CPR 2010解析.pptVIP

多巴胺 可单独应用或与肾上腺素合用 起始速度 2 -10 mcg/kg/min 其他可选择的药物治疗 对于稳定患者---观察和监测 经皮起搏和阿托品治疗是一线干预措施 寻找和治疗潜在的原因 心动过缓-总结 心动过速 QRS 波- 窄或宽? 窄QRS波: 心房纤颤 心房扑动 房室结折返心动过速 (AVNRT) 交界区心动过速 多原性房性心动过速 QRS波形态 心动过速 窄QRS心动过速 QRS 波- 窄或宽? 宽QRS心动过速 室性心动过速 预激伴房颤 房颤伴差异性传导 多型室速 QRS波形态 心动过速 宽QRS心动过速 ACLS 流程 室颤/无脉室速处理流程  心脏停搏/无脉电活动处理流程 复苏后治疗 Thanks for your attention 在头顶的复苏者用拇指和示指环绕面罩边缘使其密闭， 用其余手指抬举下颌和伸颈，同时观察胸部起伏。另一复苏者缓慢挤压气囊（持续1秒钟以上），使胸部抬举。 Slide 12- 有创通气 如果对病人进行有创通气时，气体调节，热量和水分回收以及防护机制等过程会有些什么情况发生呢？ 当病人进行有创通气时，气管插管绕过了鼻咽和口咽及一部分气管， 95% 的热量和水分是在这些部位被加上去的。气管插管也阻止了例如打喷嚏，咳嗽，作呕和吞咽等自然的防护机制，只剩下粘液纤毛清理系统成为最后的的气道防护机制。 干冷的医用气体直接输送到下气道和支气管，在这里被强迫进行热，湿交换。干冷的医用气体将使位于气管插管末端以下的粘液纤毛转运系统的运动能力下降。 这对病人将意味着什么？ 建议进行二氧化碳波形图定量分析，以确认并监测气管插管位 置和心肺复苏质量。 * A rhythm strip is generally enough to determine the width of the QRS complex, however a 12 lead will help you and later consultants determine what type of rhythm the patient had. This is a list of the most common to least common narrow complex tachycardias. You may notice that supraventricular tachycardia is not listed here. This is because SVT is a nonspecific term for any rhythm that originates above the ventricle such as sinus tachycardia or even a fib. When we use the term SVT we generally mean reentry SVT such as AVnRT. * If the patient in fact does have a narrow complex tachycardia we can see that the next step on the algorithm is to determine whether the rhythm is regular or irregular. In the event that it is irregular, the ACLS provider should only attempt rate control and obtain a cardiac consult. This is because an irregular narrow complex tachycardia is most likely to be atrial fibrillation. Chemically or electically converting a stable patient with atrial fibrillation should only be done after careful evaluation of the patients history and likely a TEE to rule out thrombus. Rate control can be achieved with a calcium channel, amiodarone or a beta blocker. * A rhythm strip is generally enough to determine the width of the QRS complex, howev