First, the ICU scene resuscitation has an attending physician or more senior physician in charge of the command, requiring two physicians and three nurses to form a resuscitation unit, using a clear division of labor, each in their own way, collaborative organizational methods. The basic division of labor includes: a person in charge of mental judgment and respiratory management, a person in charge of chest cardiac compressions and circulatory support, a nurse in charge of unobstructed intravenous access and drug input, a nurse in charge of drug dispensing and recording, and a nurse as a mobile person.
II. Basic life support (BLS)
(I) Assessment.
1. Main basis: sudden loss of consciousness and loss of aortic pulsation.
2. Other bases: disappearance of heart sounds, undetectable blood pressure, sigh-like breathing, dilated pupils, pale or cyanotic face, and non-bleeding wound.
(II) Basic life support: (2010 version of the regulations: ABC changed to CAB)
1.When a patient in need of cardiopulmonary cerebral resuscitation is found or received, members of the resuscitation unit are immediately in place.
2.Open the airway.
A, patient de-pillowed and lying flat on a hard bed or back pad cardiac massage plate to remove airway secretions.
B, jaw-holding method or head-up-chin method to open the airway.
C, immediate tracheal intubation to establish effective breathing passage.
3, artificial respiration: simple breathing airbag or ventilator ventilation, according to the specific condition to give the appropriate amount of ventilation.
Artificial circulation: chest cardiac compressions
Compression frequency: 80-100 compressions/min (2010 version: more than 100 compressions/min)
Depth of compressions: 4-5cm for adults, 3cm for children 5-13 years old (2010 version: more than 5cm for adults, more than 1/3 of anterior and posterior thoracic diameter for infants and children)
The ratio of compressions to artificial respiration: 30:2. Also establish effective intravenous access: including central and peripheral veins, and invasive hemodynamic monitoring if necessary.
(iii) Further life support.
1.Further correct the hypoxic condition of the organism and adjust the mode and parameters related to mechanical ventilation.
2. Decide on electric defibrillation or electric resuscitation according to the specific situation such as cardiac monitoring.
3. Closely monitor the patient’s vital signs, and reasonably use various resuscitation drugs, such as epinephrine, atropine, lidocaine, sodium bicarbonate, etc.
4.Actively search for and remove the factors that trigger the aggravation of the disease, and try to maintain the stability of the internal environment of the body.
5.Correct cerebral hypoxia as soon as possible, give subhypothermia protection to the brain, keep the body temperature as normal as possible, and use dehydrating diuretics, glucocorticoids, brain cell metabolism promoters, etc. as appropriate.
(IV) Effectiveness evaluation.
1.Effective: Aortic pulsation was felt, spontaneous respiration appeared, and consciousness gradually recovered.
2. Ineffective: disappearance of aortic pulsation, dilated pupils, and no voluntary breathing.