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1、EMERGENCYMANAGEMENTCPRbasiclifesupportABCA—AirwayB—BreathingC—Circulation與小兒復(fù)蘇有關(guān)的解剖生理特點(diǎn)頭部相對(duì)較大,枕凸明顯:意識(shí)不清時(shí)頭易前傾阻塞氣道頸短且胖:小嬰兒觸摸頸動(dòng)脈搏動(dòng)困難易有氣道阻塞氣管軟骨柔弱,氣道狹小,易因炎癥水腫而梗塞CharacterofanatomyandphysiologyofchildrenThenarrowestpartofairwayinfant:cricoidcartilageadult:vocalcordIndicationofCPRLossofconsciousnessNorespi
2、rationsorinvalidbreathingNoarteriopalmusorheartsound,or<60/min,Neonate<80/分neonateindeliveryroom<100次/分Attention:donotdelaytreatmentbecauseofrepeatlyexamination.AssessmentAirwayBreathingCirculationEARLYMANAGEMENTismostimportantResponsornotOpenairwayHead-tilt/chin—liftmaneuveryesBreathingornot5-10sye
3、sProvide2slowbreathingMouth-to-mouth,bag-maskyesCirculationornot5-10sarteriaA、brachialA,femoralAyesOnlyAR12-20breaths/minChestcompressionssingle:30:2,two:15:2Outhospital:callforhelpInhospital:CRPfirstABCforbasiclifesupportofchildrenopenairway,assessment:5-10slookhearfeel開放氣道(Airway,A)injury:jaw-thru
4、st非醫(yī)務(wù)人員不推薦使用☆Head-tilt/chin—liftmaneuver判斷有無反應(yīng)開放氣道壓額舉頜法托頜法(非醫(yī)務(wù)人員不用)有判斷有無呼吸5-10秒有2次人工呼吸口對(duì)口,復(fù)蘇氣囊有判斷有無循環(huán)5-10秒頸A、肱A,股A有僅做人工呼吸12-20次/分鐘胸外按壓單人:30:2,雙人:15:2院外先呼救院內(nèi)先實(shí)施CPR復(fù)蘇體位1.Breathing,B.Mouth-to-mouthbreathingMouth-to-mouthAndnosebreathing2.Bag-maskventilationBagging3.Endotrachealintubation:path:ETTortrac
5、heotomyindication:obstruction,prolongedventilatoryassistanceorcontrolrespiratoryinsufficiency,lossofprotectiveairwayreflexes,routeforapprovedmedicationssedationandparalysisrecommendedunlesspatientisunconsciousoranewborn.equipmentETT:size=(Age+16)/4Roughestimate:thefifthfinger小手指粗細(xì)size:2.5-7Laryngosc
6、opebladegenerally,astraightbladecanbeusedinallpatients.acurvedbademaybeeasierinpatientsProcedureParalyticPreparationPreoxygenationwith100%O2Atropin0.01mg/kgCircoidpressureSedative判斷有無反應(yīng)開放氣道壓額舉頜法托頜法(非醫(yī)務(wù)人員不用)有判斷有無呼吸5-10秒有2次人工呼吸口對(duì)口,復(fù)蘇氣囊有判斷有無循環(huán)5-10秒頸A、肱A,股A有僅做人工呼吸12-20次/分鐘胸外按壓單人:30:2,雙人:15:2院外先呼救院內(nèi)先實(shí)施CP
7、R復(fù)蘇體位Circulation,CCirculation胸外心臟按壓胸內(nèi)心臟按壓Suitableforchildreneasy10分無效chestboneorspinaleformityOut-chestcompressionManoeuvre:different:根據(jù)年齡選擇pisition:乳頭連線部位depth:胸廓厚度1/3-1/2frequency頻率:100次CIR/R:single