How Does a Defibrillator Work?除顫器是如何工作的？Defibrillators are instrumental in preventing sudden cardiac arrest (SCA) deaths, but how do they actually work? Though different types of defibrillators have different mechanisms behind them, they all operate on the same basic principle: using controlled electric shocks to prevent cardiac arrest or to restart a heart that no longer beats.除顫器在防止心臟驟停（SCA）死亡方面發(fā)揮著重要作用，但它們實(shí)際上是如何工作的？盡管不同類型的除顫器背后有不同的機(jī)制，但它們的工作原理都是一樣的：使用受控電擊來防止心臟驟?；蛑匦聠?dòng)不再跳動(dòng)的心臟。 A defibrillator is designed to correct or restore a heartbeat with the use of electric pulses or shocks. In a general sense, it can:Correct the kinds of heart arrhythmias (irregular heartbeats) causing cardiac arrest, specifically ventricular fibrillation, and pulseless ventricular tachycardia.·Restore a normal heartbeat in a cardiac arrest suffererA defibrillator first checks for heart arrhythmias. If a shockable arrhythmia is detected, the device triggers a shock to the heart in an effort to restore normal function. A typical defibrillator will deliver 150 to 360 Joules of electricity at a time (less in the case of children). Subsequent shocks may be automatically adjusted with more or less electricity based on the response of the patient.除顫器旨在通過使用電脈沖或電擊來糾正或恢復(fù)心跳。在一般意義上，它可以糾正導(dǎo)致心臟驟停的各種心律失常（不規(guī)則心跳），特別是心室顫動(dòng)和無脈室性心動(dòng)過速?；謴?fù)心臟驟?；颊叩恼Ｐ奶澠魇紫葯z查心律失常。如果檢測到可電擊的心律失常，該設(shè)備會(huì)觸發(fā)對心臟的電擊，以努力恢復(fù)正常功能。一個(gè)典型的除顫器每次會(huì)提供150至360焦耳的電流（兒童的情況下會(huì)更少）。隨后的電擊可以根據(jù)病人的反應(yīng)自動(dòng)調(diào)整更多或更少的電流。 In the past, defibrillators relied exclusively on monophasic shock delivery, meaning that the electrical current flows in a single direction. In recent years, all device makers have switched to lower-energy biphasic shocks, meaning that the current flow goes in both directions. In the first phase, the current flows from one paddle to the other, and in the second phase it reverses direction. The Philips HeartStart series is one of the first AED lines to standardize biphasic waveform technology. 在過去，除顫器完全依賴單相電擊輸出，這意味著電流在單一方向流動(dòng)。近年來，所有設(shè)備制造商都轉(zhuǎn)而采用能量較低的雙相電擊，這意味著電流的流動(dòng)是雙向的。在第一階段，電流從一個(gè)電極片流向另一個(gè)電極片，而在第二階段，電流方向相反。飛利浦HeartStart系列是首批將雙相波形技術(shù)標(biāo)準(zhǔn)化的AED系列之一。 One key benefit of biphasic delivery is that it allows defibrillators to restore normal heart function with less energy, thereby reducing the risk to the patient and allowing a greater likelihood of success. In fact, studies have shown that 200 J biphasic shocks can be as effective as 360 J monophasic shocks. 雙相輸送的一個(gè)關(guān)鍵好處是，它允許除顫器以較少的能量恢復(fù)正常的心臟功能，從而降低了病人的風(fēng)險(xiǎn)，使成功的可能性更大。事實(shí)上，研究表明，200焦耳的雙相電擊可以和360焦耳的單相電擊一樣有效。 Types of Defibrillators除顫器的類型There are three main types of defibrillators:·Automated external defibrillators (AEDs)·Wearable cardioverter defibrillators (WCDs)·Implantable cardioverter-defibrillators (ICD)除顫器有三種主要類型。自動(dòng)體外除顫器（AEDs）可穿戴式心律轉(zhuǎn)復(fù)除顫器（WCDs）植入式心律轉(zhuǎn)復(fù)除顫器（ICD）。 When most people think of defibrillators, they imagine pads or paddles used externally on the chest, but not all defibrillators work this way. An automated external defibrillator (AED) is reserved for cardiac arrest emergencies, but other types of devices are designed for preventive measures.當(dāng)大多數(shù)人想到除顫器時(shí)，他們想象的是在胸部外部使用的電極片或電板，但不是所有的除顫器都以這種方式工作。自動(dòng)體外除顫器（AED）專門用于心臟驟停的緊急情況，但其他類型的設(shè)備是為預(yù)防措施設(shè)計(jì)的。 Automated External Defibrillators (AEDs)自動(dòng)體外除顫器(AEDs)An AED is a small, lightweight, portable defibrillator designed for use on SCA sufferers. Though these defibrillators can vary widely in their cost and complexity, a typical device is equipped with step-by-step voice coaching so that an untrained lay user can save a life in an emergency.An AED is equipped with pads and a battery, both of which come with an expiration date. The pads are equipped with a special gel that adheres to a patient’s bare skin, and built-in sensors allow the defibrillator to analyze the heart for a shockable rhythm. Most devices will only allow shock delivery after determining that such an intervention is safe and advisable.自動(dòng)除顫器是一種小型、輕便、便攜式的除顫器，專門用于SCA患者。盡管這些除顫器在成本和復(fù)雜程度上差別很大，但一個(gè)典型的設(shè)備配備了逐步的語音指導(dǎo)，以便未經(jīng)訓(xùn)練的非專業(yè)用戶能夠在緊急情況下拯救生命。AED配備有電極片和電池，兩者都有一個(gè)有效期。電極片上裝有一種特殊的凝膠，可以粘附在病人的裸露皮膚上，內(nèi)置的傳感器允許除顫器分析心臟的可沖擊節(jié)奏。大多數(shù)設(shè)備只有在確定這種干預(yù)是安全和可取的情況下才允許電擊。 The ‘Automated’ in ‘Automated External Defibrillator’ means that these devices are designed to read the heart rhythm and make a shock/no-shock decision automatically, as opposed to hospital or EMS-grade defibrillators which allow the operator to read the EKG rhythm and make their own decision as to whether to shock, and at what energy level. AEDs use a built-in algorithm to make the determination whether a shock is needed. How that shock is delivered is what makes an AED either Fully Automated or Semi Automated. 自動(dòng)體外除顫器中的 “自動(dòng) ”是指這些設(shè)備被設(shè)計(jì)用來讀取心律并自動(dòng)做出電擊/不電擊的決定，而醫(yī)院或EMS級(jí)除顫器則允許操作者讀取EKG心律并自行決定是否電擊，以及以何種能量水平電擊。自動(dòng)體外除顫器使用一個(gè)內(nèi)置的算法來決定是否需要電擊。如何進(jìn)行電擊是使AED成為全自動(dòng)或半自動(dòng)的原因。 Semi-automatic shock delivery is standard with most AEDs. After the device determines that a shock is warranted, it instructs the user to press a “Shock” button on the device. The shock button is only activated once the AED determines a shockable rhythm, which removes the risk of accidentally shocking someone inappropriately. Devices available in semi-automatic mode include the Philips OnSite and FRx, the Heartsine 350P and 450P, and the Defibtech VIEW. 半自動(dòng)電擊輸出是大多數(shù)AED的標(biāo)準(zhǔn)配置。在設(shè)備確定需要電擊后，它會(huì)指示用戶按下設(shè)備上的一個(gè) "電擊 "按鈕。只有當(dāng)AED確定了可電擊的心律后，電擊按鈕才會(huì)被激活，這就消除了意外地不適當(dāng)?shù)仉姄裟橙说娘L(fēng)險(xiǎn)。半自動(dòng)模式的設(shè)備包括飛利浦OnSite和FRx、Heartsine 350P和450P，以及Defibtech VIEW。 Fully automatic shock delivery requires no intervention from the user once the pads are placed on the patient, other than ensuring everyone stands clear. As soon as the device determines that a shock is warranted, it sounds verbal warnings to let all responders know to stand clear due to an imminent shock, then delivers that shock automatically. This feature is becoming popular in a growing number of defibrillators and is sometimes available as an upgrade. AEDs with this option include the Cardiac Science Powerheart AED G3 Plus and the Cardiac Science Powerheart G5. Several AED models can be purchased as either semi- or fully automated, such as the ZOLL AED Plus, and the Defibtech Lifeline. 完全自動(dòng)的電擊輸出不需要用戶的干預(yù)，一旦電極片放在病人身上，除了確保每個(gè)人都站開之外。一旦設(shè)備確定需要電擊，它就會(huì)發(fā)出口頭警告，讓所有響應(yīng)者知道由于即將發(fā)生電擊而要站開，然后自動(dòng)進(jìn)行電擊。這一功能在越來越多的除顫器中變得流行，有時(shí)可作為一種升級(jí)。具有這一選項(xiàng)的AED包括Cardiac Science Powerheart AED G3 Plus和Cardiac Science Powerheart G5。有幾個(gè)AED型號(hào)可以買到半自動(dòng)或全自動(dòng)的，如ZOLL AED Plus和Defibtech Lifeline。 In addition, a typical external defibrillator will include features like CPR coaching, automatic daily self-tests, child-friendliness settings, and—in many cases—bilingual functionality. 此外，典型的體外除顫器將包括心肺復(fù)蘇輔導(dǎo)、每日自動(dòng)自檢、兒童友好型設(shè)置等功能，在許多情況下還包括雙語功能。 Unlike with other types of defibrillators, anyone can own an AED. In fact, these devices have become popular—and are often even required—in places like hotels, offices, gyms, and schools, because sudden cardiac arrest can strike at any time. 與其他類型的除顫器不同，任何人都可以擁有一臺(tái)AED。事實(shí)上，這些設(shè)備已經(jīng)變得流行，甚至經(jīng)常被要求在酒店、辦公室、健身房和學(xué)校等場所使用，因?yàn)樾呐K驟?？赡茉谌魏螘r(shí)候發(fā)生。 How to Use a Defibrillator如何使用除顫器If you have an ICD implanted, you don’t have to do anything. If you’re prescribed a WCD, you need only wear it as advised by your doctor.An AED is the only type of defibrillator with a learning curve, and even that’s pretty simple on account of the device’s intuitive nature. If you need to use an AED in an emergency, the process is pretty simple:如果您有植入ICD，您不需要做任何事情。如果您被開具了WCD，您只需要按照醫(yī)生的建議佩戴它。AED是唯一一種有學(xué)習(xí)周期的除顫器，由于該設(shè)備的直觀性，即使學(xué)習(xí)周期也很簡單。如果你需要在緊急情況下使用AED，過程也很簡單。 Have someone call 911—or do it yourself if nobody is available·Check to ensure that the patient is experiencing cardiac arrest—no breathing, no heartbeat, unconscious·Power on the AED (this may be done by pressing a Power button or opening the lid)·Follow the step-by-step voice instructions 請人撥打120，或者如果沒有人的話，就自己打吧檢查以確保病人正在經(jīng)歷心臟驟停--沒有呼吸、沒有心跳、失去意識(shí)打開AED的電源（這可以通過按下電源按鈕或打開蓋子來完成）。遵循逐步的語音指示 The device will guide you through both CPR and defibrillation, prompting you to deliver an electric shock if the intervention is warranted. If a shock is unsuccessful, or if no shockable rhythm is detected, the device will prompt you to continue CPR until emergency services arrive. Remain with the patient until help arrives. 該設(shè)備將指導(dǎo)你進(jìn)行心肺復(fù)蘇和除顫，如果有必要進(jìn)行干預(yù)，將提示你進(jìn)行電擊。如果電擊不成功，或者沒有檢測到可電擊的心律，設(shè)備將提示你繼續(xù)心肺復(fù)蘇，直到急救服務(wù)到達(dá)。保持與病人在一起，直到救援到達(dá)。 How Effective Is a Defibrillator?除顫器的效果如何？When used promptly and properly, an automated external defibrillator can be extremely effective.如果及時(shí)和正確地使用，自動(dòng)體外除顫器可以非常有效。 Every year, there are approximately 356,000 out-of-hospital cardiac arrests in the U.S., and most are fatal—this high fatality rate is partially due to delayed intervention. When an AED is used, a patient’s prognosis improves significantly. 每年，美國大約有35.6萬起院外心臟驟停，而且大多數(shù)是致命的--這種高死亡率部分是由于延遲干預(yù)。當(dāng)使用AED時(shí)，病人的預(yù)后明顯改善。 One study examined the data from 13,769 out-of-hospital SCA incidents and found that: 一項(xiàng)研究檢查了13,769起院外SCA事件的數(shù)據(jù)，發(fā)現(xiàn)： Overall survival to hospital discharge was 7%·Overall survival with CPR but no AED was 9%·Overall survival with AED application was 24%·Overall survival with AED shock delivery was 38% 出院前的總生存率為7%。使用心肺復(fù)蘇但不使用AED的總生存率為9%。使用AED的總生存率為24%。使用AED電擊的總生存率為38%。 In other words, the immediate use of an external defibrillator can increase an SCA patient’s odds of survival by more than five times. Studies into ICDs and WCDs have similarly found these devices to be effective for prolonging the lives of high-risk individuals, even those who have previously suffered a cardiac arrest. 換句話說，立即使用體外除顫器可以將SCA患者的生存幾率提高五倍以上。對ICD和WCD的研究同樣發(fā)現(xiàn)這些設(shè)備對延長高危人群的生命是有效的，甚至是那些曾經(jīng)遭受過心臟驟停的人。 Defibrillators Save Lives除顫器拯救生命If you’ve experienced a cardiac arrest or you’re at a heightened risk for SCA, speak to your doctor about whether a wearable or implantable defibrillator is right for you.如果你經(jīng)歷過心臟驟?；蚰闾幱赟CA的高風(fēng)險(xiǎn)中，請與你的醫(yī)生討論可穿戴或植入式除顫器是否適合你。 If you’re simply looking to protect yourself or others in your home or place of business, consider investing in an automated external defibrillator. Anyone can establish an AED program, and it may just save a life one day. 如果你只是想保護(hù)你的家庭或商業(yè)場所中的自己或他人，考慮投資一臺(tái)自動(dòng)體外除顫器。任何人都可以建立一個(gè)自動(dòng)體外除顫器項(xiàng)目，它可能會(huì)在某一天拯救一條生命。 信息來源：CPR1 LLC. |