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Sudden cardiac arrest课程教案、知识点、字幕

心脏骤停

是公共卫生和临床医学领域中

最危急的情况之一

表现为心脏机械活动突然停止

患者对刺激无反应

无脉搏 无自主呼吸

或者濒死叹息样呼吸

如果不能得到及时救治

常致患者立刻死亡

就是我们所说的 心脏性猝死

在我国 心脏性猝死的发生率

为每年41.84/10万人

以13亿人口推算

我国每年发生心脏性猝死

54.4万例

即使在美国

心脏性猝死抢救的成活率

仍然小于5%

心脏骤停后

心泵的功能完全丧失

血液循环停止

血氧浓度显著降低

全身组织器官

处于缺血缺氧的状态

造成内环境紊乱

时间过长

就会发生不可逆的损伤

心脏骤停后

体内各种主要器官对无氧

缺血的耐受能力阈值是不同的

中枢神经系统

对缺血缺氧的耐受程度最差

脑组织只占体重的2%

静息时氧摄取

占人体总摄取氧量的20%

血液供应为心排出量的15%

所以最容易受到

缺血缺氧的损伤

脑组织耗氧量高能量储存少

无氧代谢能力有限

因此在正常体温下

心脏停搏4到6分钟

就可以造成不可逆转的脑损伤

在心跳停止后

脑组织中的氧

只够维持大约15秒

当脑组织的氧耗尽后

脑组织将只能通过葡萄糖的

无氧酵解产生ATP提供能量

不同部位的脑组织

对缺氧的耐受能力也不一样

大脑的皮层可以耐受

约4分钟的缺血缺氧

脑干最多耐受10分钟

当心跳骤停4分钟后

脑组织开始出现不可逆的损伤

当心跳骤停10分钟后

脑组织死亡

所以 抢救心跳骤停的患者

有一个黄金4分钟的说法

就是基于以上的原理

引起心跳骤停的病因有很多

可以大致分为心源性

和非心源性两大类

心源性包括心血管疾病

比如冠心病

冠状动脉粥样硬化性心脏病

非粥样硬化性冠状动脉病

比如冠状动脉口狭窄

先天畸形等等

主动脉疾病

比如主动脉夹层

心内膜疾病

比如感染性心内膜炎

心脏瓣膜病

心肌疾病

比如心肌病

另外还有心脏肿瘤

以及高血压 肺动脉栓塞等

那么非心血管事件

也同样可以引起心脏骤停

比如说意外事件

例如创伤 电击伤 溺水 自缢等

还有中毒

像一氧化碳中毒

鼠药和农药中毒

电解质紊乱和酸碱失衡

麻醉意外脑卒中等等

心脏骤停的类型

第一 室颤

第二 无脉性电活动

第三 心脏停搏

其中无脉性电活动分为

电机械分离和无脉性室速

其中心室颤动和无脉性室速

属于可除颤心率

当我们看到这两种心率的时候

应当迅速地为患者除颤

Gateway to Medicine: An Introduction to the Field of Medicine课程列表:

CH01 Smog and Lung Diseases

-01-The basic condition of the air

--The basic condition of the air

-02-What is smog and its influence to the body

--What is smog and its influence to the body

-03-The structure and the function of human respiratory system

--The structure and the function of human respiratory system

-04-How the smog cause the human respiratory system disease

--How the smog cause the human respiratory system disease

-05-Asthma

--Asthma

-Exercise 01

-06-COPD

--COPD

-07-Lung cancer Ⅰ

--Lung cancer Ⅰ

-08-Lung cancer Ⅱ

--Lung cancer Ⅱ

-Exercise 02

CH02 Pregnancy and Delivery

-01 Dissection of genital organs

--Dissection of genital organs

-Exercise 01

-02 The formation of embryo and fetal appendage

--The formation of embryo and fetal appendage

-Exercise 02

-03 Characteristic of embryonic and fetal development

--Characteristic of embryonic and fetal development

-04 Maternal changes during pregnancy

--Maternal changes during pregnancy

-05 Four factors that affect childbirth

--Four factors that affect childbirth

-06 Mechanism of labor

--Mechanism of labor

CH03 Children’s nutrition requirement and infant feeding

-01 The energy requirement and the metabolic characteristics of kids

--The energy requirement and the metabolic characteristics of kids

-02 Need of the nutrition and metabolism of kids Ⅰ

--Need of the nutrition and metabolism of kids Ⅰ

-Exercise 01

-03 Need of the nutrition and metabolism of kids Ⅱ

--Need of the nutrition and metabolism of kids Ⅱ

-Exercise 02

-04 Guided feeding of infant Ⅰ

--Guided feeding of infant Ⅰ

-Exercise 03

-05 Guided feeding of infant Ⅱ

--Guided feeding of infant Ⅱ

-06 Guided feeding of infant Ⅲ

--Guided feeding of infant Ⅲ

CH04 Get to know about tumor

-01 Introduction

--Introduction

-02 What is tumor

--What is tumor

-03 The general shape of tumor

--The general shape of tumor

-04 The atypia of the tumor

--The atypia of the tumor

-05 Name and classification of the tumor

--Name and classification of the tumor

-Exercise 01

-06 The growing type of the tumor

--The growing type of the tumor

-07 Spread of tumor

--Spread of tumor

-Exercise 02

-08 The grading and staging of tumors and the effects to the body

--The grading and staging of tumors and the effects to the body

-09 The difference between benign and malignant tumors

--The difference between benign and malignant tumors

-10 The environmental causes of cancer

--The environmental causes of cancer

-11 Heredity and tumor

--Heredity and tumor

CH05 Emergency (Cardiopulmonary resuscitation) and Disaster Medicine

-01 Overview

--Overview

-02 Sudden cardiac arrest

--Sudden cardiac arrest

-Exercise 01

-03 Non-professional life support

--Non-professional life support

-Exercise 02

-04 Professional life support

--Professional life support

-Exercise 03

-05 Adult advanced life support Ⅰ

--Adult advanced life support Ⅰ

-Exercise 04

-06 Adult advanced life support Ⅱ

--Adult advanced life support Ⅱ

-Exercise 05

-07 Electric defibrillation

--Electric defibrillation

CH06 Cardiovascular disease (Atherosclerosis and hypertension)

-01 Introduction

--Introduction

-02 Risk factors and pathogenesis of atherosclerosis

--Risk factors and pathogenesis of atherosclerosis

-03 Pathological changes of atherosclerosis

--Pathological changes of atherosclerosis

-Exercise 01

-04 Atherosclerosis of vital organs

--Atherosclerosis of vital organs

-05 Coronary atherosclerotic heart disease

--Coronary atherosclerotic heart disease

-Tips 03

--Tips 03

-06 Primary hypertension

--Primary hypertension

-Exercise 02

-07 The etiology and pathogenesis of hypertension

--The etiology and pathogenesis of hypertension

-08 The types and pathologic changes of essential hypertension

--The types and pathologic changes of essential hypertension

-Exercise 03

CH07 The war that never ends——Human versus virus

-01 Overview Ⅰ

--Overview Ⅰ

-02 Overview Ⅱ

--Overview Ⅱ

-03 What is virus

--What is virus

-Exercise 01

-04 The structure and functions of influenza viruses

--The structure and functions of influenza viruses

-Exercise 02

-05 Different type of influenza viruses

--Different type of influenza viruses

-Exercise 03

-06 Bird flu

--Bird flu

-Exercise 04

-07 Street virus

--Street virus

-Exercie 05

CH08 The germs that gastric acid can't kill——Helicobacter pylori and Gastric diseases

-01 Introduction

--Introduction

-02 Chronic gastritis caused by helicobacter pylori infection

--Chronic gastritis caused by helicobacter pylori infection

-Exercise 01

-03 Helicobacter pylori causes peptic ulcer

--Helicobacter pylori causes peptic ulcer

-Exercise 02

-04 Pathological changes of peptic ulcer

--Pathological changes of peptic ulcer

-Exercise 03

-05 Gastric cancer

--Gastric cancer

CH09 The movement and injury of human body——The motor function of human body

-01 The evolution of biological motion

--The evolution of biological motion

-02 Biomechanics of human motion

--Biomechanics of human motion

-Exercise 01

-03 The perfect unity of function and structure

--The perfect unity of function and structure

-Exercise 02

-04 A brief history of trauma orthopedic development Ⅰ

--A brief history of trauma orthopedic development Ⅰ

-05 A brief history of trauma orthopedic development Ⅱ

--A brief history of trauma orthopedic development Ⅱ

-Exercise 03

-06 Sprain and fracture of the ankle joint

--Sprain and fracture of the ankle joint

-Exercise 04

-07 Ankle sprain

--Ankle sprain

-Exercise 05

-08 Prevention of ankle sprain

--Prevention of ankle sprain

Final Exam

-Final Exam

Sudden cardiac arrest笔记与讨论

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