Department of Emergency Medicine, Singapore General Hospital, Outram Road, Singapore 169608.
Singapore Med J. 2011 Aug;52(8):538-42; quiz 543.
The core skills required in resuscitation of cardiac arrest individuals is referred to as Basic Cardiac Life Support or cardiopulmonary resuscitation (CPR). Once cardiac arrest (an unresponsive patient with no breathing or only gasping motions) is recognised, chest compressions should be initiated. Healthcare workers may choose to also check for a pulse to verify cardiac arrest if they are trained. The time taken for breathing check (and pulse check) should not exceed ten seconds. Good quality chest compressions are recommended with each being delivered with arms extended, elbows locked, shoulders vertically above the patient's chest and the heel of the palm on the lower half of the sternum. The rescuer should push hard and fast, with a compression of at least 5.0 cm,100 compressions per minute for adults and allow complete chest recoil after each compression. Every 30 chest compressions should be followed promptly by two quick and short ventilations (each 400-600 ml tidal volume) delivered within six seconds. Chest compression-only CPR is recommended for dispatcher-instructed CPR or if the rescuer, for any reason, is unable or unwilling to do mouth-tomouth ventilations. CPR should only be stopped when the patient wakes up or an emergency team arrives and takes over patient care, or if an automated external defibrillator were to prompt interruption of chest compressions for analysis of heart rhythm or delivery of shock.
心肺复苏术(CPR)是对心跳呼吸骤停患者进行抢救的基本生命支持技术,也称为基础生命支持。一旦识别出心跳呼吸骤停(无反应且无呼吸或仅有濒死喘息的患者),就应立即开始进行胸外按压。如果受过培训,医护人员可能会选择同时检查脉搏以确认是否发生心脏骤停。进行呼吸检查(和脉搏检查)的时间不应超过 10 秒。建议进行高质量的胸外按压,按压时手臂伸直,肘部锁定,肩膀垂直于患者胸部,手掌根部放在胸骨下半部。施救者应用力快速按压,按压深度至少 5.0 厘米,每分钟 100 次,每次按压后胸部完全回弹。每 30 次胸外按压后,应立即迅速进行两次通气(每次潮气量 400-600 毫升),通气时间应在 6 秒内完成。如果调度员指示进行单纯胸外按压心肺复苏术,或者由于任何原因施救者无法或不愿意进行口对口通气,则建议进行单纯胸外按压心肺复苏术。只有在患者醒来或急救小组到达并接管患者的护理,或者自动体外除颤器提示中断胸外按压以分析心律或进行电击时,才应停止心肺复苏术。