest compression Defibrillation The present standard of CPR is guidelines CPR and ECC 2005. And it was pubulished on the journal Circulation Nov. 2005 we call it guidelines 2005.Completely CP

14、CR includes three partsBasic life support BLSBdvanced cardiac life support ACLSProlonged life support PLS一 BLSThe main aim of BLS is to deliver oxygen to muscles of the heart and all of the important organs BLS Consists of 4 parts A airway B breathing C circulation D defibrillation But today ,we jus

15、t discuss the ABC sequence ,the step D place on the next class ,Now we know , SCA is the life and death disease , lets watch the statistics here The relationship of the starting CPR and the ratio of survival .If the victim get the CPR Within 4min 50% Within 46min 10% More than 6min 4% More than 10mi

16、n 0%This picture shows the chain of survival .it consists of 4 links ,Early acces ,early CPR ,early defibrillation and early advance care .Early access refers to recognize and activate the emergency medical system early ,and early CPR ,we just talked about the relationship of starting CPR and the ra

17、tio of survival ,and we know early CPR increase the ratio of survival ,early defibrillation also increase the ratio of survival ,the reason is （question）,ok ,the most common SCA were caused by ventricular fibrillation .and early advanced care refers to bring equipment to support ventilation and esta

18、blish the intravenous access and stabilized the victim to transfer . the chain of survival summarize the present understanding of the best approach to the treatment the person in SCA.1：position When you meet a person in SCA , at first ,put him or her on back on a firm plant surface. Put the hand bes

19、ide the body naturally . assessShout for the victim ,and palpate the victims shoulder .if no response ,call 120 and active the EMS.3: opening airwayThen take the steps of ABC sequence The A of the ABC sequence is airway then opening the airway ,The common cause of the airway obstruction in the unres

20、ponsive victim is the tongue block the upper airway.At the same time clear the foreign objective in the airway .There are two postures to open the airway Head tilt-chin lift jaw thrust The most common posture we use is head tilt-chin lift ,1.Put one hand on the victim s forehead and push with you pa

21、lm to tilt the head back.2.place the fingers of the other hand under the bony part of the lower jaw near the chin.3.Lift the jaw to bring the chin forward .Please note .you just need to put the fingers on the bony part of the lower jaw, dont put on the soft tissue , it would obstruct the airway .But

22、 when you suspect the victim has cervical spine injure ,you must open airway with the manuvaur jaw thrust ,After opening the airway ,take the rescuer breathing 4：B breathing At first ,assess the breathing Assess the breathing by looking, listening ,feeling .Put you face close to the victims mouth an

23、d nose LOOK for the chest to rise and fallLISTEN for air escaping during exhalationFEEL for the flow of air against your cheekThe time you must take at least 5 seconds but no more than 10 seconds .If you cant look for the chest to rise and fall ,you cant listen for air escaping during exhalation ,an

24、d you cant feel for the flow of air against your cheekThen the victim has no breathing .The healthcare provider must delivery rescuer breathing to the victim.Mouth to mouth breathing is a quick ,effective way to provide oxygen to the victim ,the rescuers exhaled air contains approximately 17%and 4%c

25、arbon dioxide ,This is enough oxygen to supply the victims needs.Hold the victims airway open with a head tilt-chin lift.Pinch the nose closed with your thumb and index finger （using the hand on the forehead.）Take a regular （not deep ）breath and seal your lips around the victims mouth, creating an a

26、irtight seal.Give 1 breath （blow for 1 second）. Watch for the chest to rise as you give the breath.If the chest does not rise, repeat the head tilt-chin lift.Give a second breath （blow for 1 second）. Watch for the chest to risePlease note:Take 1 second to deliver each breathDeliver enough air to mak

27、e the victims chest rise. If you give breaths too quickly or with too much force ,air is likely to enter the stomach rather than the lungs .This can cause gastric inflationThe risk of infection from CPR is very low but if you meet the victim in the workplace when there is any exposure to blood or bo

28、dily fluids .Standard precautions include using barrier device such as a face mask or a bag mask device when giving breaths.Some masks have an oxygen inlet that allows you to administer supplementary oxygen.Mouth to mask breathing has two obvious advantagesPrevent the infection and can administer th

29、e supplementary oxygen ,Now ,we have just talk about the A B steps of ABC sequence . lets watch a short video to recall the contents.Ok, from the video ,we know after delivery 2 rescuer breathing ,the next step is 5:We have known, the person in SCA loss the function of the heart ,cease the blood flo

30、w .the easy mean to assess the person if he or she loss the heart function ,Assess the pulse on major artery. Like carotid or femoral .Maintain a head tilt, Locate the trachea , Slide these 2 or 3 fingers between the trachea and the muscles at the side of the neck, check the carotid pulse .Palpate t

31、he artery at least 5 seconds but no more than 10 seconds If you can find the definite pulse ,Give 1 breath every 5 to 6 secondsRecheck pulse every 2 minutes.If you are not sure whether the victim has a pulse ,you should start the steps of CPR with chest compression ,chest compression refers to compress the chest to build circulation again, create blood circulationincrease coronary perfusion increase