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医生鼓励市民遇心跳骤停“大胆按

2019-03-28 08:05:08     来源:中新网     责任编辑:刘欣

  医生鼓励市民遇心跳骤停“大胆按!”
  专家呼吁,公共场所应广布AED,推广急救技能培训;北京市卫健委正制定方案推动安装AED

医生鼓励市民遇心跳骤停“大胆按

医生鼓励市民遇心跳骤停“大胆按

  北京协和医院呼吸内科医生留永健

  ■ “东单救人事件”追踪

  协和医生“组团”救回东单体育馆球友一事(详见本报3月27日A10版),在社交网络仍热度不减,除了热议“东单地区是世界上最安全的区域”,更多网友开始关注隐藏在个案背后的院外急救问题——如果没有医生、没有AED,这位球友还能救回来吗?专家呼吁,公共场所都应设置AED,急救技能也应走进千家万户。

  现状

  北京约有150台“救命神器”

  这次急救中,大展身手的除了协和的医生,还有东单体育馆的一台AED——电击除颤4次后,该市民恢复了窦性心律、转送到同仁医院急诊科。

  北大医院急诊科副主任医师熊辉告诉记者,AED俗称救命神器,而且是老百姓也能使用的急救仪器。对于抢救呼吸心跳骤停非常重要,能将室颤恢复为正常的窦性心律。在国外,机场、赌场、市政府相关部门等场所都会设置AED,便于公众使用。随着国内急救意识的提高,越来越多的AED走进人流密集场所,他认为,所有公共场所都应普及AED。

  不少专家发出了同样的呼吁。微博认证用户@急救医生贾大成就对东单急救一事发表评论称,及时的心肺复苏和AED的使用,二者缺一不可。“只有人人学会急救,处处安装AED,心脏骤停的病人才有可能起死回生。”

  北京急救中心急救医疗培训中心主任陈志告诉记者,北京大约有150台AED,其中首都机场有70台,白云观、雍和宫、奥体公园等旅游景点及东单体育场等约有50台,学校等场所约有30台。清华大学校友正在为清华大学安装343台。

  前期,北京市卫生健康委委托北京急救中心起草了《北京市社会急救培训大纲》和《公共场所医疗急救物资配置清单》,其中提及AED,已于2018年向社会公开。目前,北京市卫生健康委正着手制定详细的公共场所应急物资管理方案,这一方案将推动各公共场所和企事业单位安装AED。

  难题

  如何破解“不会救、不敢救”

  急救结束后,协和医生留永健反思,如果同事们不在场,这位球友是否能救回来?周围的球友们会救吗?敢救吗?他认为,普通大众的急救素养还有待提高。

  熊辉也有同样的感受。一方面是急救技能尚未走进千家万户,普通人面对突发情况束手无策,另一方面则是出于种种顾虑而不敢施加援手,两方面的障碍导致院外急救不容乐观。“AED其实是傻瓜式的仪器,每一步骤都有语音提示,老百姓培训之后就会使用,但很多人还是不敢。”他说,在一些配置了AED的公共场所,其使用频率也非常低。此外,高铁追责、“碰瓷”等事件的发生,也让普通民众怯于救人。

  他建议,心肺复苏的技能应该进一步普及,急救立法也应予以完善,减轻公众的后顾之忧。

  陈志介绍,北京急救中心从2008年开始针对高风险岗位人群进行急救培训,包括地铁职工、航空公司空乘人员、公园服务人员、市政管理人员等。目前,中心正在和西城区教委沟通,计划为西城全区中小学教师提供培训。此外,北京急救中心的北京急救科技馆,从2007年成立伊始,每月12日向公众免费开放,至今已累计接待了近万名市民参观。

  ■ 对话

  北京协和医院呼吸内科医生留永健:

  院外急救,勇敢有时比专业更重要

  回应“成网红”:救人是件值得开心的事情

  新京报:“协和医生组团救人”已经刷屏了,有的网友说“东单是世界上最安全的地方”,还有人建议体育馆应该向医生免费开放,你怎么想?

  留永健:都是可以预料的,因为以前就有好几次路人在东单附近被协和大夫抢救的事情了。我们同事也开玩笑说,那天的阵容甚至比医院里还大,六个人、各个科室,很多同事在抢救方面非常有经验。我觉得(救人)毕竟是件值得开心的事情。

  谈院外急救:不专业也能争取宝贵时间

  新京报:你自己对这次急救怎么看?

  留永健:说实话,这次急救在专业上是非常普通的一件事,没有什么太值得说的。但急救过后我反思了一下,如果当晚我们几个医生不在场,现场的人能做到什么程度?或者有没有人敢上前去救?

  新京报:当时现场情况呢?你们去之前周围有没有人在给他急救?

  留永健:周围站了一圈着急的人,但没有人做心肺复苏。

  新京报:你觉得这个问题应该怎么解决?

  留永健:希望大家能明白一个院外急救的原则:心肺复苏,做一定比不做好,哪怕不完全标准。国外的最新急救指南也提出,即使不会人工呼吸,至少应该做胸外按压。

  新京报:有些人可能担心做不好、做坏了。

  留永健:会有这种情况。我们急救过程中,旁边就有人拿了手机去百度标准的急救方法。急救当然有比较规范的程序,但是对普通人来说,这种“规范”可能反而会吓到他们。碰到这种情况怎么办?千万不要觉得自己不是医务人员不敢下手,一定要勇敢地上前去做胸外按压,心跳骤停抢救的黄金时间是3-4分钟,做与不做可能就是生与死的差别。急救能做到完美当然更好,但最重要的是有人去做。

  新京报:还有人会担心没有救回来,反而被要求承担责任。

  留永健:在法律层面,对施救者是有保护的。前段时间女大夫在高铁上救人被索要证明,中国医师协会法务部已经出面表示,根据《民法总则》的有关条款,在紧急情况下为他人施救,施救者可以免责。

  当然,更多人还是出于惊慌恐惧,或出于自我道德,怕因为自己不懂,好心不成反而更害了人家。借此机会我要鼓励大家,不要怕。只要是当场看到心跳骤停,都要勇敢地上去做胸外按压,即使你不够专业,也能为后面赶来的更专业的人争取到宝贵时间。这时候真的是争分夺秒,救得过来,只是一次心跳骤停事件;耽误几分钟,救不过来就是猝死,差别太大了。

  谈AED布局:运动场所有必要配

  新京报:我们有些惊讶的是,这样一个运动馆里会有AED,你一开始就知道吗?

  留永健:我们也觉得特别棒,也在朋友圈给他们点赞。之前并不知道,急救的时候问了一下工作人员才知道有,好像还不止一个。其实很多场合都会发生心跳骤停,但不一定都有AED。

  新京报:AED在这次急救中起到了什么作用?

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