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2010心肺复苏指南的新亮点----“A - B- C”步骤更改为“C - A - B” 打印

2010年AHA的CPR和ECC指南最新发变化是将成人和儿童患者(不包括新生儿)基本生命支持(BLS)中“ABC”(气道,呼吸,胸外按压)的步骤更改为“CAB”(胸外按压,气道,呼吸)。其重要性是减少开始首次胸外按压的时间,这一步骤顺序变化需要所有人重新学习心肺复苏术。指南推荐变化的理由如下:

 

 2010_cpr_guidelines

 

 

绝大多数心跳骤停发生在成人,据报告所有年龄心脏骤停者CPR存活率最高均属被目击的室颤或无脉搏性室性心动过速(VT)患者。这些患者CPR早期最关键要素是胸外按压和电除颤。 
ABC顺序,现场急救者开放气道、嘴对嘴呼吸、放置防护隔膜或其他通气设备会导致胸外按压延误。通过改变顺序,使胸外按压开始的更快,至胸外按压第一组完成(30次按压约18秒即完成),因通气延迟时间最少。 
不足50%的心脏骤停者能得到在场目击者所施CPR。其原因很多,但其中之一是ABC的顺序,开放气道和人工呼吸对救援者开始做最为困难。开始就胸外按压可使更多心脏骤停者得到CPR,特别对不能或不愿予人工通气者至少会实施胸外按压。 
这对大多数骤停者采取急救最为合理。例如,如果单独的急救者看到有人突然倒地,他意识到此人因突发室颤致心脏骤停,一经证实,该人无反应,无呼吸或喘息,急救者应立即求救EMS系统,获取和使用AED,并予CPR。但对一个溺水或其他窒息者在EMS到达前优先予5组(约2分钟)常规心肺复苏(包括人工呼吸)。此外,新生儿心脏骤停更可能是呼吸道病因,通常复苏按ABC顺序,除非已知心脏病的病因。(编辑:冯丽洁)

相关链接:

2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science 

Part 1Executive Summary

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S640

Part 2Evidence Evaluation and Management of Potential or Perceived Conflicts of Interest

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S657

Part 3Ethics

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S665

Part 4Part 4: CPR Overview

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S676

Part 5Adult Basic Life Support

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S685

Part 6Electrical Therapies: Automated External Defibrillators, Defibrillation, Cardioversion, and Pacing

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S706

Part 7CPR Techniques and Devices

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S720

Part 8Adult Advanced Cardiovascular Life Support

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S729

Part 9Post–Cardiac Arrest Care

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S768

Part 10Acute Coronary Syndromes

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S787

Part 11Adult Stroke

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S818

Part 12Cardiac Arrest in Special Situations

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S829

Part 13Pediatric Basic Life Support

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S862

Part 14Pediatric Advanced Life Support

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S876

Part 15Neonatal Resuscitation

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S909

Part 16Education, Implementation, and Teams

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S920

 

2010 American Heart Association and American Red Cross Guidelines for First Aid 

Part 17First Aid

http://circ.ahajournals.org/cgi/content/full/122/18_suppl_3/S934