醫學專欄~陳志中-高級心臟救命術之發展歷史與最新進展

1. (American Heart
Association AHA)
1950
1956
1958
1960
(National
Academy of Science) 1963
1966
1973
(CPR and Emergency Cardiovascular Care)
JAMA
1979 1985 1992
2000
(International Liaison Committee
on Resuscitation ILCOR)
2000
2005
2010 2015
Advanced
Cardiovascular life support ACLS
2000
2015
2000年高級心臟救命術對於急救所
作的建議及說明

2. CPR 15:2
4 1
- CPR
5:1
100
-
80-100 100
4-5
1.5-2
vasopression 40 U
epinephrine
2005年高級心臟救命術對於急救所
作的建議及說明如下
CPR 30:2
5 2
-
1
- -
-CPR-
- 3
2
- Vf Pulseless VT
(PEA)
2010年高級心臟救命術對於急救所
作的建議及說明如下
C-A-B
- A-B-C
C-A-B
C-A-B

3. - 100
5
2010
atropine
(asystole) PEA
atropine
2015年高級心臟救命術對於急救所
作的建議及說明如下
2010
- -
2015
- -
2010 100
2015 100-120
120
2010 5 (2 )
2015 5-6 (2-2.4 )
6
2010 8-10 ( 6-8
)
2015 10 ( 6
)

4. ?
2010 (OHCA)
(AED) CPR
1.5-3 AED
2015 OHCA
AED
CPR AED
- OHCA AED
CPR
AED
- (IHCA)
CPR
( 3
)
(IHCA)
OHCA
- IHCA
(Rapid
Response Team RRT)
:
:
CPR
:
vasopressin
2010
vasopressin
epinephrine vasopressin
epinephrine
2015 vasopressin
vasopressin epinephrine
vasopressin
epinephrine
vasopressin

5. epinephrine
CPR 20
end-tidal CO2
(ET-CO2)
-
ET-CO2 10 mmHg
CPR 20
10 mmHg
TTM
2010 (Return
Of Spontaneous Circulation ROSC)
32-34
12-24
- TTM : OHCA Vf ROSC
- TTM : OHCA asystole/
PEA ROSC
- TTM : IHCA
ROSC
2015 ROSC
32-36 12
- TTM :
ROSC
- TTM 24
- 4
2015 10
ILCOR
2015
2015
2010

6. 1. American Heart Association in collaboration
with International Liaison Committee
on Resuscitation. Guidelines 2000 for
Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care. Circulation.
2000; 102 (suppl): I1–I384.
2. Hazinski MF, Nadkarni VM, Hickey RW,
O’Connor R, Becker LW, Zaritsy A. The
major changes in the 2005 AHA guidelines for
cardiopulmonary resuscitation and emergency
cardiovascular care. Circulation. 2005; 112:
IV-206–IV-211.
3. Field JM, Hazinski MF, Sayre MR, Chameides
L, Schexnayder SM, Hemphill R, Samson
RA, Kattwinkel J, Berg RA, Bhanji F, Cave
DM, Jauch EC, Kudenchuk PJ, Neumar RW,
Peberdy MA, Perlman JM, Sinz E, Travers
AH, Berg MD, Billi JE, Eigel B, Hickey
RW, Kleinman ME, Link MS, Morrison
LJ, O’Connor RE, Shuster M, Callaway
CW, Cucchiara B, Ferguson JD, Rea TD,
Vanden Hoek TL. 2010 American Heart
Association Guidelines for Cardiopulmonary
Resuscitation and Emergency Cardiovascular
Care. Circulation. 2010;122(suppl 3):S640–
S656. doi: 10.1161/CIRCULATION
AHA.110.970889.
4. Monica E. Kleinman, Chair; Erin E. Brennan;
Zachary D. Goldberger; Robert A. Swor;ark
Terry; Bentley J. Bobrow; Raul J. Gazmuri;
Andrew H. Travers; Thomas Rea; 2015
American Heart Association Guidelines
Update for Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care. Circulation.
2015;132[suppl 2]:S414–S435.