Portal field news

Portal field news

in ,

⚽ | EURO2020, fainting Eriksen regains consciousness Representative doctor explains lifesaving measures


写真 

EURO2020, fainting Eriksen regains consciousness Representative doctor explains lifesaving measures

 
If you write the contents roughly
Eriksen received an electric shock on the spot with a manual cardiac massage and a defibrillator.
 

A shocking accident happened at EURO 1, which opened over a year.Group B Denmark ... → Continue reading

 Qoly


Wikipedia related words

If there is no explanation, there is no corresponding item on Wikipedia.

Electric shock

Electric shockThere are the following things called.

Cardiopulmonary resuscitation

Cardiopulmonary resuscitation(CardioPulmonary Resuscitation, CPR) IsBreatheStops,心 臓Is not working (Cardiopulmonary arrest) Of those who are seenHelpIt is a method of assisting circulation to maintain a chance to.

In CPRHeart massage[1]Mainly doIf you can afford itAirway securityAnd it is a method of assisting breathingArtificial respirationAlso do (Ministry of Internal Affairs and CommunicationsFire departmentAccording to the document, "Guidelines for Emergency Resuscitation 2015 (for citizens)", "if the rescuer is trained in artificial respiration and has the skill and willingness to do so", artificial respiration should be performed. .. )[2][3]

Cardiopulmonary resuscitation (hereinafter abbreviated as CPR) is a special deviceMedicineDo withoutPrimary life support(Basic Life Support, BLS) And when the heartbeat does not resume with BLS alone, in an ambulance or in a hospitalParamedic,DoctorAlso performed using tracheal intubation, high oxygen concentration, and drug administrationSecondary life support(Advanced Life Support, ALS).Also, within the scope of BLS, CPR performed in an ambulance or in a hospital is different from CPR performed by a citizen rescuer before the ambulance arrives.There are some differences between untrained civilian rescuers and trained civilian rescuers.

Here, we will explain the CPR of the range of BLS by civil rescuers.

Significance of CPR

What is CPRbrainMaintaining oxygen supply to.

The brain itself does not have the ability to store oxygen and falls into an irreversible state due to hypoxia 4 to 6 minutes after breathing stops.Therefore, it is necessary to send oxygen to the brain as soon as possible.

In the human brain, if cardiopulmonary resuscitation is started within 2 minutes, the lifesaving rate is about 90%, but it is about 4% in 50 minutes and about 5% in 25 minutes.

Therefore, within a few minutes (5-6 minutes) before the arrival of the ambulance crew, "the person who was present at the scene" ("BystanderWhether or not CPR is performed by "citizen rescuers" has a great influence on the lifesaving rate (called "citizen rescuer").Life-saving chain).

Effectiveness

Post-CPR Outcomes in Adults
YearsIn-hospital CPR in the United StatesOut-of-hospital CPR in the United States[4]
Total survival rate (source)Bystanderby
CPR with AED
Bystander CPR
(With or without AED)
CPR implementation
Not witnessed
Total survival rate
Percentage of heartbeat resumption
201849%41.9%20.6%31.3%
Discharge survival rate
201835%16.2%4.4%10.4%
201725.6% (p.e381, e390, 2019 AHA)[5]33%16.4%4.6%10.4%
201626.4% (p.e365, 2018 AHA)32%17.0%4.7%10.8%
201523.8% (p.e471, 2017 AHA)[6]32%16.7%4.6%10.6%
201424.8% (p e270, 2016 AHA)[7]32%16.7%4.9%10.8%
201316.8%4.7%10.8%
2012
201122.7% (p. 499, 2014 AHA)[8]
2010
200918.6% (p. 12, Girotra supplement)[9]
200819.4% [9]

Technique

Chest compressions

Chest compressions are commonly referred to as cardiac massage.

A central remedy for cardiopulmonary resuscitation,Cardiac arrestOf the person who didchestSqueeze the area around your heart with both handsbloodPromote the circulation of. sternumPlace the base of your hand in the lower half of your chest and place your hands on top of each other to press.Straighten and repeat compression as strong as you can continue at a speed of 100 to 120 times / minute. The guideline says, "Press the chest so that it sinks about 5 cm, but do not exceed 6 cm." However, it cannot be measured on the spot, so it can be "strong" as long as it can be continued. Press it to firmly return your chest. Untrained rescuersAutomatic external defibrillator(AED), or Hands Only CPR until the arrival of the ambulance crew[10]That is, continue chest compressions.

Involve other people as much as possible. You can just have them count as 12345 in seconds. If it is 5 times or more in 8 seconds, it satisfies 100 times / minute or more (described later). If you accept the count, it is likely that you will be able to replace chest compressions. If you get tired, ask the people around you to take over for just one minute. A change is necessary to maintain "strong and fast". Minimize the time to interrupt chest compressions. Of cardiopulmonary resuscitationInternational guidelinesIn (2010 revision), the rapid initiation of chest compressions and the minimization of interruptions have become the most important aspects of CPR.

"Heart massage"surgeonChestIncisionIt is a method of rubbing the heart directly with the hands, and chest compressions are not a heart massage.opinionThere is also a misunderstanding. Cardiopulmonary resuscitation performed by incising the chest is called thoracotomy heart (visceral) massage, thoracotomy CPR,Secondary life supportAlthough it is included in (Advanced Life Support; ALS), a heart massage performed without opening the chest is sometimes called a thoracotomy heart massage. In that closed chest massage, doctorsnurse,ParamedicsOther than the general publicambulanceDo it beforePrimary life supportThe heart massage recommended as (Basic Life Support; BLS) is this chest compression.

Cardiac massager

LUCAS,AutoPulseThere is.

Examples of CPR for adults in Japan

The outline of the procedure for performing CPR when neither consciousness nor breathing is performed is described below in accordance with JRC Guideline 2015. Strictly speaking, CPR does not include AED, but it is actually inseparable, so the procedure will be explained here within the scope of BLS including AED. For details of each procedurePrimary life supportSee (BLS).

1. Check safety

To prevent a secondary disaster, first check the safety of the surrounding area.

2. Confirmation of consciousness

Check if you are conscious (tapping both shoulders with both hands and calling "Are you okay !?" in the other person's ear. Also, if you know the name from the certificate etc., "Mr. XX, okay Is it more effective?).

3. Call for support

Call 119. If you are not trained, you can call 119 from your cell phone on the spot and get advice on what to check and what to do. In that adviceAEDAnd the following CPR methods are included.
Involve people around you as much as possible. For example, ask them to pick up an AED, or ask for instructions without hanging up when calling 119 (consult the dispatcher over the telephone).

4. Check breathing

Are you breathing regularly and normally as you see it? If you are breathing, you are in the recovery position. Indistinguishable, unnatural breathing, or if not confirmed within 10 seconds, treat as "no breathing". Unnatural breathing, such as slow, irregular breathing, is called "agonal respiration" and occurs in about half of people within minutes of cardiac arrest (ventricular fibrillation). If you feel relieved that you have breathing, you will miss an important lifesaving opportunity. If you are uncertain about breathing, apply chest compressions immediately.

5. Heart massage (chest compressions) (Circulation, C)

The above.

6. Airway management (A: Airway)

Untrained civilian rescuers do not have to.
For trained and confident civilian rescuers, lie on their backs, hold the forehead with one hand, and lift the chin up with the other index and middle fingers (head-posterior chin elevation) ) By doing. Remove any foreign matter in your mouth.

7. Artificial respiration (B: Breathing)

Untrained civilian rescuers do not have to.
For trained and confident civilian rescuers, hold your nose and breathe in for about 1 second to inflate your chest. At this time, from the viewpoint of preventing infectious diseases, a special pocket mask or the like is attached to the patient's mouth.[12].. The interval for artificial respirationChest compressionsAs a guide, 30 times every 2 times. However, the interruption of chest compressions for this purpose should be within 10 seconds.

8. AED defibrillation (D)

AEDUse when arrives. If your body is wet, wipe it off. For other procedures, follow the AED voice guidance. AEDs deployed in public places automate operations so that even ordinary people can use them, and AEDs analyze electrocardiograms to automatically determine whether an electric shock is necessary.

The American Heart Association (AHA)TV commercial Now, let ’s make it more simple for the general public.First call the emergency, then press hard and fast in the middle of the chest", Only emphasized. And "quickly", that is, about the tempo of chest compressions, the disco movie "Saturday Night FeverMasterpiece "Stain AliveIs recommended. The tempo of this song was 1 times per minute, and it was adopted because it was about 103 times / minute when pressed while remembering. It does not mention the degree of "strong". In the case of a moment, it is not possible to verify the depth, and even if it is 113 to 4 cm (old guideline) in the CPR class, beginners are generally weaker than that. Therefore, it is only necessary for people to be conscious of "strongly".

The rationale for hands-only CPR, or chest compressions, is that current guidelines will be disseminated so that one can do the right thing, rather than requiring everyone to have perfect CPR. This is because it is an important idea for lifesaving. Therefore, it refers to guidance focusing on continuous chest compressions, which is considered to be the most important key to resuscitation. In actual situations, many people hesitate to perform CPR due to resistance to artificial respiration, and if only chest compressions are sufficient, the implementation rate of CPR can be expected. In the case of a person who collapsed in front of him, there is data that the lifesaving rate is high when continuous chest compressions are performed if it takes about 10 minutes for the ambulance to collapse. However, in children with cardiac arrest, which often results from respiratory arrest, and in cardiac arrest such as drowning, artificial respiration is necessary because oxygen in the blood is inevitably depleted.

Changes in Guideline 2015

The point is to perform chest compressions as quickly as possible and to minimize their interruptions. It also made the procedure easier to understand so that all rescuers could perform CPR with or without training. In addition, the 119 side said that the person who contacted should be instructed in CPR only for chest compressions.[13].. The main changes in the procedure are as follows.

  • The depth of chest compressions is "about 4 to 5 cm", "at least 5 cm or more", and then "5 cm or more and does not exceed 6 cm". (For children and babies, 1/3 of the chest thickness)
  • The tempo of chest compressions is "about 100 times / minute", "at least 100 times / minute or more", and then "100 times to 120 times / minute".
  • As for chest compressions, it was emphasized that "pressing firmly restores the chest". No force or leaning between compressions. It has the image of circulating blood instead of the stopped heart, and appropriately compresses and releases the pressure.
  • It was emphasized that interruptions in chest compressions should not exceed 10 seconds. It is desirable to continue chest compressions when applying the AED electrode pads, so CPR should be done by helping each other as much as possible.
  • If breathing was abnormal, it was considered to be in cardiac arrest, and it was revised so that chest compressions would not hesitate. If you find a victim, check if you are breathing normally and if you are conscious, but if you feel unnatural at this time or if you are wondering whether it is cardiac arrest, start CPR (cardiopulmonary resuscitation) immediately.
  • No need to check the pulse from Guideline 2005. Even healthcare professionals are inaccurate and time consuming. Citizen rescuers also have a great deal of psychological resistance.
  • The position of chest compressions is "middle of the chest". Immediately easier to understand than "middle of both nipples"[14]Since it is easy to judge, the start of compression is quick. You can wear it over your clothes.
  • Rescuers who are trained and willing to ventilate suggest that chest compressions and ventilation be performed for all adult cardiac arrest victims.

Survival rate

In critically ill patients, at least 10% survive CPR.According to a 2001-2010 sampling survey at US hospitals[15]The overall survival rate was 19%, 10% in cancer patients and 12% in dialysis patients.

80% were over 14 years old, 15% were black, 17% were long-term care patients, 19% were heart failure patients, and 25% were cardiac monitoring patients outside the ICU.Another study of patients with advanced cancer had a survival rate of 10%.[16]..In a study of patients in Sweden, 30% of patients aged 70-79 years, 40% of those aged 80-89, and 29% of those aged 90 and over survived at least 27 days after CPR.[17].

footnote

  1. ^ What is usually called "heart massage" is exactly "chest compression".
  2. ^ Artificial respiration, OK? Changing cardiopulmonary resuscitation: lifesaving training from the Kyoto City Fire Department(Sankei West posted: 2015.4.4. Reference date: 2018.6.18.)
  3. ^ Emergency Resuscitation Act 2015 (for citizens)(Fire and Disaster Management Agency, Ministry of Internal Affairs and Communications)
  4. ^ "National Reports by Year «MyCares". mycares.net. 2019/6/26Browse.
  5. ^ Benjamin Emelia J .; Muntner Paul; Alonso Alvaro; Bittencourt Marcio S .; Callaway Clifton W .; Carson April P .; Chamberlain Alanna M .; Chang Alexander R. et al. (2019-03-05). Stroke Statistics—2019 Update: A Report From the American Heart Association ”. Circulation 139 (10): e56–e528. two:10.1161 / CIR.0000000000000659. PMID 30700139. 
  6. ^ Benjamin, Emelia J .; Blaha, Michael J .; Chiuve, Stephanie E .; Cushman, Mary; Das, Sandeep R .; Deo, Rajat; de Ferranti, Sarah D .; Floyd, James et al. (2017-03- 07). “Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association” (English). Circulation 135 (10): e146–e603. two:10.1161 / CIR.0000000000000485. ISSN 0009-7322 . PMC: 5408160. PMID 28122885. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408160/. 
  7. ^ Mozaffarian Dariush; Benjamin Emelia J .; Go Alan S .; Arnett Donna K .; Blaha Michael J .; Cushman Mary; Das Sandeep R .; de Ferranti Sarah et al. (2016-01-26). Statistics—2016 Update ”. Circulation 133 (4): e38–e360. two:10.1161 / CIR.0000000000000350. PMID 26673558. 
  8. ^ Go, Alan S .; Mozaffarian, Dariush; Roger, Véronique L .; Benjamin, Emelia J .; Berry, Jarett D .; Blaha, Michael J .; Dai, Shifan; Ford, Earl S. et al. (2014-01) -twenty one). “Heart Disease and Stroke Statistics—2014 Update: A Report From the American Heart Association” (English). Circulation 129 (3): e28–e292. two:10.1161 / 01.cir.0000441139.02102.80. ISSN 0009-7322 . PMC: 5408159. PMID 24352519. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408159/. 
  9. ^ a b Girotra, Saket; Nallamothu, Brahmajee K .; Spertus, John A .; Li, Yan; Krumholz, Harlan M .; Chan, Paul S. (2012-11-15). “Trends in Survival after In-Hospital Cardiac Arrest-supplement”. New England Journal of Medicine 367 (20): 1912–20. two:10.1056 / NEJMoa1109148. ISSN 0028-4793 . PMC: 3517894. PMID 23150959. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3517894/. 
  10. ^ AHA Recommendation Statement on Hands Only CPRSee
  11. ^ Introduction of face shield
  12. ^ The AED usually contains a face shield made of clear vinyl sheet. However, this is for the purpose of reducing the psychological resistance to direct mouthing, and has no or sufficient effect of blocking vomit.
  13. ^ The Japanese Red Cross Society and the Fire and Disaster Management Agency have joined the JRC (Japan Radio Company).
  14. ^ The line connecting the nipples is unreliable. There is little error in the "middle of the chest".
  15. ^ “Hospital variation in survival after in-hospital cardiac arrest” (English). Journal of the American Heart Association 3 (1): e000400. (January 2014). two:10.1161 / jaha.113.000400. PMC: 3959682. PMID 24487717. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959682/. 
  16. ^ “Patterns of Resuscitation Care and Survival After In-Hospital Cardiac Arrest in Patients With Advanced Cancer”. Journal of Oncology Practice 13 (10): e821–e830. (October 2017). two:10.1200 / JOP.2016.020404. PMC: 5640412. PMID 28763260. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640412/. 
  17. ^ Hirlekar, G .; Karlsson, T .; Aune, S .; Ravn-Fischer, A .; Albertsson, P .; Herlitz, J .; Libungan, B. (September 2017). in-hospital cardiac arrest ”. Resuscitation 118: 101–106. two:10.1016 / j.resuscitation.2017.07.013. ISSN 1873-1570 . PMID 28736324. 

References

Related item

外部 リンク

For other BLS guidelines, etc.External links for basic life supportSee


 

Back to Top
Close