歯科診療室における新しい心肺蘇生術
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概要
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This paper is based on the of 1985 American National Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC) and the Standards and Guidelines for Cardiopulmonary Resuscitaion (CPR) and Emergency Cardiac Care (ECC) in 1986. They include several important alterations of CPR. Maneuver to open airways must be simple and effective, and the chin lift maneuver meets these criteria. Adequate time for two breaths (1 to 1.5 seconds per breath) shoud be allowed to provide good chest expansion and to decrease the possibility of gastric distension. The guidlines establish proper hand positions for the external chest compression. Advanced "thoracic pump mechanism" has been accepted while conventional "cardiac pump theory" of blood flow during CPR has not. Accoridng to the accepted theory, external chest compression produces a rise in the intrathoracic pressure that is transmitted equally to all intrathoracic vascular structures. Thus, self-induced CPR is pos- sible, and the patient has the ability to cough forcefully. Increased intrathoracic pressure will generate blood flow to the brain and so maintain consciousness for a longer period of time. The most advanced alternation is seen in drug therapy in CPR. Atropine sulfate is recognised for its β-stimulating efficacy in the therapy of ventricular asystole. Neither calcium agents or sodium bicarbonate improve the ability to defibrillate. Cardiopulmonary resuscitation and ECC are dynamic disciplines, and further improvements can be expected through accumlating experience and research.
- 1991-06-30
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