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ISSN:1524-4539Copyright©2010AmericanHeartAssociation.Allrightsreserved.PrintISSN:0009-7322.Online72514CirculationispublishedbytheAmericanHeartAssociation.7272GreenvilleAvenue,Dallas,TXDOI: 10.1161/CIRCULATIONAHA.110.9708892010;122;S640-S656CirculationHoekCallaway,BrettCucchiara,JeffreyD.Ferguson,ThomasD.ReaandTerryL.VandenMarkS.Link,LaurieJ.Morrison,RobertE.O'Connor,MichaelShuster,CliftonW.MarcD.Berg,JohnE.Billi,BrianEigel,RobertW.Hickey,MonicaE.Kleinman,Neumar,MaryAnnPeberdy,JeffreyM.Perlman,ElizabethSinz,AndrewH.Travers,FarhanBhanji,DianaM.Cave,EdwardC.Jauch,PeterJ.Kudenchuk,RobertW.Schexnayder,RobinHemphill,RicardoA.Samson,JohnKattwinkel,RobertA.Berg,JohnM.Field,MaryFranHazinski,MichaelR.Sayre,LeonChameides,StephenM.CardiopulmonaryResuscitationandEmergencyCardiovascularCarePart1:ExecutiveSummary:2010AmericanHeartAssociationGuidelinesfor:Theonlineversionofthisarticle,alongwithupdatedinformationandservices,is:Informationaboutreprintscanbefoundonlineat journalpermissions@lww.com410-528-8550.E-mail:Fax:KluwerHealth,351WestCamdenStreet,Baltimore,MD21202-2436.Phone:410-528-4050.Permissions:Permissions&RightsDesk,LippincottWilliams&Wilkins,adivisionofWolters :InformationaboutsubscribingtoCirculationisonlineatbyonOctober21,2010circ.ahajournals.orgDownloadedfromPart1:ExecutiveSummary2010AmericanHeartAssociationGuidelinesforCardiopulmonaryResuscitationandEmergencyCardiovascularCareJohnM.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.VandenHoekThepublicationofthe2010AmericanHeartAssociationGuidelinesforCardiopulmonaryResuscitationandEmergencyCardiovascularCaremarksthe50thanniversaryofmodernCPR.In1960Kouwenhoven,Knickerbocker,andJudedocumented14patientswhosurvivedcardiacarrestwiththeapplicationofclosedchestcardiacmassage.1Thatsameyear,atthemeetingoftheMarylandMedicalSocietyinOceanCity,MD,thecombinationofchestcompressionsandrescuebreathingwasintroduced.2Twoyearslater,in1962,direct-current,monophasicwaveformdefibrillationwasde-scribed.3In1966theAmericanHeartAssociation(AHA)developedthefirstcardiopulmonaryresuscitation(CPR)guidelines,whichhavebeenfollowedbyperiodicupdates.4Duringthepast50yearsthefundamentalsofearlyrecogni-tionandactivation,earlyCPR,earlydefibrillation,andearlyaccesstoemergencymedicalcarehavesavedhundredsofthousandsoflivesaroundtheworld.Theselivesdemonstratetheimportanceofresuscitationresearchandclinicaltransla-tionandarecausetocelebratethis50thanniversaryofCPR.Challengesremainifwearetofulfillthepotentialofferedbythepioneerresuscitationscientists.Weknowthatthereisastrikingdisparityinsurvivaloutcomesfromcardiacarrestacrosssystemsofcare,withsomesystemsreporting5-foldhighersurvivalratesthanothers.5–9Althoughtechnology,suchasthatincorporatedinautomatedexternaldefibrillators(AEDs),hascontributedtoincreasedsurvivalfromcardiacarrest,noinitialinterventioncanbedeliveredtothevictimofcardiacarrestunlessbystandersareready,willing,andabletoact.Moreover,tobesuccessful,theactionsofbystandersandothercareprovidersmustoccurwithinasystemthatcoordi-natesandintegrateseachfacetofcareintoacomprehensivewhole,focusingonsurvivaltodischargefromthehospital.Thisexecutivesummaryhighlightsthemajorchangesandmostprovocativerecommendationsinthe2010AHAGuide-linesforCPRandEmergencyCardiovascularCare(ECC).ThescientistsandhealthcareprovidersparticipatinginacomprehensiveevidenceevaluationprocessanalyzedthesequenceandprioritiesofthestepsofCPRinlightofcurrentscientificadvancestoidentifyfactorswiththegreatestpotentialimpactonsurvival.Onthebasisofthestrengthoftheavailableevidence,theydevelopedrecommendationstosupporttheinterventionsthatshowedthemostpromise.Therewasunanimoussupportforcontinuedemphasisonhigh-qualityCPR,withcompressionsofadequaterateanddepth,allowingcompletechestrecoil,minimizinginter-ruptionsinchestcompressionsandavoidingexcessiveventilation.High-qualityCPRisthecornerstoneofasystemofcarethatcanoptimizeoutcomesbeyondreturnofspontaneouscirculation(ROSC).Returntoapriorqualityoflifeandfunctionalstateofhealthistheultimategoalofaresuscitationsystemofcare.The2010AHAGuidelinesforCPRandECCarebasedonthemostcurrentandcomprehensivereviewofresuscitationlitera-tureeverpublished,the2010ILCORInternationalConsensusonCPRandECCScienceWithTreatmentRecommendations.10The2010evidenceevaluationprocessincluded356resuscita-tionexpertsfrom29countrieswhoreviewed,analyzed,evalu-ated,debated,anddiscussedresearchandhypothesesthroughin-personmeetings,teleconfer
本文标题:2010年美国心脏病学会心肺复苏指南(英文版)
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