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现代基础生命支持、调度和 AED 概念。

Modern BLS, dispatch and AED concepts.

机构信息

Academic Medical Center, Department of Cardiology, Room F4-228, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

出版信息

Best Pract Res Clin Anaesthesiol. 2013 Sep;27(3):327-34. doi: 10.1016/j.bpa.2013.07.005.

Abstract

Basic Life Support has changed significantly over the last 15 years. Evidence-based changes in recommendations involved compression rate, compression depth and the ratio between compressions and ventilations. There is much evidence that early basic life support increases the probability of survival two- to three-fold. Recognition of a cardiac arrest remains challenging for witness and dispatcher. Educating the public in basic life support and recognition of cardiac arrest are key factors in improving survival of cardiac arrest. The large differences in survival between countries and regions clearly indicate that education and implementation must be high on the agenda in each community. Dispatchers play an increasingly important role in the process, both in rapid recognition of the cardiac arrest as well as giving telephone guidance to those bystanders that had not followed a training in basic life support. Those instructions should only instruct to deliver chest compressions. For those who have been trained in BLS and who are willing to give full CPR, should administer ventilations and chest compressions according to the guidelines. The AED plays a key role in early management of cardiac arrest and can substantially contribute to better survival. Logistics of placement of AEDs and the optimal way to bring AEDs to a victim require much more efforts, especially for victims in residential area's, where the great majority of cases of cardiac arrest occur.

摘要

基础生命支持在过去 15 年中发生了重大变化。推荐建议中的基于证据的变化涉及按压频率、按压深度以及按压与通气的比例。有大量证据表明,早期的基础生命支持将生存的可能性提高了两到三倍。目击者和调度员对心脏骤停的识别仍然具有挑战性。对公众进行基础生命支持和心脏骤停识别的教育是提高心脏骤停患者生存率的关键因素。不同国家和地区之间生存率的巨大差异清楚地表明,教育和实施必须成为每个社区的首要任务。调度员在这一过程中扮演着越来越重要的角色,他们不仅要快速识别心脏骤停,还要为那些没有接受过基础生命支持培训的旁观者提供电话指导。这些指导应该只指示进行胸外按压。对于那些接受过 BLS 培训并愿意进行完整心肺复苏的人,应根据指南进行通气和胸外按压。AED 在心脏骤停的早期管理中起着关键作用,可以显著提高生存率。AED 的放置物流和将 AED 带到受害者的最佳方式需要更多的努力,特别是对于住宅区内的受害者,那里发生了绝大多数心脏骤停病例。

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