2005年版美國心臟學會之心肺復甦術重大改變

Major Changes in the 2005 AHA Guidelines for CPR

眾所關注美國心臟學會(American Heart Association,AHA)2005年版心肺復甦術(CardiopulmonaryResuscitation,CPR)與緊急心臟照護(Emergency Cardiovascular Care,ECC)指導方針，終於在11月Circulation雜誌之網站搶先公佈，同時於12月份Circulation雜誌上出刊。強調CPR是高級心臟救命術(Advanced Cardiac Life Support,ACLS)最重要的部分，專家也一致認為愈多的壓胸可提供更多的血流，修改壓吹比、縮短吹氣時間，簡化壓胸位置等，期望能提供更快、更多的壓胸動作，以提高存活率。專家們亦針對非專業人員提供簡單、易學、易記之CPR方法，以提升其施救率。例如：施救於所有年齡層，壓胸及吹氣比都一樣，也不需摸脈搏或看循環跡象，只要像瀕死的喘息(agonal gasps)就需CPR等。欲救回猝死病人，2005年版更強調「生命之鍊」中「高品質的CPR」的重要，才能真正救活病人。本文將AHA於2005年底公佈之CPR準則做重點整理，依CPR操作程序依序做一介紹。

The authors of the 2005 AHAGuidelines for CPR and ECC simplified the BLS sequences,particularly for lay rescuers, to minimize differences in the steps and techniques of CPR used forinfant, child, and adult victims. These guidelines provide simplified information and emphasize theimportance of high-quality CPR. The goal of these changes is to make CPR easier for all rescuersto learn, remember, and perform. Some skills will no longer be taught to lay rescuers. To achieveoptimal compression rates and reduce the frequency of interruptions in compressions, a universalcompression-ventilation ratio of 30:2 for all lone rescuers of victims from infancy through adulthoodis recommended. Rescuers are encouraged to perform effective chest compressions (pushhard, push fast), allow complete chest recoil after each compression, and minimize interruptions inchest compressions. New recommendation created a change from a 3-shock sequence to 1 shock totreat VF/pulseless VT followed immediately by CPR. When VF/pulseless VT is present, the rescuershould deliver 1 shock and should then immediately resume CPR, beginning with chestcompressions.