全部分类 / 紧急情况:先做什么

13-1 79 项研究、142,740 人合起来算(荟萃分析)。心跳停在医院外面(院外心脏骤停)的人,活着出院…

79 项研究、142,740 人合起来算(荟萃分析)。心跳停在医院外面(院外心脏骤停)的人,活着出院的总共只有 7.6%。在场者做心肺复苏与较高的出院存活率有关。按各研究原有存活率分层后,接受在场者心肺复苏的人,出院存活率为 3.9% 到 16.1%。这两个数来自不同分层,不能当作按压前后的变化。有人在旁边看见发作的占 53%,真得到在场者按压的只有 32%。中国 BASIC-OHCA 登记了 38,227 例急救接诊病例。其中 30,282 例(79.2%)的心脏骤停发生在家中。这批人里,在场者按压率 20.3%,活着出院的 1.2%。顺序是先按压,再让第二个人打电话和拿 AED。机器开机后照着它的语音做。要不要按,看的是有没有正常呼吸。国际红十字 2025 年急救指南写明,心跳刚停的头几分钟,人可能还会不规则地、费力地倒气,或者大声喘。这不算正常呼吸。拿不准算不算正常,就当作不正常。呼吸不正常的,包括喘、呼吸不规则和没有呼吸,都要立刻做心肺复苏
来源:Sasson C 等 (2010). Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes. https://doi.org/10.1161/CIRCOUTCOMES.109.889576 ; Zheng J 等 (2023). Incidence, process of care, and outcomes of out-of-hospital cardiac arrest in China: a prospective study of the BASIC-OHCA registry. The Lancet Public Health. https://doi.org/10.1016/S2468-2667(23)00173-1 ; International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025,第 154 页:「If the person is breathing abnormally (gasping, taking irregular breaths or not breathing), start CPR immediately」;第 161 页:「In the first few minutes after cardiac arrest, a person may have agonal breathing (an irregular and laboured breathing pattern, or gasping noisily). This type of breathing is not normal. If there is any doubt about whether breathing is normal, assume it is not」. https://www.ifrc.org/sites/default/files/2026-03/IFRC%20International%20First%20Aid,%20Resuscitation%20and%20Education%20Guidelines%202025.pdf ; 全国人大 (2020). 民法典(第一百八十四条). https://www.spp.gov.cn/spp/fl/202006/t20200602_463888.shtml
补充说明:不满 1 岁的孩子手法不同,要吹气,见本节第 44 条(婴儿心肺复苏)。不要先掐人中,不要先找家属,不要先拍视频。也不要因为怕按断肋骨就不敢用力。民法典第一百八十四条写明:自愿做紧急救助、把受助人弄伤了,救助人不承担民事责任。