新生儿窒息复苏-双语课件

Resuscitationof

NeonatalAsphyxia

QiujiTao2011.7.29学习目标NeonatalResuscitationProcess掌握新生儿窒息复苏流程SummaryofKeyIssuesandMajorChanges了解窒息复苏新进展overview19%ofthenewbornsdiebecauseofasphyxiaovertheworld.Most(90%)oftheNewbornsareviable.Aminority(fewerthan10%)ofnewlyborninfantsrequirealittlehelptoestablishbreath.Only1%needfurtherresuscitationtolive.Neonatalasphyxiarecoveryprocess

neonatalresuscitationcanbedividedintofoursteps(4for30seconds),2minutesrapidassessment---30spositivepressureartificialrespiration---30schestcompressions----30suseofepinephrine---30s第一个30秒

(新生儿快速综合评估)第三个30s

(人工呼吸+胸外按压)30秒正压人工呼吸后心率仍低于60bpm第四个30s

(给肾上腺素)有效的正压人工呼吸30sec+30sec胸外按后心率仍在﹤60次/分SummaryofKeyIssuesandMajorChangesNeonatalcardiacarrestispredominantlyasphyxial,sotheA-B-Cresuscitationsequencewitha3:1compression-to-ventilationratiohasbeenmaintainedexceptwhentheetiologyisclearlycardiac.胸外按压指征：30s正压人工呼吸后仍无心率或心率持续60次/min。按压深度为前后胸直径的1/3。AssessmentofHeartRate,RespiratoryRate,andOxygenation2010(New):AssessmentofHeartRate,RespiratoryRate,andOxygenation2005（旧）：在2005版本中，根据心率、呼吸速率和肤色评估结果进行评估。Why:

Assessmentofcolorissubjective.Therearenowdataregardingnormaltrendsinoxyhemoglobinsaturationmonitoredbypulseoximeter.SupplementaryOxygenWhy:

Evidenceisnowstrongthathealthybabiesbornattermstartwithanarterialoxyhemoglobinsaturationof<60%andcanrequiremorethan10minutestoreachsaturationsof>90%.Hyperoxiacanbetoxic,particularlytothepretermbabyRecommendationsforMonitoringExhaledCO22010(New):ExhaledCO2detectorsarerecommendedtoconfirmendotrachealintubation.2005（旧）：可使用呼出二氧化碳监护仪验证气管插管的位置。Why:Furtherevidenceisavailableregardingtheefficacyofthismonitoringdeviceasanadjuncttoconfirmingendotrachealintubation.Suctioning2010(New):Thereisinsufficientevidencetorecommendachangeinthecurrentpracticeofperformingendotrachealsuctioningofnonvigorousbabieswithmeconium-stainedamnioticfluid.SuctioningWhy:尚无证据证明气道抽吸对健壮婴儿有好处，即使有胎粪也是如此，有证据证明此类抽吸存在风险。现有证据不足以支持或反对为出生时吸入胎粪污染羊水而导致呼吸窘迫的婴儿常规性地执行气管插管内抽吸。DRUGS麻醉