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北京市红十字会 韩陆
美国心脏协会(AHA)于2010年10月18日正式发布仅以手快速压胸的心肺复苏术(CPR)新指南，并限制以往口对口人工呼吸法的使用。据《今日美国报》报导，新的急救法将采用一分钟快压胸100下、压下深度达两吋的方法，让血液中氧气快速跑到脑部，降低脑死机率。
医学界人士表示，这份新指南象征着该组织针对挽救心脏骤停或心脏病患者，而提倡至少近半个世纪的传统急救法已走入历史。
AHA急救专家塞瑞(Michael Sayre)表示：“压胸法是正确方法。”但他也强调说，口对口人工呼吸法仍可应用在儿童以及可能因缺氧造成的心脏骤停。
这项决定源自于越来越多的研究显示，一般民众对于需要急救的陌生人，最常使用仅压胸的CPR，但其效果却优于传统的CPR。
有研究指出，许多围观路人因不愿进行口对口人工呼吸法，而未伸出援手。早已呼吁进行改变的范德堡大学急救医学主任斯洛维斯(Corey Slovis)说：「这是重大改变。围观路人见到有人濒临死亡，只要压胸即可施救。」
据统计，美国每年有30万人在医院外发生心脏骤停，其中只有不到8%的人获救。《探针》(Lancet)医学周刊最新发表一份针对3700名心脏骤停患者的研究亦指出，仅以手压胸的CPR，能挽救的生命比传统的CPR超出22%。
该研究作者华盛顿大学专家纳吉雷(Peter Nagele)表示，新的CPR可让美国每年多挽救3000人。
应该说，这是半个世纪以来CPR技术的一项重要改进，为此，中国红十字会所采用的教材也应该及时更改，以更好地推广群众性自救互救培训工作。我们北京市红十字会已在准备出版的新教材中进行了更改。
以上材料来自：
http://www.usatoday.com/yourlife/health/medical/2010-10-18-CPR18_ST_N.htm
American Heart Association revises CPR guidelines
An analysis of 3,700 cardiac arrests published Friday in the journal ''''Lancet'''' found that hands-only CPR saved 22% more lives than the conventional method.
Enlarge image Enlarge By Haraz N. Ghanbari, AP
An analysis of 3,700 cardiac arrests published Friday in the journal ''''Lancet'''' found that hands-only CPR saved 22% more lives than the conventional method.
By Steve Sternberg, USA TODAY
It''''s official: Mouth-to-mouth resuscitation died today.
The American Heart Association (AHA) today issued new guidelines for cardiopulmonary resuscitation, better known as CPR, making rapid chest compressions the mainstay of basic life support for bystanders trying to revive people whose hearts have stopped.
Doctors say the AHA''''s change marks the end of the organization''''s advocacy of a practice believed for at least half a century to be essential for saving victims of cardiac arrest or heart attacks. "Compression is the only way to go," says AHA''''s Michael Sayre, an emergency physician at Ohio State University. He added that rescue breathing is still recommended for children and anyone whose cardiac arrest is likely due to oxygen deprivation.
The AHA decision was driven by a growing body of research showing that bystanders are more likely to perform compression-only CPR on strangers and that it works better than conventional CPR.
"It''''s a big deal," says Corey Slovis, chairman of emergency medicine at Vanderbilt University in Nashville and an early advocate of the change. "People are standing around while others are dying, when all they have to do is pump on their chests."
About 300,000 people suffer out-of-hospital cardiac arrest in the USA each year, either because they''''ve had a heart attack or suffered a rhythm disturbance; fewer than 8% survive. An analysis of 3,700 cardiac arrests published Friday in the journal Lancet found that hands-only CPR saved 22% more lives than the conventional method. All told, the switch could save up to 3,000 additional lives a year in the USA and 5,000 to 10,000 in North America and Europe, says lead author Peter Nagele of Washington University in St. Louis.
A landmark study published Oct. 6 in The Journal of the American Medical Associationfound that bystanders who applied hands-only CPR were able to boost survival to 34% from 18% for those who got conventional CPR or none at all. In addition, the percentage of people willing to provide CPR rose from 28% in 2005 to 40% in 2009.
The new guidelines dictate that a bystander should compress the victim''''s chest 100 times a minute to a depth of about 2 inches. That keeps blood and oxygen flowing to the brain, sustaining it until help arrives. Stopping for rescue breaths can interrupt blood flow, AHA''''s Sayre says.
Studies also show that bystanders reluctant to perform mouth-to-mouth breathing often give up, thinking there''''s nothing they can do. "Bystanders aren''''t doing anything in two-thirds of cases," Sayre says. "This is not hard; it''''s really easy."
Slovis says it''''s natural to balk. "Doing artificial ventilation, risking getting infectious disease, is something that most of us are afraid of," he says.
WHAT TO DO
New American Heart Association guidelines for bystander compression-only CPR make saving lives much simpler.
* To perform the chest compressions, place the heel of your hand on the breastbone.
* Keeping elbows locked and arms straight, push down firmly 2 inches with only the heel of your hand touching the chest.
* Release. Repeat until help arrives. Aim for 100 compressions per minute.
Source: USA TODAY |
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