2010心肺复苏指南
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ISSN: 1524-4539 Copyright © 2010 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online72514Circulation is published by the American Heart Association. 7272 Greenville Avenue, Dallas, TXDOI: 10.1161/CIRCULATIONAHA.110.970889 2010;122;S640-S656 CirculationHoek Callaway, Brett Cucchiara, Jeffrey D. Ferguson, Thomas D. Rea and Terry L. VandenMark S. Link, Laurie J. Morrison, Robert E. O'Connor, Michael Shuster, Clifton W. Marc D. Berg, John E. Billi, Brian Eigel, Robert W. Hickey, Monica E. Kleinman,Neumar, Mary Ann Peberdy, Jeffrey M. Perlman, Elizabeth Sinz, Andrew H. Travers, Farhan Bhanji, Diana M. Cave, Edward C. Jauch, Peter J. Kudenchuk, Robert W.Schexnayder, Robin Hemphill, Ricardo A. Samson, John Kattwinkel, Robert A. Berg, John M. Field, Mary Fran Hazinski, Michael R. Sayre, Leon Chameides, Stephen M. Cardiopulmonary Resuscitation and Emergency Cardiovascular CarePart 1: Executive Summary: 2010 American Heart Association Guidelines for
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2010AmericanHeartAssociationGuidelinesforCardiopulmonary
ResuscitationandEmergencyCardiovascularCare
JohnM.Field,Co-Chair*;MaryFranHazinski,Co-Chair*;MichaelR.Sayre;LeonChameides;
StephenM.Schexnayder;RobinHemphill;RicardoA.Samson;JohnKattwinkel;RobertA.Berg;
FarhanBhanji;DianaM.Cave;EdwardC.Jauch;PeterJ.Kudenchuk;RobertW.Neumar;
MaryAnnPeberdy;JeffreyM.Perlman;ElizabethSinz;AndrewH.Travers;MarcD.Berg;
JohnE.Billi;BrianEigel;RobertW.Hickey;MonicaE.Kleinman;MarkS.Link;LaurieJ.Morrison;
RobertE.O’Connor;MichaelShuster;CliftonW.Callaway;BrettCucchiara;JeffreyD.Ferguson;
ThomasD.Rea;TerryL.VandenHoek
Thepublicationofthe2010AmericanHeartAssociation
GuidelinesforCardiopulmonaryResuscitationand
EmergencyCardiovascularCaremarksthe50thanniversary
ofmodernCPR.In1960Kouwenhoven,Knickerbocker,and
Judedocumented14patientswhosurvivedcardiacarrest
withtheapplicationofclosedchestcardiacmassage.1That
sameyear,atthemeetingoftheMarylandMedicalSocietyin
OceanCity,MD,thecombinationofchestcompressionsand
rescuebreathingwasintroduced.2Twoyearslater,in1962,
direct-current,monophasicwaveformdefibrillationwasde-
scribed.3In1966theAmericanHeartAssociation(AHA)
developedthefirstcardiopulmonaryresuscitation(CPR)
guidelines,whichhavebeenfollowedbyperiodicupdates.4Duringthepast50yearsthefundamentalsofearlyrecogni-
tionandactivation,earlyCPR,earlydefibrillation,andearly
accesstoemergencymedicalcarehavesavedhundredsof
thousandsoflivesaroundtheworld.Theselivesdemonstrate
theimportanceofresuscitationresearchandclinicaltransla-
tionandarecausetocelebratethis50thanniversaryofCPR.
Challengesremainifwearetofulfillthepotentialoffered
bythepioneerresuscitationscientists.Weknowthatthereis
astrikingdisparityinsurvivaloutcomesfromcardiacarrest
acrosssystemsofcare,withsomesystemsreporting5-fold
highersurvivalratesthanothers.5–9Althoughtechnology,
suchasthatincorporatedinautomatedexternaldefibrillators
(AEDs),hascontributedtoincreasedsurvivalfromcardiac
arrest,noinitialinterventioncanbedeliveredtothevictimof
cardiacarrestunlessbystandersareready,willing,andableto
act.Moreover,tobesuccessful,theactionsofbystandersand
othercareprovidersmustoccurwithinasystemthatcoordi-
natesandintegrateseachfacetofcareintoacomprehensive
whole,focusingonsurvivaltodischargefromthehospital.Thisexecutivesummaryhighlightsthemajorchangesand
mostprovocativerecommendationsinthe2010AHAGuide-
linesforCPRandEmergencyCardiovascularCare(ECC).
Thescientistsandhealthcareprovidersparticipatingina
comprehensiveevidenceevaluationprocessanalyzedthe
sequenceandprioritiesofthestepsofCPRinlightofcurrent
scientificadvancestoidentifyfactorswiththegreatest
potentialimpactonsurvival.Onthebasisofthestrengthof
theavailableevidence,theydevelopedrecommendations
tosupporttheinterventionsthatshowedthemostpromise.
Therewasunanimoussupportforcontinuedemphasison
high-qualityCPR,withcompressionsofadequaterateand
depth,allowingcompletechestrecoil,minimizinginter-
ruptionsinchestcompressionsandavoidingexcessive
ventilation.High-qualityCPRisthecornerstoneofa
