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高级生命支持（ACLS）心脏骤停处理流程图
心肺复苏质量
·用力（≥5厘米）、快速（≥100次/分钟）按压
并等待胸壁回弹
·尽可能减少按压的中断
·避免过度通气
·每2分钟交换一次按压职责
·如果没有高级气道，应采用30：2的按压—通
气比率
恢复自主循环（ROSC）
·脉搏和血压
电击能量
·双相波：建议值（120-200J）；如果该值未知，
使用可选的最大值，第二次及后续的剂量应相当，
而且可考虑提高剂量
·单项波：360J（成人）；儿童初次2J/Kg,第二次
2-4J/Kg，第三次4J/Kg
药物治疗
·肾上腺素静脉注射剂量：每3-5分钟1mg
高级气道
·声门高级气道或气管插管
·每分钟8-10次人工呼吸，伴以持续的胸外按压
可逆病因
低血容量、张力性气胸、缺氧、心脏填塞、酸中
毒、毒素、低钾血症/高钾血症、肺动脉血栓形成、
低温治疗、冠状动脉血栓形成等。
危重病人心肺复苏操作流程英文回答：Cardiopulmonary resuscitation (CPR) is a critical procedure used to revive a patient in cardiac arrest or experiencing respiratory failure. It involves a series of steps that aim to restore blood circulation and oxygenation to vital organs. As a healthcare professional, I have been trained in the proper protocol for performing CPR on critically ill patients. Let me walk you through the process:1. Assess the situation: Before initiating CPR, it is crucial to assess the patient's condition and ensure personal safety. Check for responsiveness and if thepatient is not responsive, shout for help and activate the emergency response system.2. Open the airway: Position the patient on their back and tilt their head back to open the airway. This helps tofacilitate breathing and allows for effective ventilation.3. Check for breathing: Look, listen, and feel for breathing. If the patient is not breathing or only gasping, it indicates a need for CPR.4. Begin chest compressions: Place the heel of one hand on the center of the patient's chest, slightly above the lower half of the sternum. Interlock the fingers of your other hand and position them on top of the first hand. Keep your arms straight and use your body weight to compress the chest at a depth of about 2 inches. Perform compressions at a rate of 100-120 compressions per minute.5. Provide rescue breaths: After 30 compressions, give two rescue breaths. Maintain an open airway by tilting the head back and lifting the chin. Pinch the patient's nose shut and create a seal over their mouth with your mouth. Give a breath that lasts about 1 second, watching for chest rise. Repeat this step for a total of two breaths.6. Continue cycles of compressions and breaths:Alternate between 30 compressions and two breaths until help arrives or the patient shows signs of life.7. Use an automated external defibrillator (AED): If an AED is available, follow the prompts to attach the pads to the patient's chest. The AED will analyze the patient's rhythm and provide instructions for delivering a shock if necessary. Resume CPR immediately after delivering the shock.8. Continue CPR until help arrives: Continue performing CPR until advanced medical personnel take over or the patient shows signs of life.It is important to note that CPR is a physically demanding procedure that requires proper training and practice. Remember to stay calm and focused during the process, as saving a life may depend on your actions.中文回答：心肺复苏（CPR）是一种关键的操作，用于使心脏停跳或呼吸衰竭的患者恢复生命体征。
心肺复苏的三阶段CABD四步法根据CPR’2010国际指南（刚于2010年10月18日用中英文同步向全世界正式公布），心肺复苏的标准步骤和方法，高度概括起来就是三个“ABCD”，称为“三阶段CABD四步法”，即“CABD”渐进式地重复三次:最初紧急处置：第一个ABCD (基础生命支持BLS，最为重要)A Assessment + Airway判断后徒手开放气道B Breathing口对口人工呼吸C Circulation徒手胸外心脏按压D Defibrillation体外电击除颤(AED)但最新的国际指南对步骤做了重大修改CPR’2010国际新指南规定：C Circulation 胸外心脏按压30次A Airway 然后才用徒手开放气道B Breathing 器械或徒口人工呼吸2次D Defibrillation 体外电击除颤(AED)注意：在胸外按压之前仍然是先判断----A即Assessment，当发现有人突然倒地或/和意识丧失，必须首先检查他的神志、呼吸和心跳，在10秒钟内快速完成！BLS步骤改为CABD的理由尽管CPR’2005国际指南强调了高质量胸外按压的重要性，但2005 年以后发表的研究表明：（1）在实施新指南以后心肺复苏质量虽有改善且存活率已上升，但胸外按压的质量仍然需要提高；（2）各个急救系统中的院外心脏骤停存活率相差较大；（3）对于大多数院外心脏骤停患者，均未看见任何旁观者对其进行心肺复苏。
因此，为了更好地实施高质量的心肺复苏，CPR’ 2010国际新指南作出一些更改建议，最大的修改之处就是将成人及儿童的基础生命支持程序（不包括新生儿），从过去的A-B-C-D（开放气道、人工呼吸、胸外按压、电击除颤），更新为C-A-B-D（首先做胸外按压）。
尽管这一根本性更改将需要对所有曾学习过心肺复苏的人员重新进行培训，但参与制定心肺复苏指南的人员及相关专家一致认为，为此付出努力必然是值得的。
