临床医学英语教学课件：Unit 12 Emergency Medicine

1、Unit 12Emergency MedicineImportant Combining Forms1. de-: leave; take away2. intra-: within3. therm(o)-: heat4. a-: withoutCardiopulmonary resuscitation Definition Cardiopulmonary resuscitation (CPR) is a procedure to support and maintain breathing and circulation for a person who has stopped breath

2、ing (respiratory arrest) and/or whose heart has stopped (cardiac arrest). Cardiopulmonary resuscitation, commonly called CPR, combines rescue breathing (one person breathing into another person) and chest compression in a lifesaving procedure performed when a person has stopped breathing or a person

3、s heart has stopped beating.The medical term for the condition in which a persons heart has stopped is cardiac arrest (also referred to as cardiorespiratory arrest). CPR is used on patients in cardiac arrest in order to oxygenate the blood and maintain a cardiac output to keep vital organs alive.If

4、the patient still has a pulse, but is not breathing, this is called respiratory arrest and artificial respiration is more appropriate. However, since people often have difficulty detecting a pulse, CPR may be used in both cases, especially when taught as first aid. Cardiopulmonary resuscitation (CPR

5、) is an emergency medical procedure for a victim of cardiac arrest or, in some circumstances, respiratory arrest. CPR is performed in hospitals, or in the community by laypersons or by emergency response professionals. Description CPR is part of the emergency cardiac care system designed to save liv

6、es. Many deaths can be prevented by prompt recognition of the problem and notification of the emergency medical system (EMS), followed by early CPR, defibrillation (which delivers a brief electric shock to the heart in attempt to get the heart to beat normally), and advanced cardiac life support mea

7、sures.CPR must be performed within four to six minutes after cessation of breathing so as to prevent brain damage or death. It is a two-part procedure that involves rescue breathing and external chest compressions. To provide oxygen to a persons lungs, the rescuer administers mouth-to-mouth breaths,

8、 then helps circulate blood through the heart to vital organs by external chest compressions. When performed by a bystander, CPR is designed to support and maintain breathing and circulation until emergency medical personnel arrive and take over. When performed by healthcare personnel, it is used in

9、 conjunction with other basic and advanced life support measures.According to the American Heart Association, early CPR and defibrillation combined with early advanced emergency care can increase survival rates for people with a type of abnormal heart beat called ventricular fibrillation by as much

10、as 40%. CPR by bystanders may prolong life during deadly ventricular fibrillation, giving emergency medical service personnel time to arrive.However, many CPR attempts are not ultimately successful in restoring a person to a good quality of life. Often, there is brain damage even if the heart starts

11、 beating again. CPR is therefore not generally recommended for the chronically or terminally ill or frail elderly. For these people, it represents a traumatic and not a peaceful end of life.Purpose When performed quickly enough, CPR can save lives in such emergencies as loss of consciousness, heart

12、attacks or heart arrests, electric shock, drowning, excessive bleeding, drug overdose, and other conditions in which there is no breathing or no pulse. The purpose of CPR is to bring oxygen to the victims lungs and to keep blood circulating so oxygen gets to every part of the body. When a person is

13、deprived of oxygen, permanent brain damage can begin in as little as four minutes and death can follow only minutes later. There are three physical symptoms that indicate a need for CPR to be performed immediately and for emergency medical support to be called: unconsciousness, not breathing, and no

14、 pulse detected. CPR in Basic Life Support Figure A: The victim should be flat on his back and his mouth should be checked for debris. Figure B: If the victim is unconscious, open airway, lift neck, and tilt head back. Figure C: If victim is not breathing, begin artificial breathing with four quick

15、full breaths. Figure D: Check for carotid pulse. Figure E: If pulse is absent, begin artificial circulation by depressing sternum. Figure F: Mouth-to-mouth resuscitation of an infant. Unconsciousness Unconsciousness is when the victim seems to be asleep but has lost all awareness and is not able to

16、respond to questions or to touch or gentle shaking. An unconscious person will not respond to noise or shaking. When unconscious, a person can not cough or clear the throat, which can block the windpipe and cause suffocation and death. People with a major illness or injury or who have had recent sur

17、gery are at risk for losing consciousness. If the person has fainted, which is brief unconsciousness, the cause may be dehydration (lack of body fluids), low blood pressure, or low blood sugar. This is a temporary condition. If the victim is known to have diabetes, a bit of fruit juice may revive th

18、e person once they have regained consciousness. Not Breathing Not breathing, which is also called apnea, is the lack of spontaneous breathing. It requires immediate medical attention. The victim may become limp and lifeless, have a seizure, or turn blue. Prolonged apnea is called respiratory arrest.

19、 In children, this can lead quickly to cardiac arrest in which the heart stops beating. In adults, cardiac arrest usually happens first and then respiratory arrest. The common causes of apnea in adults are obstructive sleep apnea (something blocks the airway during sleep), choking, drug overdose, ne

20、ar-drowning, head injury, heart irregularities (arrhythmia, fibrillation) or cardiac arrest, nervous system disorders, or metabolic disorders. In children the causes may be different, such as prematurity, bronchial disturbances or pneumonia, airway blockage or choking on a foreign object, holding th

21、e breath, seizures, meningitis, regurgitating food, or asthma attacks.No Pulse Detected If the rescuer is unable to detect a pulse or has difficulty in feeling a pulse it can be an indication of the use of improper technique by the rescuer, or shock or cardiac arrest in the victim. If a sudden, seve

22、re decrease occurs in pulse quality (such as pulse weakness) or pulse rate (how many beats in a minute) when other symptoms are also present, life-threatening shock is suspected. The rescuer may need to explain to a doctor or medical professional where on the victims body the pulse was measured, if

23、the pulse is weak or absent altogether, and what other symptoms are present. Medical help and CPR are needed immediately if any of these symptoms is found. Time is critical. A local emergency number should be called immediately. If more than one person is available to help, one can call a local emer

24、gency medical service, while the other person begins CPR. Ideally, someone CPR certified performs the procedure. If a critically ill patient or post-operative patient is being cared for at home, it is a good idea for a family member to take a CPR course to be better prepared to help in case of an emergency.Difficult Words in the Text1. fibrillation: Rapid uncoordinated twitching movements that replace the normal rhythmic contraction of the heart and may cause a lack of circulation an