第29届奥运会场馆内心脏猝死抢救成功一例  

Advanced life support in rescue of sudden cardiac arrest:report of a case during the Beijing Olympic Games

作　　者：何忠杰[1] 陈晓红[2] 李笃志[3] 姚晓芳[1] 王增芬[4] 张丽伟[1] 张杰石[5] 曾世京[1] 

机构地区：[1]中国人民解放军总医院第一附属医院急危重症中心ICU,北京100037 [2]中国人民解放军总医院 [3]国家体育总局自剑中心信息中心 [4]北京急救中心 [5]中国协和医科大学

出　　处：《中国急救复苏与灾害医学杂志》2008年第9期517-520,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：2008年8月19日,一位南非自行车教练在老山自行车馆发生猝死。一位第一反应者——女运动员立即实施胸外心脏按压。3min后专业急救人员跑步赶到,接替该运动员进行现场抢救。一位主任医师任现场指挥。所需要医疗设备亦迅速送到。猝死者口腔内的分泌物、呕吐物被清除以打通气道。在贵要静脉留置插管,并行颈外静脉穿刺。通过静脉给予肾上腺素和阿托品。气管插管通气。进行高频率的胸外心脏按压,术中出现胸骨下端塌陷(胸肋关节脱位)。尽早开始心电监控。11min后出现室颤,予以及时除颤取得成功。12min后,患者恢复血压、心跳,心电转为不齐的窦性心律。头颈部冷敷。待患者面色红润、血压稳定后通过奥运车道将患者转送奥运指定医院。运送过程中有专人负责插管的固定。途中转运9min后送到医院,院前抢救时间持续39min。1d后,患者脱离呼吸机,气管插管拔出。未发现脑损伤。On 19 August 2008 a South African cycling coach suffered from sudden death in the Laoshan Cycling Palaestra. A female cyclist, the first responder, practiced extra-thoracic cardiac massage immediately. Three minutes later the professional medical team staff members hurried to the spot at a run and took over the first aid. A chief physician-volunteer was appointed as the on-the-spot commander. Necessary equipments were sent without delay. The secretion in the mouth and trachea was removed so as to open an air path. External jugular vein puncture was practiced in addition to the use of indwelling needle in the basilica vein as the main venous route. Adrenalin and atropine were given via venous route. Extrathoracic cardiac compression with a high frequency was conducted. Sunken lower part of the sternum （dislocation of sternocostal joint） was found. Electrocardiac monitoring was established as soon as possible. Eleven minutes after CPR ventricular fibrillation occurred and defibrillation was performed in time successfully. Ice compress was applied to the head and neck. After cheeks became rosy and blood pressure was stable the patient was transported to a designated hospitals for Olympic Games via special driveway for Beijing Olympic vehicles. During the transportation there was a special person in charge of fixation of the tracheal tube. Nine minutes were needed on the way. The CPR lasted 39 minutes. One day later, the patient was weaned from the respirator, and the tracheal catheter was removed. No cerebral damage was found.

关 键 词：心肺复苏 高级生命支持 现场急救 猝死 

分 类 号：R541.78[医药卫生—心血管疾病]