Adult BLS 2015 AHA Guidelines for Cardiopulmonary ResuscitationCPR

Adult BLS 2015 AHA Guidelines for Cardiopulmonary Resuscitation(CPR) and Emergency Cardiovascular Care(ECC) M. Nikouyeh, MD. Emergency Medicine specialist Shahid Sadughi University Of Medical Sciences

Basic Life Support 3 1

Basic life support (BLS) Is the foundation of saving lives following cardiac arrest ﺍﺳﺎﺱ ﻧﺠﺎﺕ ﺣیﺎﺕ پﺲ ﺍﺯ ﺍیﺴﺖ ﻗﻠﺒی ﺍﺳﺖ ØRecognition ﺗﺸﺨیﺺ ﺳﺮیﻊ Including CVA and MI ØResuscitation ﺍﺣیﺎ ﺯﻭﺩﺭﺱ ØDefibrillation ﺷﻮک ﺩﺭ ﺍﺳﺮﻉ ﻭﻗﺖ

Key changes of 2015 adult BLS from 2010 ﺗﻐییﺮﺍﺕ کﻠیﺪی The Adult BLS Algorithm has been modified to reflect the fact that rescuers can activate an emergency response (ie, through use of a mobile telephone) without leaving the victim’s side. EMS ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻣﻮﺑﺎیﻞ ﺍﻣکﺎﻥ ﻓﻌﺎﻝ کﺮﺩﻥ ﺭﺍ ﺑﺪﻭﻥ ﻧیﺎﺯ ﺑﻪ ﺗﺮک کﺮﺩﻥ ﺑیﻤﺎﺭ ﻓﺮﺍﻫﻢ ﻣیکﻨﺪ

Key changes of 2015 adult BLS from 2010 ﺗﻐییﺮﺍﺕ کﻠیﺪی It is recommended that communities with people at risk for cardiac arrest implement PAD(public access defibrillation) programs ﺗﻮﺻیﻪ ﺑﻪ ﺍﻧﺠﺎﻡ ﺑﺮﻧﺎﻣﻪ ﺩﺳﺘﺮﺳی ﻋﻤﻮﻣی ﺑﻪ ﺩﻓیﺒﺮیﻼﺗﻮﺭ ﺩﺭ ﺍﻣﺎکﻦ ﺑﺎ ﺍﺣﺘﻤﺎﻝ ﺑﺎﻻی ﺍیﺴﺖ ﻗﻠﺒی

Community Lay Rescuer AED Program ﺑﺮﺍی ﺍﻣﺪﺍﺩگﺮﺍﻥ AED ﺑﺮﻧﺎﻣﻪ ﻏیﺮ ﺣﺮﻓﻪ ﺍی ﺟﺎﻣﻌﻪ The implementation of a PAD program requires 4 essential components ﺟﺰ ﺍﺻﻠی ﺍﺳﺖ 4 ﺍیﻦ ﺑﺮﻧﺎﻣﻪ ﺷﺎﻣﻞ 1. A planned and practiced response, including identification of locations and neighborhoods where there is high risk of cardiac arrest, placement of AEDs in those areas and ensuring that bystanders are aware of the location of the AEDs ،AED ﺗﻌﺒیﻪ ، ﺷﻨﺎﺳﺎیی ﺍﻣﺎکﻦ ﺑﺎ ﺍﺣﺘﻤﺎﻝ ﺑﺎﻻی ﺍیﺴﺖ ﻗﻠﺒی ﺍﻃﻤیﻨﺎﻥ ﺍﺯ ﺍیﻨکﻪ ﺍﻓﺮﺍﺩ ﺍﺯ ﻣﺤﻞ آﻦ ﺍﻃﻼﻉ ﺩﺍﺭﻧﺪ 2. Training of anticipated rescuers in CPR and use of the AED آﻤﻮﺯﺵ ﺍﻓﺮﺍﺩ ﺟﻬﺖ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ

Community Lay Rescuer AED Program ﺑﺮﺍی ﺍﻣﺪﺍﺩگﺮﺍﻥ AED ﺑﺮﻧﺎﻣﻪ ﻏیﺮ ﺣﺮﻓﻪ ﺍی ﺟﺎﻣﻌﻪ 3. An integrated link with the local EMS system ﻣﺤﻠی EMS ﺍﺭﺗﺒﺎﻁ آﻦ ﺑﺎ ﺳیﺴﺘﻢ 4. A program of ongoing quality improvement کﻨﺘﺮﻝ کیﻔیﺖ ﻣﺴﺘﻤﺮ

Key changes of 2015 adult BLS from 2010 ﺗﻐییﺮﺍﺕ کﻠیﺪی Emphasis has been increased about the rapid identification of potential cardiac arrest by dispatchers, with immediate provision of CPR instructions to the caller

Dispatcher Identification of Agonal Gasps ØDispatchers should be educated to identify unresponsiveness with abnormal and agonal gasps across a range of clinical presentations and descriptions ﺍﻋﺰﺍﻡ کﻨﻨﺪگﺎﻥ ﺑﺎیﺪ ﺑﺪﻭﻥ پﺎﺳﺦ ﺑﻮﺩﻥ ﺑﺎ ﺗﻨﻔﺲ ﻏیﺮ ﻋﺎﺩی ﺭﺍ ﺍﺯ ﻣیﺎﻥ ﺗﻮﺻیﻔﺎﺕ ﺗﺸﺨیﺺ ﺩﻫﻨﺪ Ø Dispatchers should also be aware that brief generalized seizures may be the first manifestation of cardiac arrest ﺍﻋﺰﺍﻡ کﻨﻨﺪگﺎﻥ ﺑﺎیﺪ ﺗﻮﺟﻪ ﺩﺍﺷﺘﻪ ﺑﺎﺷﻨﺪ کﻪ ﺗﺸﻨﺞ کﻮﺗﺎﻩ ژﻨﺮﺍﻟیﺰﻩ ﻣیﺘﻮﺍﻧﺪ ﻧﺸﺎﻧﻪ ﺍیﺴﺖ ﻗﻠﺒی ﺑﺎﺷﺪ ØThe dispatcher should ask straightforward questions about whether the patient is unresponsive and if breathing is normal or abnormal in order to identify patients with possible cardiac arrest and enable dispatcher-guided CPR.

Key changes of 2015 adult BLS from 2010 ﺗﻐییﺮﺍﺕ کﻠیﺪی Bystander-administered naloxone may be considered for suspected life-threatening opioidassociated emergencies ﺍﺳﺘﻔﺎﺩﻩ ﺍﻓﺮﺍﺩ ﺍﺯ ﻧﺎﻟﻮکﺴﺎﻥ ﺩﺭ ﺍﻭﺭژﺎﻧﺴﻬﺎی ﻣﺮﺗﺒﻂ ﺑﺎ ﻣﺨﺪﺭ ﻣﻮﺭﺩ ﺗﻮﺟﻪ ﻗﺮﺍﺭ گﺮﻓﺘﻪ ﺍﺳﺖ

Bystander Naloxone in Opioid. Associated Life Threatening Emergencies ØFor patients with known or suspected opioid addiction who are unresponsive with no normal breathing but a pulse, it is reasonable for appropriately trained lay rescuers and BLS providers, in addition to providing standard BLS care, to administer intramuscular (IM) or intranasal (IN) naloxone. ﺩﺭﻣﻮﺍﺭﺩی کﻪ ﺑیﻤﺎﺭ ﺑﺪﻭﻥ پﺎﺳﺦ ﻭ ﻓﺎﻗﺪ ﺗﻨﻔﺲ یﺎ ﺑﺎ ﺗﻨﻔﺲ ﻏیﺮ ﻃﺒیﻌی ﺍﺳﺖ ﻭ ﺷک ﺑﻪ ﺍﻋﺘیﺎﺩ ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﺍﻣﺪﺍﺩگﺮ ﺍﻣﻮﺯﺵ ﺩیﺪﻩ ﺩﺭ کﻨﺎﺭ ﺍﺣیﺎ ﻣیﺘﻮﺍﻧﺪ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻧﺎﻟﻮکﺴﺎﻥ ﺭﺍ ﻣﺪ ﻧﻈﺮ ﺩﺍﺷﺘﻪ ﺑﺎﺷﺪ ØIn 2014, the naloxone autoinjector was approved by the FDA for use by lay rescuers and HCPs. ﻧﺎﻟﻮکﺴﺎﻥ ﺭﺍ autoinjector ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ FDA 2014 ﺩﺭ ﺳﺎﻝ ﺑﺮﺍی ﺍﻣﺪﺍﺩگﺮﺍﻥ ﺗﺎییﺪ کﺮﺩﻩ ﺍﺳﺖ

Untrained Lay Rescue ﺍﻣﺪﺍﺩ گﺮ ﻏیﺮ ﺣﺮﻓﻪ ﺍی آﻤﻮﺯﺵ ﻧﺪیﺪﻩ Untrained lay rescuers should provide compression-only CPR, with or without dispatcher assistance. The rescuer should continue compression-only CPR until the arrival of an AED or rescuers with additional training ﺑﺎ CPR ﺍﻣﺪﺍﺩ گﺮ ﻏیﺮ ﺣﺮﻓﻪ ﺍی آﻤﻮﺯﺵ ﻧﺪیﺪﻩ ﺑﺎیﺪ یﺎ ﺍﻣﺪﺍﺩگﺮ AED ﻣﺎﺳﺎژ ﺑﻪ ﺗﻨﻬﺎیی ﺭﺍ ﺗﺎ ﺭﺳیﺪﻥ آﻤﻮﺯﺵ ﺩیﺪﻩ ﺍﺩﺍﻣﻪ ﺩﻫﺪ

Trained Lay Rescuer ﺍﻣﺪﺍﺩ گﺮ ﻏیﺮ ﺣﺮﻓﻪ ﺍی آﻤﻮﺯﺵ ﺩیﺪﻩ All lay rescuers should, at a minimum, provide chest compressions for victims of cardiac arrest. If the trained lay rescuer is able to perform rescue breaths, he or she should add rescue breaths in a ratio of 30 compressions to 2 breaths. The rescuer should continue CPR until an AED arrives and is ready for use or EMS providers take over care of the victim. ﺑﺎ CPR ﺍﻣﺪﺍﺩ گﺮ ﻏیﺮ ﺣﺮﻓﻪ ﺍی آﻤﻮﺯﺵ ﺩیﺪﻩ ﺑﺎیﺪ ﺣﺪﺍﻗﻞ 30 ﻣﺎﺳﺎژ ﺑﻪ ﺗﻨﻬﺎیی ﺭﺍ ﺍﻧﺠﺎﻡ ﺩﻫﺪ ﻭ ﺍگﺮ ﻣیﺘﻮﺍﻧﺪ ﺑﺎ ﻧﺴﺒﺖ یﺎ ﺗﺎ ﺯﻣﺎﻥ AED ﺗﻬﻮیﻪ ﻧیﺰ ﺍﻧﺠﺎﻡ ﺩﻫﺪ ﺗﺎ ﺯﻣﺎﻥ ﺭﺳیﺪﻥ 2 ﺑﻪ EMS ﺭﺳیﺪﻥ

Adult Basic Life Support and CPR Quality: HCP BLS ØTrained rescuers are encouraged to simultaneously perform some steps (ie, checking for breathing and pulse at the same time ﺍﻣﺪﺍﺩگﺮﺍﻥ ﺍﻣﻮﺯﺵ ﺩیﺪﻩ ﺗﺸﻮیﻖ ﻣیﺸﻮﻧﺪ کﻪ چﻨﺪ ﻣﺮﺣﻠﻪ ﺭﺍ ﻫﻤﺰﻣﺎﻥ ﺍﻧﺠﺎﻡ ﺩﻫﻨﺪ Ø Integrated teams of highly trained rescuers may use a choreographed approach that accomplishes multiple steps and assessments simultaneously rather than the sequential manner used by individual rescuers ﺗیﻢ ﻣﺘﺸکﻞ ﺍﺯ ﺍﻣﺪﺍﺩگﺮﺍﻥ آﻤﻮﺯﺵ ﺩیﺪﻩ ﻣﺮﺍﺣﻞ ﺭﺍ ﺑﻪ ﺻﻮﺭﺕ ﻫﻤﺰﻣﺎﻥ ﺍﻧﺠﺎﻡ ﻣیﺪﻫﻨﺪ

Adult Basic Life Support and CPR Quality: HCP BLS ØIncreased emphasis has been placed on high-quality CPR using performance targets ﺑﺮ ﺍﺣیﺎ ﺑﺎ کیﻔیﺖ ﺑﺎﻻ ﺍﻫﺪﺍﻑ ﻋﻤﻠیﺎﺗی ﺗﺎکیﺪ ﻣیﺸﻮﺩ Ø Criteria for minimizing interruptions is clarified with a goal of chest compression fraction as high as possible, with a target of at least 60% کﺮﺍیﺘﺮیﺎی کﺎﻫﺶ ﻭﻗﻔﻪ ﺩﺭ ﻣﺎﺳﺎژ ﺑﺎ ﻫﺪﻑ ﺩﺳﺘیﺎﺑی ﺑﻪ کﺴﺮ ﻣﺸﺨﺺ ﻣیﺸﻮﺩ %60 ﻣﺎﺳﺎژ ﺑﺎﻻ ﺣﺪﺍﻗﻞ Ø In continuous chest compressions setting, the use of passive ventilation techniques may be considered for victims of OHCA ﻣﺎﺳﺎژ ﻣﺪﺍﻭﻡ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺗکﻨیکﻬﺎی ﺗﻬﻮیﻪ ﻏیﺮ setting ﺩﺭ ﻓﻌﺎﻝ ﻣیﺘﻮﺍﻧﺪ ﻣﺪ ﻧﻈﺮ ﻗﺮﺍﺭ گیﺮﺩ

Adult Basic Life Support and CPR Quality: HCP BLS ØFor patients with ongoing CPR and an advanced airway in place, a simplified ventilation rate of 1 breath every 6 seconds (10 breaths per minute) is recommended. ﺛﺎﻧیﻪ 6 ﺩﺭ ﺑیﻤﺎﺭﺍﻧی کﻪ ﺭﺍﻩ ﻫﻮﺍیی پیﺸﺮﻓﺘﻪ ﺩﺍﺭﻧﺪ ﻫﺮ یک ﻧﻔﺲ ﺩﺍﺩﻩ ﻣیﺸﻮﺩ ØIt is reasonable for healthcare providers to provide chest compressions and ventilation for all adult patients in cardiac arrest, from either a cardiac or noncardiac cause ﺍﻣﺪﺍﺩگﺮ ﺣﺮﻓﻪ ﺍی ﺑﺎیﺪ ﺑﺮﺍی ﻫﻤﻪ ﺑیﻤﺎﺭﺍﻥ ﺍﺣیﺎ ﺭﺍ ﺑﺎ ﻣﺎﺳﺎژ ﻭ ﺗﻬﻮیﻪ ﺍﻧﺠﺎﻡ ﺩﻫﺪ

Recognition of arrest ﺗﺸﺨیﺺ ﺍﺭﺳﺖ Scenario: Pulse Present, Normal Breathing: Closely monitor the patient, and activate the emergency response system ﺭﺍ ﻓﻌﺎﻝ EMS ﺑیﻤﺎﺭ ﺭﺍ ﺑﻪ ﺩﻗﺖ ﻣﻮﻧیﺘﻮﺭ کﺮﺩﻩ ﻭ کﻨیﺪ

Recognition of arrest ﺗﺸﺨیﺺ ﺍﺭﺳﺖ Scenario: Pulse Present, No Normal Breathing For a patient with known or suspected opioid overdose who has a definite pulse but no normal breathing or only gasping, in addition to providing standard BLS care, it is reasonable for appropriately trained BLS healthcare providers to administer intramuscular or intranasal naloxone. For patients in cardiac arrest, naloxone administration may be considered after initiation of CPR if there is high suspicion for opiate overdose. It is reasonable to provide opioid overdose response education with or without naloxone distribution to persons at risk for opioid overdose ﺩﺭ ﺑیﻤﺎﺭ ﻣﺸکﻮک ﺑﻪ ﻣﺴﻤﻮیﺖ ﺑﺎ ﺍپیﻮﻡ ﺍگﺮ ﺑیﻤﺎﺭ پﺎﻟﺲ ﺩﺍﺭﺩ ﺍگﺮ ﺑیﻤﺎﺭ پﺎﻟﺲ ﻧﺪﺍﺭﺩ. ﻣیﺘﻮﺍﻥ ﺍﺯ ﻧﺎﻟﻮکﺴﺎﻥ ﺍﺳﺘﻔﺎﺩﻩ کﺮﺩ پﺲ ﺍﺯ ﺷﺮﻭﻉ ﺍﺣیﺎ ﻣیﺘﻮﺍﻥ ﺍﺯ ﻧﺎﻟﻮکﺴﺎﻥ ﺍﺳﺘﻔﺎﺩﻩ کﺮﺩ

Recognition of arrest ﺗﺸﺨیﺺ ﺍﺭﺳﺖ Scenario: Pulse Absent, No Breathing or Only Gasping As in the 2010 Guidelines, rescuers should initiate CPR and use an AED as soon as possible. By this point in all potential scenarios, the emergency response system is activated, and a defibrillator and emergency equipment are retrieved or requested. AED ﺍﻣﺪﺍﺩگﺮ ﺑﺎیﺪ ﺍﺣیﺎ ﺭﺍ ﺷﺮﻭﻉ کﺮﺩﻩ ﻭ ﺍﺯ ﺩﺭ ﺍیﻦ ﻣﺮﺣﻠﻪ ﺩﺭ ﺗﻤﺎﻡ ﺳﻨﺎﺭیﻮ ﻫﺎ. ﺍﺳﺘﻔﺎﺩﻩ کﻨﺪ ﺳیﺴﺘﻢ پﺎﺳﺨﺪﻫی ﺍﻭﺭژﺎﻧﺲ ﻓﻌﺎﻝ ﺷﺪﻩ ﻭ ﺩﻓیﺒﺮیﻼﺗﻮﺭ ﻭﺭﺩﻩ ﺷﺪﻩ یﺎ ﺩﺭﺧﻮﺍﺳﺖ ﺷﺪﻩ ﺍﺳﺖ /

Hand Position During Compressions ﻣﺤﻞ ﺩﺳﺖ ﺣیﻦ ﻣﺎﺳﺎژ Lower half of the sternum in adults ﻧیﻤﻪ ﺗﺤﺘﺎﻧی ﻗﻔﺴﻪ ﺳیﻨﻪ

Chest Compression Rate ﺳﺮﻋﺖ ﻣﺎﺳﺎژ 100/min to 120/min

Chest Compression Depth ﻋﻤﻖ ﻣﺎﺳﺎژ At least 2 inches or 5 cm for an average adult Avoid excessive chest compression depths (greater than 2. 4 inches or 6 cm) ﺳﺎﻧﺘی ﻣﺘﺮ 5 ﺍیﻨچ یﺎ 2 ﺣﺪﺍﻗﻞ ﺳﺎﻧﺘیﻤﺘﺮ 6 ﺍیﻨچ یﺎ 2. 4 ﺍﺯ ﻋﻤﻖ ﺑیﺸﺘﺮ ﺍﺯ پﺮﻫیﺰ ﺷﻮﺩ

Chest Wall Recoil ﺑﺎﺯگﺸﺖ ﻗﻔﺴﻪ ﺳیﻨﻪ It is reasonable for rescuers to avoid leaning on the chest between compressions to allow full chest wall recoil for adults in cardiac arrest ﺍﺯ ﺗکیﻪ ﺩﺍﺩﻥ ﺑﻪ ﻗﻔﺴﻪ ﺳیﻨﻪ ﺑیﻤﺎﺭ ﺑﺎیﺪ ﺍﺟﺘﻨﺎﺏ کﺮﺩ

Chest Compressions ﺑﻪ ﺣﺪﺍﻗﻞ ﺭﺳﺎﻧﺪﻥ ﻭﻗﻔﻪ ﺩﺭ ﻣﺎﺳﺎژ total preshock and postshock pauses in chest compressions should be as short as possible ﻭﻗﻔﻪ ﺩﺭ ﻣﺎﺳﺎژ ﻗﺒﻞ ﻭ ﺑﻌﺪ ﺍﺯ ﺷﻮک ﺩﺍﺩﻥ ﺑﺎیﺪ ﺣﺪﺍﻗﻞ ﺑﺎﺷﺪ For adults in cardiac arrest receiving CPR without an advanced airway, it is reasonable to pause compressions for less than 10 seconds to deliver 2 breaths 2 ﺩﺭ ﺍﺣیﺎ ﺑﺪﻭﻥ ﺭﺍﻩ ﻫﻮﺍیی پیﺸﺮﻓﺘﻪ ﺑﺮﺍی ﺍﻧﺠﺎﻡ ﺛﺎﻧیﻪ ﻭﻗﻔﻪ ﻣﻨﻄﻘی ﺍﺳﺖ 10 ﺗﻨﻔﺲ کﻤﺘﺮ ﺍﺯ In adult cardiac arrest with an unprotected airway, it may be reasonable to perform CPR with the goal of a chest compression fraction as high as possible, with a target of at least 60% کﺴﺮ ﻣﺎﺳﺎژ ﻗﻔﺴﻪ ﺳیﻨﻪ ﺑﻬﺘﺮ ﺍﺳﺖ ﺗﺎ ﺣﺪ ﻣﻤکﻦ ﺑﺎﻻ

Compression-to-Ventilation Ratio ﻧﺴﺒﺖ ﻣﺎﺳﺎژ ﺑﻪ ﺗﻬﻮیﻪ It is reasonable for rescuers to provide a compression-toventilation ratio of 30: 2 for adults in cardiac arrest

Managing the Airway ﺍﺩﺍﺭﻩ ﺭﺍﻩ ﻫﻮﺍیی Lay rescuer ØFor victims with suspected spinal injury, rescuers should initially use manual spinal motion restriction rather than immobilization devices ﺍﻣﺪﺍﺩگﺮ ﺍﻣﻮﺯﺵ ﻧﺪیﺪﻩ ﺩﺭ ﻣﻮﺍﺭﺩ ﻣﺸکﻮک ﺑﻪ ﺗﺮﻭﻣﺎی ﺳﺘﻮﻥ ﻓﻘﺮﺍﺕ ﺑﺎیﺪ ﺑیﺤﺮکﺘی ﺩﺳﺘی ﺑﺮﺍی ﺑیﻤﺎﺭ ﻓﺮﺍﻫﻢ کﻨﺪ ØSpinal immobilization devices may interfere with maintaining a patent airway, but ultimately the use of such a device may be necessary to maintain spinal alignment during transport. ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻭﺳﺎیﻞ ﺑیﺤﺮکﺘی ﺳﺘﻮﻥ ﻓﻘﺮﺍﺕ ﻣیﺘﻮﺍﻧﺪ ﺩﺭ ﺍﺣیﺎ ﺗﺪﺍﺧﻞ ﺍیﺠﺎﺩ کﻨﺪ ﻭﻟی ﺑﺮﺍی ﺍﻧﺘﻘﺎﻝ ﺑیﻤﺎﺭ ﻻﺯﻡ ﺍﺳﺖ

Managing the Airway ﺍﺩﺍﺭﻩ ﺭﺍﻩ ﻫﻮﺍیی ØHealthcare Provider A healthcare provider uses the head tilt–chin lift maneuver to open the airway of a victim with no evidence of head or neck trauma. In case of spinal injury jaw trust may be preferred ﺍﻣﺪﺍﺩگﺮ ﺣﺮﻓﻪ ﺍی ﺩﺭ ﻣﻮﺍﺭﺩی کﻪ ﺍﺳیﺐ ﺳﺮ ﻭ head گﺮﺩﻥ ﻭچﻮﺩ ﻧﺪﺍﺭﺩ ﻣیﺘﻮﺍﻧﺪ ﺍﺯ ﻣﺎﻧﻮﺭ ﺩﺭ ﺻﻮﺭﺕ ﻭﺟﻮﺩ. ﺍﺳﺘﻔﺎﺩﻩ کﻨﺪ tilt–chin lift jaw trust ﺗﺮﻭﻣﺎی گﺮﺩﻥ ﺑﻬﺘﺮ ﺍﺳﺖ ﺍﺯ ﻣﺎﻧﻮﺭ ﺍﺳﺘﻔﺎﺩﻩ گﺮﺩﺩ

Rescue Breathing ﺗﻨﻔﺲ ﻣﺼﻨﻮﻋی Mouth-to-Mouth Rescue Breathing Mouth–to–Barrier Device Breathing Mouth-to-Nose and Mouth-to-Stoma Ventilation

Rescue Breathing ﺗﻨﻔﺲ ﻣﺼﻨﻮﻋی Ventilation With Bag-Mask Device provide ventilation with room air or oxygen ﺍﻣکﺎﻥ ﺗﻬﻮیﻪ ﺑﺎ ﻫﻮﺍی ﺍﺗﺎﻕ ﺭﺍ ﻓﺮﺍﻫﻢ ﻣیکﻨﺪ provide positive-pressure ventilation without an advanced airway ﺍﻣکﺎﻥ ﺗﻬﻮیﻪ ﺑﺎ ﻓﺸﺎﺭ ﻣﺜﺒﺖ ﺑﺪﻭﻥ ﺭﺍﻩ ﻫﻮﺍیی پیﺸﺮﻓﺘﻪ ﺭﺍ ﻓﺮﺍﻫﻢ ﻣیکﻨﺪ may result in gastric inflation and its potential complications ﺧﻄﺮ پﺮ ﺷﺪﻥ ﻣﻌﺪﻩ ﻭ ﻋﻮﺍﺭﺽ آﻦ ﺭﺍ ﺑﻪ ﻫﻤﺮﺍﻩ ﺩﺍﺭﺩ Bag-mask ventilation requires considerable practice for competency ﻧیﺎﺯﻣﻨﺪ ﻣﻬﺎﺭﺕ ﻗﺎﺑﻞ ﺗﻮﺟﻪ ﺍﺳﺖ The rescuer delivers breaths during pauses in compressions and delivers each breath over approximately 1 second ﺩﺍﺩﻥ ﺗﻨﻔﺲ ﺑﺎیﺪ یک ﺛﺎﻧیﻪ ﺍﺩﺍﻣﻪ یﺎﺑﺪ

Rescue Breathing ﺗﻨﻔﺲ ﻣﺼﻨﻮﻋی Ventilation With an Advanced Airway deliver 1 breath every 6 seconds (10 breaths per minute) ﺛﺎﻧیﻪ یک ﻧﻔﺲ ﺩﺍﺩﻩ ﻣیﺸﻮﺩ 6 ﻫﺮ

Rescue Breathing ﺗﻨﻔﺲ ﻣﺼﻨﻮﻋی Passive Oxygen Versus Positive-Pressure Oxygen During CPR continuous delivery of oxygen or air directly into the trachea after intubation by using a modified endotracheal tube that had microcannulas inserted into its inner wall. ﺗﺤﻮیﻞ ﻣﺪﺍﻭﻡ ﺍکﺴیژﻦ یﺎ ﻫﻮﺍ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻟﻮﻟﻪ ﺗﺮﺍﺷﻪ ﺗﻐییﺮ یﺎﻓﺘﻪ high-flow oxygen delivery by nonrebreather face mask after oropharyngeal airway insertion as part of a resuscitation ﻭ پﺲ nonrebreather ﺗﺤﻮیﻞ ﺍکﺴیژﻦ ﺑﺎ ﺟﺮیﺎﻥ ﺑﺎﻻ ﺍﺯ ﻃﺮیﻖ ﻣﺎﺳک ﺍﺯ ﺗﻌﺒیﻪ ﺭﺍﻩ ﻫﻮﺍیی ﺍﻭﺭﻭﻓﺎﺭﻧژیﺎﻝ routine use of passive ventilation techniques during conventional CPR for adults is not recommended ﺍﺳﺘﻔﺎﺩﻩ ﺭﻭﺗیﻦ ﺍﺯ ﺗکﻨیکﻬﺎی ﺗﻬﻮیﻪ ﻏیﺮﻓﻌﺎﻝ ﺣیﻦ ﺍﺣیﺎ ﺑﺎﻟﻐیﻦ ﺗﻮﺻیﻪ ﻧﻤیﺸﻮﺩ

AED Defibrillation For witnessed adult cardiac arrest when an AED is immediately available, it is reasonable that the defibrillator be used as soon as possible. ، ﻓﻮﺭﺍ ﺩﺭ ﺩﺳﺘﺮﺱ ﺍﺳﺖ AED ﺩﺭ ﻣﻮﺍﺭﺩ ﺍیﺴﺖ ﻗﻠﺒی ﺷﺎﻫﺪ ﺩﺍﺭ ﺍگﺮ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺩﻓیﺒﺮیﻼﺗﻮﺭ ﺩﺭ ﺍﻭﻟیﻦ ﻓﺮﺻﺖ ﻣﻨﻄﻘی ﺍﺳﺖ For adults with unmonitored cardiac arrest or for whom an AED is not immediately available, it is reasonable that CPR be initiated while the defibrillator equipment is being retrieved and applied and that defibrillation, be attempted as soon as the device is ready for use ﻓﻮﺭﺍ AED ﺩﺭ ﻣﻮﺍﺭﺩ ﺍیﺴﺖ ﻗﻠﺒی ﺑﺪﻭﻥ ﺷﺎﻫﺪ یﺎ ﺩﺭ ﻣﻮﺍﺭﺩی کﻪ ﺩﺭ ﺩﺳﺘﺮﺱ ﻧیﺴﺖ ﺩﺭ ﺣﺎﻟی کﻪ ﺩﻓیﺒﺮیﻼﺗﻮﺭ ﺍﻣﺎﺩﻩ ﻣیﺸﻮﺩ ﺷﺮﻭﻉ ﻣﻨﻄﻘی ﺑﻪ ﻧﻈﺮ ﻣیﺮﺳﺪ CPR

Timing of Rhythm Check ﺯﻣﺎﻥ چک ﺭیﺘﻢ It may be reasonable to immediately resume chest compressions after shock delivery for adults in cardiac arrest in any setting ﻣﺎﺳﺎژ ﺑﺎیﺪ ﺑﻌﺪ ﺍﺯ ﺷﻮک ﺍﺩﺍﻣﻪ یﺎﺑﺪ

Team-Based Resuscitation ﺍﺣیﺎ ﺗیﻤی a designated team leader is needed to direct and coordinate all components of the resuscitation with a central focus on delivering high-quality CPR. through the use of real-time feedback ﺑﺎ CPR ﺭﻫﺒﺮ ﺗیﻢ ﺗﻤﺎﻡ ﺍﺟﺰﺍ ﺍﺣیﺎ ﺭﺍ ﺑﺎ ﻓﻮکﻮﺱ ﺭﻭی کیﻔیﺖ ﺑﺎﻻ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻓیﺪﺑک ﺩﺭ ﻟﺤﻈﻪ ﺭﻫﺒﺮی ﻭ ﻫﻤﺎﻫﻨگ ﻣی کﻨﺪ

Duration of Resuscitatio extending the duration of resuscitation may be a means of improving survival in selected hospitalized patients. ﻃﻮﻻﻧی کﺮﺩﻥ ﻣﺪﺕ ﺍﺣیﺎ ﻣﻤکﻦ ﺍﺳﺖ ﺭﺍﻫی ﺑﺮﺍی ﺑﻬﺒﻮﺩ ﺑﻘﺎ ﺩﺭ ﺑیﻤﺎﺭﺍﻥ ﺑﺴﺘﺮی ﺍﻧﺘﺨﺎﺑی ﺑﺎﺷﺪ

Family Presence During Resuscitation ﺣﻀﻮﺭ ﺧﺎﻧﻮﺍﺩﻩ ﺩﺭ ﻃﻮﻝ ﺍﺣیﺎ Given the evidence for improved psychological benefits for families present during out-of-hospital resuscitation, and without an apparent negative effect on outcomes at hospitals that allow families to be present, family presence represents an important dimension in the paradigm of resuscitation quality.