Historically CPR was intended to be used in situations where death was accidental, 比如溺水或触电, 或者当一个健康的人心脏病发作时. 在这样孤立的事件中，每年都有成千上万的生命通过心肺复苏术得以挽救. 然而, attempting CPR is not always the right choice and may represent a violation of a person’s right to die with dignity. 今天, 医院和疗养院都有, 尝试心肺复苏术已经成为标准程序，并提供给每个人.
Cardiopulmonary Resuscitation (CPR) is the combination of measures performed to attempt to get oxygen into your body and maintain blood circulation to the brain and heart in the event that breathing stops and/or the heart stops beating. 这也被称为心脏骤停. 做心肺复苏术不能保证成功.
这些措施*可包括:
- A=气道，B=呼吸:先进行口对口人工呼吸, 然后这可能需要袋子和面罩或呼吸管. A tube may be put through the patient’s nose or mouth into the lungs in order to force air into and out of them. A ventilator or respirator (breathing machine) may be required as the next step.
- C=Circulation: Chest compressions where the chest is forcefully pressed in order to pump blood from the heart into the rest of the body. Electric shock (defibrillation/cardioversion) may be used in an attempt to restore normal heart rhythm. Medications are injected in an attempt to restore normal heart rhythm and blood pressure.
*Any or all of these measures may be used in the sequence/steps of resuscitation.
尝试和使用心肺复苏术并不是一个简单的决定. 在某些情况下不应该使用或尝试心肺复苏术. The person’s health condition, chances of survival and quality of life need to be considered. 选择不做心肺复苏术是可以的. 它不影响任何其他治疗选择.
心肺复苏术的效果如何?
- 心肺复苏术的有效性取决于以前的健康状况, the cause of cardiac arrest and how soon CPR is performed after the heart or breathing stops.
- The survival rate for CPR decreases when there are multiple illnesses present.
- CPR will not cure an underlying disease but may restore heartbeat and breathing.
- CPR is not likely to be beneficial if advanced life-threatening illnesses are present.
- Cardiac arrest is usually the final step in the body’s natural process of aging leading to death.
CPR存活率
The evidence overwhelmingly shows that CPR is not able to restore most people who are at the end of a life-threatening illness to their previous level of functioning. 心肺复苏术对这些病人没有医学上的益处. 在电视上, 心肺复苏术在现实生活中表现得并不十分准确, 这个过程更加残酷，成功率也更低. 当一个人由于严重的或进展性的疾病而健康每况愈下时, 心肺复苏术几乎没有成功的机会. 结果可能只是部分成功和暂时的.
对住院病人进行心肺复苏术与不良预后相关, as the cause of arrest is usually associated with advanced chronic illness rather than an easily reversible heart or breathing failure.
The largest and most comprehensive source of in-hospital CPR outcomes data is the National Registry of Cardiopulmonary Resuscitation, 报告14,2000-2002年，美国207例成人720例复苏尝试.S. 医院. Survival 20 minutes after CPR was 44%, but only 17% of all CPR patients survived to discharge.
Fewer than 15% of patients who have CPR while in the hospital’s intensive care units survive and are able to function as they used to. Studies report that CPR is successful in only 5-12% of patients whose heart or lungs stop working outside the hospital and who receive CPR before entering the hospital. Only 1-5% of long-term care patients receiving CPR survive CPR because such patients usually have health problems affecting many organs in the body.
It is normal and instinctive to try to save life, no matter what the cost or outcome. Some people are concerned that not doing everything possible to preserve life is the same as “killing” someone. It also simply means respecting the end stage of a disease and allowing the natural course of events as the physical body naturally shuts down.
心肺复苏的风险
Chest compressions during CPR can cause bruising/pain on the chest, broken ribs or a collapsed lung.
If CPR is successful, care may need to be provided in an intensive care unit. 呼吸机可能是必要的.
Even if breathing and heart beat is restored by CPR, brain damage may have occurred. 心肺复苏术可以延缓或延长死亡过程.
谁来决定心肺复苏术?
You and your physician will decide whether CPR should be attempted during a cardiopulmonary arrest. 如果你在医院, you will be asked about your choices and personal preference on admission and if there are substantial changes in your health status. It is important that family members are clear on your decisions regarding CPR.
如果我决定不做心肺复苏术怎么办?
决定是选择还是拒绝心肺复苏, 将继续提供适当的医疗和精神电子游艺靠谱排行. Comfort is always provided, not allowing an individual to suffer or struggle. 就像有许多治疗方法可以尝试修复和治愈一样, there are measures to keep people comfortable and allow dignity without hastening death. 在Altru, you will be asked to sign a document confirming your request called a POLST (Physician’s Orders for Life Sustaining Treatment). 你有权利随时改变主意.
如果我不能表达我的愿望怎么办?
如果你无法沟通或自己做决定, your healthcare provider should make treatment decisions based on your wishes, 如果知道这些. If your wishes are not known by your healthcare provider they will take in account your known values, 从了解你信仰的人那里得到的信息, and aspects of your culture and religion that would influence medical decisions.
我可以把我的决定写下来吗?
是的. Using Advanced 医疗指令s is the best method to prepare written instructions about the type of care you would want if you were to lose your decision-making capacity or be unable to make your wishes known. 心肺复苏术是这类文献中讨论的主要治疗方法之一. 它也让你所爱的人不必做出这个艰难的决定. 个人医疗问题和整体健康, life goals and beliefs about life support are all important considerations in determining whether CPR is the right choice. 这也可能随着时间的推移而改变. Discuss your wishes and concerns about CPR with your family and your physician or healthcare provider. 您是否需要更多的信息或想要讨论您对心肺复苏术的愿望, 建议您与您的医生联系, 医疗保健或精神顾问.
