Cardiopulmonary resuscitation (CPR): First aid(心肺复苏术)
Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. CPR involves a combination of mouth-to-mouth rescue breathing and chest compression that keeps oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm.
在许多急救中,包括心脏病发作或溺水,在病人呼吸或心脏停止的情况下,心肺复苏术是一种救治生命的技巧。心脏复苏术包括了嘴对嘴人工呼吸和胸部按压,以保持含氧的血液流向脑部和其它重要器官,直到最后医疗救治使正常心跳恢复。
When the heart stops, the absence of oxygenated blood can cause irreparable brain damage in only a few minutes. Death will occur within eight to 10 minutes. Time is critical when you're helping an unconscious person who isn't breathing.
当心跳停止,含氧血液的缺乏能在几分钟之内造成大脑不可逆转的损害。8到10分钟内造成死亡。当你正在救助一名丧失意识并没有呼吸的病人时,时间是关键因素。
To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an automated external defibrillator (AED).
正确学习心肺复功术,要参加正规的急救训练课程,包括心肺复功术和怎样使用自动体外心脏除颤器(AED)。
Before you begin
Assess the situation before starting CPR:
Is the person conscious or unconscious?
If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?"
If the person doesn't respond, call 911 (or your local emergency number), or have someone else do it. But if you're alone and the victim is an infant or a child age 1 to 8 who needs CPR, perform two minutes of CPR before calling for help.
在开始进行心肺复苏术之前,评估情势:
病人是否有意识?
如果病人看起来没有意识,轻拍或摇动病人的肩膀,并大声询问:“你还好吗?”
如果病人没有反应,打紧急救援电话。但是如果现场只有你一个人,或者需要进行心肺复苏的病人是婴儿或1-8岁的儿童,那么先进行两分种的心肺复苏,然后再打救援电话。
Remember the ABCs
Airway, Breathing and Circulation ― to remember the steps explained below.
切记A、B、C的顺序:
即呼吸通道(Airway), 呼吸(Breathing)和血液循环(Circulation)――记住如下步骤。
AIRWAY: Clear the airway
1. Put the person on his or her back on a firm surface.
2. Kneel next to the person's neck and shoulders.
3. Open the person's airway using the head tilt-chin lift. Put your palm on the person's forehead and gently push down. Then with the other hand, gently lift the chin forward to open the airway.
4. Check for normal breathing, taking no more than 10 seconds: Look for chest motion, listen for breath sounds, and feel for the person's breath on your cheek and ear. Do not consider gasping to be normal breathing. If the person isn't breathing normally or you aren't sure, begin mouth-to-mouth breathing.
清理呼吸通道:
1、让病人仰卧在一个坚固的表面上。
2、跪在病人的脖子和肩旁。
3、采用仰头提颏法(head tilt-chin lift),打开病人的呼吸道。将你的手掌放在病人前额,并轻轻向下推。然后用另一只手,轻轻向上抬颏部,以打开气道。
注:仰头提颏法(head tilt-chin lift) 用一手将病人的头向后仰,置另一只手的手指于下颌骨缘下面,将颏部提向前(垂直向上)直至上下牙齿几乎合拢,但小心避免完全闭合口腔
4、检查病人是否有正常呼吸, 不超过10秒:观察胸部的运动,听呼吸的声音,用你的脸颊和耳朵去感觉病人的呼吸。不要把喘气当成正常呼吸。如果病人没有正常呼吸,或者你不确定他是否正常呼吸,开始做嘴对嘴的人工呼吸。
BREATHING: Breathe for the person
Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened.
1. With the airway open (using the head tilt-chin lift), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.
2. Prepare to give two rescue breaths. Give the first rescue breath ― lasting one second ― and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head tilt-chin lift and then give the second breath.
3. Begin chest compressions ― go to "CIRCULATION" below.
为病人做人工呼吸:
人工呼吸可以有嘴对嘴的形式,或者在嘴受到严重伤害或不能打开的情况下,可以采取嘴对鼻的形式。
1、采用仰头提颏法(head tilt-chin lift),打开病人的呼吸道,如果是进行嘴对嘴的人工呼吸,捏住病人的鼻子,然后用你的嘴封住病人的嘴。
2、准备进行两次人工呼吸。第一次人工呼吸――持续一秒钟――看病人胸部是否上升。如果胸部上升,则进行第二次人工呼吸。如果胸部没有上升,重新对病人做仰头提颏(head tilt-chin lift),然后开始第二次人工呼吸。
3、开始按压胸部――进行如下“血液循环”步骤。
CIRCULATION: Restore blood circulation
1. Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
2. Use your upper body weight (not just your arms) as you push straight down on (compress) the chest 1 1/2 to 2 inches. Push hard and push fast ― give two compressions per second, or about 100 compressions per minute.
3. After 30 compressions, tilt the head back and lift the chin up to open the airway. Prepare to give two rescue breaths. Pinch the nose shut and breathe into the mouth for one second. If the chest rises, give a second rescue breath. If the chest doesn’t rise, repeat the head tilt-chin lift and then give the second rescue breath. That's one cycle. If someone else is available, ask that person to give two breaths after you do 30 compressions.
4. If the person has not begun moving after five cycles (about two minutes) and an automated external defibrillator (AED) is available, open the kit and follow the prompts. If you're not trained to use an AED, a 911 operator may be able to guide you in its use. Trained staff at many public places are also able to provide and use an AED. Use pediatric pads, if available, for children ages 1 to 8. If pediatric pads aren't available, use adult pads. Do not use an AED for infants younger than age 1. If an AED isn't available, go to Number 5 below.
5. Continue CPR until there are signs of movement or until emergency medical personnel take over.
恢复血液循环:
1、将一个手的掌根放在病人胸部双乳之间,另一只手叠在第一只手上。你的手肘伸直,保持肩部在手的正上方。
2、用你的上身重量(不仅是手臂)向下直压病人胸部,使其下沉1.5―2英寸。用力而且快速下压――每秒两次或者一分钟约100次。
3、按压30次后,采用仰头提颏,打开病人的呼吸道,准备进行两次人工呼吸。捏紧病人鼻子,嘴对嘴人工呼吸持续一秒钟。如果胸部上升,则进行第二次人工呼吸。如果胸部没有上升,重新对病人做仰头提颏(head tilt-chin lift),然后开始第二次人工呼吸。这是一次抢救周期。如果其他人也可以做,就在你每做30次胸部按压之后做两次人工呼吸。
4、如果病人经过5次抢救周期(约两分种)之后仍没有活动,如果有自动体外心脏除颤器(AED)可以使用,则按照料机器的示使用。如果你未受过如何使用AED,紧急救援电话可以指引你如何使用。受过训练的公共机构工作人员也可以提供和使用AED。对待儿童尽量使用小儿心脏除颤垫,如果没有的话,则使用成人的心脏除颤垫。不要对小于1岁的婴儿使用AED。如果没有AED可用,则按以下步骤进行。
5、持续进行心肺复苏术,直到病人有活动的迹象,或者直到有医疗急救人员接管病人。
注:自动体外心脏除颤器(automated external defibrillator, AED)是一种笔记本电脑大小可以分析和记录心脏节律的计算机化装置,当该装置识别出心脏异常节律时可以自动释放一定标准的电流来使心脏复律,帮助心脏恢复正常的窦性心律。它通过粘附于患者胸前的体外两个电极,自动感知分析心脏的节律,通过声音来提示操作[5]。如果需要可重复多次进行除颤。由于其操作简便,携带方便,经过简单的心肺复苏和心脏复律知识的培训,一般人均可操作。这使AED的普及成为可能。因此西方一些发达国家特别是美国,在一些公司、购物中心、机场、体育馆、学校及其他一些公共场所均设置有AED,这些地方通常是心脏骤停事件的高发区。而我国在急救措施――生存链上还有待进一步完善,特别是在尽早进行心肺复苏、尽早进行复律治疗这两个环节上。前不久在北京国际马拉松比赛中曾出现我国两位业余运动员先后在比赛中猝死,猝死的原因最大可能为心源性,我国每年经临床证实心脏猝死发生率约在0. 36 ‰ ~1. 28 ‰之间[6]。当时围观的群众手足无措,缺乏必要的心肺复苏和心脏复律知识,错过了最佳的心肺复苏时间。如果当时围观群众具有心肺复苏和心脏复律知识,而且事发附近有AED,这两位运动员存活的可能性大大增加。而现阶段我国的现状是AED还处于刚刚引进阶段,还没有开始普及。这就对急救措施――生存链的实施带来了一定困难,需要认识、了解和使用AED。
与临床使用的直流电心脏除颤器相比AED有以下特点:
1.重量轻,携带方便。2.应用简便,安全,有效。3.自动分析心脏的节律。4.可以提示是否需要除颤。5.指导使用者一步步操作。6.自动检测操作程序。7.及时提示救援人员进行心肺复苏。
使用AED 七个基本步骤:
1.检查患者的意识和反应。2.拨打急救电话和就近寻找AED。3.检查患者呼吸,如果无呼吸给以人工呼吸。4.检查患者脉搏,如果没有脉搏打开 AED,同时另外一营救者应持续进行心肺复苏。5.在正确部位粘附AED 电极。(现有的各种型号AED仅适用于没有呼吸和脉搏、年龄>8岁、体重>30公斤的患者)6.分析心脏节律,确信无人接触患者。 7.根据AED的提示按下放电按钮。第一次放电结束后,AED会再次分析心脏节律提示是否进行下一次操作。
因为其相对简单的操作步骤,接受AED培训的人员通常为:警察、消防队员、保安、已经接受过心肺复苏培训的人员、志愿者和行业服务人员等。AED的销售要有专业医师的指导和处方。
以下是如何对儿童和婴儿进行心肺复苏术(主要不同是动作要更轻柔,如对儿童只用一只手,对婴儿只用两根手指按压胸部,人工呼吸时要轻柔,不要晃动婴儿,注意清理嘴中异物,抢救要更及时等等),有兴趣的朋友自己看看吧。
To perform CPR on a child:
The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an adult. The differences are as follows:
Perform five cycles of compressions and breaths on the child ― this should take about two minutes ― before calling 911 or the local emergency number, unless someone else can call while you attend to the child.
Use only one hand to perform heart compressions.
Breathe more gently.
Use the same compression/breath rate as is used for adults: 30 compressions followed by two breaths. This is one cycle. Following the two breaths, immediately begin the next cycle of compressions and breaths. Continue until the victim moves or help arrives.
To perform CPR on a baby:
Most cardiac arrests in infants occur from lack of oxygen, such as from drowning or choking. If you know the infant has an airway obstruction, perform first aid for choking. If you don't know why the infant isn't breathing, perform CPR.
To begin, assess the situation. Stroke the baby and watch for a response, such as movement, but don't shake the child.
If there's no response, follow the ABC procedures below and time the call for help as follows:
If you're the only rescuer and CPR is needed, do CPR for two minutes ― about five cycles ― before calling 911 or your local emergency number.
If another person is available, have that person call for help immediately while you attend to the baby.
AIRWAY: Clear the airway
1. Place the baby on his or her back on firm, flat surface, such as a table. The floor or ground also will do.
2. Gently tip the head back by lifting the chin with one hand and pushing down on the forehead with the other hand.
3. In no more than 10 seconds, put your ear near the baby's mouth and check for breathing: Look for chest motion, listen for breath sounds, and feel for breath on your cheek and ear.
If the infant isn't breathing, begin mouth-to-mouth breathing immediately.
BREATHING: Breathe for the infant
1. Cover the baby's mouth and nose with your mouth.
2. Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby's mouth one time, taking one second for the breath. Watch to see if the baby's chest rises. If it does, give a second rescue breath. If the chest does not rise, repeat the head tilt-chin lift and then give the second breath.
3. If the chest still doesn't rise, examine the mouth to make sure no foreign material is inside. If the object is seen, sweep it out with your finger. If the airway seems blocked, perform first aid for a choking infant.
4. Begin chest compressions ― go to "CIRCULATION" below.
CIRCULATION: Restore blood circulation
1. Imagine a horizontal line drawn between the baby's nipples. Place two fingers of one hand just below this line, in the center of the chest.
2. Gently compress the chest to about one-third to one-half the depth of the chest.
3. Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of about 100 times a minute.
4. Give two breaths after every 30 chest compressions.
5. Perform CPR for about two minutes before calling for help unless someone else can make the call while you attend to the baby.
6. Continue CPR until you see signs of life or until a professional relieves you.
RELATED相关链接
Choking: First aid 休克
Foreign object inhaled: First aid 异物吸入
Web Resources相关网络资源
American Red Cross www.redcross.org
American Heart Association www.americanheart.org |