On October 15, 2015, the American Heart Association (AHA) published the latest version of the Cardiopulmonary Resuscitation Guide. Last week, Xiao Bian has compared the “Adult Basic Life Support and CPR Quality (BLS)†section of the new edition with the 2010 edition, and this article will focus on the pediatric foundation and advanced life support sections of this guide. Giving a summary.
The first is the 2015 AHA cardiopulmonary resuscitation guidelines for pediatric basic life support cardiopulmonary resuscitation (CPR).
1. The survival of children with cardiac arrest outside the hospital is not optimistic, and the survival rate of each age group is about 8%.
2. Because asphyxiated cardiac arrest is more common in children, ventilation devices are critical for children. However, the chest compression, open airway and artificial respiration sequence in children with cardiopulmonary resuscitation are consistent with adult treatment.
3. High quality cardiopulmonary resuscitation (CPR) includes:
Full chest compression frequency (100~120 bpm) and depth (1/3 of the thoracic anteroposterior diameter);
Minimize the number of interruptions to chest compressions;
Avoid hyperventilation (visible rebound of the thorax, 12~20 times/min);
4. Chest compression/artificial respiration is better than simple compression. If the rescuer is not willing to perform artificial respiration, he can also simply press the chest.
2015 AHA cardiopulmonary resuscitation guide pediatric advanced life support content points:
1. The survival rate of cardiac arrest in the pediatric hospital has increased to about 43%.
2. Prolonged CPR is not ineffective. The survival rate of patients who received CPR for more than 35 minutes was 12%, and the neurological prognosis of 60% of patients improved.
3. Treatment before cardiac arrest
The pediatric rapid response treatment team and pediatric early warning scores can reduce mortality in non-ICU patients and general patients, but the findings are inconsistent. These programs can be used in high-risk children in general wards;
For patients with septic shock, infusion bolus treatment (dose up to 20 cc / kg), but subsequent treatment should be based on individual assessment;
In patients with acute fulminant meningitis at risk of cardiac arrest, venous-arterial extracorporeal membrane oxygenation (ECMO) therapy may be considered.
4. Treatment during sudden stop
ECMO cardiopulmonary resuscitation (ECPR) can be used in patients with abnormal cardiac surgery diagnosis, and the prognosis of these patients after ECPR treatment is better than other patients;
Application of end-tidal CO2 and interventional hemodynamic monitoring to assess the quality of CPR treatment, but there is no specific reference value yet;
Defibrillation energy: 2 J/kg, 4 J/kg, >4 J/kg, maximum energy 10 J/kg or adult dose;
For patients with refractory ventricular fibrillation or pulseless ventricular tachycardia, consider amiodarone or lidocaine.
5. Treatment after sudden arrest
Treatment of patients with fever (>38 ° C) after recovery cycle;
Treatment of hypoxemia and normocapnea;
Use fluid and vasoactive drugs to maintain systolic blood pressure (at least 5 percentile in the age group);
EEG was used to predict neurological prognosis within 7 days.
6. The rest of the new guide still uses the 2010 companion proposal.
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