【外科学习课件】_4.2.3CPCR Cardiopulmonary Cerebral Resuscitation.pptVIP

1 1 Clinical Anaesthesiology（ Cardiopulmonary Cerebral Resuscitation ） 教学内容 复苏的概念 心跳骤停的原因 心跳骤停的诊断要点 复苏过程的三个阶段和处理原则 常用的抢救药物 Contents Etiologies of Cardiac Arrest Diagnosis of Cardiac Arrest Patterns of ECG of Cardiac Arrest Three stages of Cardiopulmonary Cerebral Resuscitation Management of Cardiopulmonary Cerebral Resuscitation Drugs are used in ACLS 什么是心跳骤停？ Cardiac Arrest 指心脏本身的病变，或其他原因所导致的心脏有效搏动突然停止，血液循环中断，造成中枢神经系统和其他组织完全缺氧的状态 什么是心肺脑复苏？ 使心跳、呼吸骤停的病人迅速恢复循环、呼吸和脑功能所采取的抢救措施，称为心肺脑复苏 Cardiopulmonary Cerebral Resuscitation Etiologies of Cardiac Arrest Consider most frequent causes Hypovolemia Hypoxia Hydrogen ion-acidosis Hyper-/Hypokalemia, other metabolic Hypothemia Etiologies of Cardiac Arrest Consider most frequent causes ‘Tables’(Drug OD, accidents) Tamponnade, cardiac Tension pneumothorax Thrombosis, coronary Thrombosis, pulmonary (embolism) Diagnisis (Signs) of Cardiac Arrest Sudden deep unconsciousness Absent carotid and femoral pulse Ashen cyanosis Apnoea or gasping Dilated pupils Patterns of ECG of Cardiac Arrest Ventricular fibrillation (VF) Ventricular tachycardia with no cardiac output Asystole Electromechanical dissociation (EMD) Ventricular fibrillation (VF) Disorganized ventricular electrical activity, Rate too rapid and disorganized to count, Rhythm irregular, No discernible P waves of QRS complexes, Irregular undulations in electrocardiograph baseline, Always results on no effective cardiac output Defibrillation as soon as possible and repeated a necessary, Epinephrine (0.5-1 mg I.V.), Lidocaine (1 mg/kg iv.) Ventricular tachycardia Rate 100-220/min, Rhythm regular of irregular, P waves usually not present, QRS complexes appear like premature ventricular contractions, Usually associated with dramatic decline in blood pressure and cardiac output If blood pressure is stable, deliver a precordial thump or give lidocaine (1.5 mg/kg I.V. repeated once), If pulse is present but blood pressure is unstable,