2007-09-05

CPR & AED / 心肺復甦法與自動心臟復甦機(AED)

一般自動心臟復甦機(AED)使用:

全自動體外電擊器(Automated External Defibrillator, AED)生存之鏈包括儘早求救、儘早心肺復甦術、儘早去顫電擊及儘早高級醫療照護,而前三者現已歸類為基本心臟救命術(Basic Life Support),大部份突然心跳停止的病人(≧8歲),其起始的心律是心室顫動(VF),故理想目標是在5分鐘內儘速給予去顫電擊。
AED的使用步驟

步驟1:打開電源開關 (Power on the AED)。

步驟2:貼上電擊片,插入導線 (Attach electrode pads)。

步驟3:分析心律 (Analyze the rhythm)。

步驟4:確定無人接觸病患,依機器指示電擊(Clear the victim and press the shock button)。


AED電擊貼片黏貼的位置

右側電擊片貼在右胸部上方鎖骨下面,胸骨右側處。左側電擊片貼在左乳頭外側,電擊片上緣要距離左腋窩下約7公分左右。


AED的禁忌:

1. 小於8歲以下或體重小於25公斤病患不能使用。

2. 避免接觸水源,若胸部潮濕,須先擦乾再使用AED。

3. 若胸部有藥物貼片或胸部內裝有心律調節器或電擊器(Implantable cardioverter-defibrillators, ICDs),則AED的電極片須貼在遠離上述器具至少2.5公分處。

4. 分析心律時,不可晃動病人,若在行駛的救護車上AED無法分析心律,須先將救護車停穩再行使用。


PAD (Public Access Defibrillator):在公共場所設置AED使大眾能及時拿到AED,這種公用的AED稱為PAD。


PAD設置的考量:

1. 每年1000個社區居民有大於1個居民發生心跳停止的比率即可考慮設置PAD。

2. 啟動EMS服務系統不能在5分鐘抵達急救現場即可考慮設置PAD。

3. 社區內有經過急救訓練的居民可在5分鐘內趕抵急救現場啟動EMS服務系統,有施予CPR及使用AED的能力,即可考慮設置PAD。


PAD急救員的分類

第一級急救員:如警察、消防隊員、警衛、運動教練、空服人員、保全人員、遊艇業者等都應積極接受AED操作的訓練。

第二級急救員:如工廠、公司行號、工作人員等應儘可能接受AED操作的訓練。

第三級急救員:如高危險群疾病的家人或朋友等應儘可能接受AED操作的訓練。

http://www.24drs.com/special_report/first_aid/0910_2_4.asp

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Place AEDs in public areas


I REFER to “Golden hour to treat heart attack” (The Star, Sept 3), where Prof Dr Wan Azman Wan Ahmad, head of the cardiology unit of UMMC, was quoted as saying that the risk of death among heart attack victims increased when they did not seek treatment in time.
While the professor is correct, this survival refers to victims who can still decide whether to seek treatment or not.


These victims would not have suffered a severe arrthymia (heart rhythm disturbance) called ventricular fibrillation.


If heart attack victims do suffer ventricular fibrillation (and the majority do), and if they are untreated immediately, they usually do not even survive the first few minutes.


In the condition of ventricular fibrillation, the heart quivers rather than beats, and is unable to pump blood to all parts of the body. This is called sudden cardiac arrest.


With no blood flow to the brain, death occurs in a matter of minutes. Survival is only in the order of 2%.


However, ventricular fibrillation can be treated if a device called an automated external defibrillator (AED) is used.


With this device, under optimal conditions where it can be applied within three minutes, survival has been shown to improve to almost 75%!


Wikipedia’s entry on acute myocardial infarction states:
“If an AED is available, the rescuer should immediately bring the AED to the patient’s side and be prepared to follow its instructions should the victim lose consciousness.”


AEDs are fully automated devices that, once applied to the chest of the victim, can deliver an electric shock to the heart to correct ventricular fibrillation.


If no ventricular fibrillation is detected, and a shock is thus not needed, it cannot be made to deliver the shock.


As such, AEDs can only help, and will not harm the victim.
Thus, lay responders need not fear harming any victim suspected of having sudden cardiac arrest due to ventricular fibrillation.


In the United States, there are laws to ensure that all federal buildings and public places with high pedestrian traffic flow (stadiums and airports), as well as all commercial airlines, have AEDs.


Sudden cardiac arrest can strike anybody, as shown by the untimely death of 22-year-old Spanish international footballer Antonio Puerta.


I propose that the Government installs AEDs at all government buildings with high pedestrian traffic flow, as well as legislate to have them in public places like airports, sports stadiums, and shopping malls.


Those private citizens who are at high risk of heart attacks, like those who have had a previous heart attack, or are diabetic, should also consider having one in their own homes.

DR T.H. LIEW,
Johor Baru.

http://thestar.com.my/news/story.asp?file=/2007/9/4/focus/18769479&sec=focus

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香港心臟專科學院 自動心臟復甦機(AED)推廣計劃 (詳情)


香港心臟專科學院舉辦了「自動心臟復甦機(AED)推廣計劃」,以提高市民對心臟病及猝死的認識和警覺性。於零七年三月十一日,蘭桂坊協會成為首個獲學院捐贈AED的機構。自動心臟復甦機的成本效益是與該地點的人流與及發生猝死的機會有著非常密切的關係。

蘭桂坊是一個非常理想的地點,裝設了自動心臟復甦機的蘭桂坊現已成為令人「安心」的消閒地方。其他可以考慮安裝自動心臟復甦機的地點包括公共運動場館、地鐵站及安老院等。

香港心臟專科學院相信,如能在緊急情況下可即時使用自動心臟復甦機,將有助拯救更多生命。學院是次推廣計劃的目標是要加強公眾的認知、推廣基本急救技能的訓練與及統籌在合適地點裝設自動心臟復甦機。

本院更與律敦治及鄧肇堅醫院急症科訓練中心合辦六小時之實習課程供有興趣學習急救技術及AED操作的市民參與。

http://www.hkcchk.com/public_aed.php

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1 Comments:

Blogger ccpling said...

my factory has one unit of AED. It was placed in our ERT cabinet.

October 8, 2007 at 9:00 PM  

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