王桂芳+钱东荣

[摘要] 通过《2005心肺复苏与心血管急救指南》与《2010心肺复苏与心血管急救指南》的比较与应用，总结成人生存链的建立，提高心肺复苏（CPR）的急救成功率，说明了团队协作从院外第一目击者进行CPR到“120”急救人员到达现场急救，快速转运，院内CPR基础生命支持阶段的定位定责，即连续不间断胸外心脏按压同时行电除颤、气管插管、生命支持药物应用及对高级生命支持中重要脏器的保护。阐述在CPR救护中的团队协作对提高复苏成功率、降低致残率起到的积极推进作用。

[关键词] 团队协作；心肺复苏；救护

[中图分类号] R472.2[文献标识码] A[文章编号] 1674-4721（2014）05（b）-0189-03

Application progress of teamwork in CPR rescue

WANG Gui-fang1 QIAN Dong-rong2

1.Department of Emergency,People′s Hospital of Lingbi County in Anhui Province,Lingbi 234200,China;2.Family Planning Guidance Station of Lingbi County in Anhui Province,Lingbi 234200,China

[Abstract] By comparing and practicing Cardio Pulmonary Resuscitation & Emergency Cardiovas Cularcare Manual in 2005 edition and 2010 edition,the article summarizes establishment of adult survival chain can increase the success rate of cardiopulmonary resuscitation (CPR) and explain the position and responsibility of teamwork from CRP by first eyewitness out of hospital to field first aid by "120" emergency workers,rapid transport,to basic life support by CPR in hospital including electric defibrillation,endotracheal intubation,application of life support drug,and protection of vital viscera in advanced life support as well as continuous chest compression simultaneously.The article elaborate teamwork in CPR rescue played promoting roles in increasing success rate of resuscitation and lower down disability rate.

[Key words] Teamwork;Cardiopulmonary resuscitation;Rescue

心脏骤停（cardiac arrest，CA）是多种病因引起的最为危重的临床症状，是急诊急救常见的突发事件，需要紧急处理。心肺复苏（cardiopulmonary resuscitation，CPR）是对CA患者所采取的最紧急最有效的救护措施，是抢救CA的关键环节。救护中的医护和护护配合是CPR成功的重要因素[1]。新版《2010美国心脏协会心肺复苏及心血管急救指南》采用循证医学的原则和方法，对《2005心肺复苏及心血管急救指南》进行最新筛选，分析和论证而形成新的指南[2]。新旧指南中均提及成人生存链的建立，更支持团队协作型急救在CPR中应用的意义。

1 成人生存链的启用

1.1 成人生存链的概念

最早于1992年提出，最新2010生存链内容：立即识别CA并启动急救系统；尽早进行CPR，着重于胸外按压；快速除颤；有效的高级生命支持；综合的CA后治疗。余涛等[2]对成人生存链2005指南和2010指南比较显示，成人生存链强调CPR是一个整体，连续的抢救体系流程，每一个环节都会对患者的生存和预后产生重要影响。……