课件：儿科急救处理.ppt

Drugs，D Attention: consider early administration of antibiotics or corticosteroids if clinical status. Pharmacotherapy can not instead of AR and cardiac compression. 药物治疗决不能取代人工呼吸与心脏按压。 ? Allergic emergencies (Anaphylaxis) 1. Definition: is the clinical syndrome of immediate hypersensitivity. It is characterized by cardiovascular collapse and respiratory compromise, as well as cutaneous and gastrointestinal symptoms(e.g. urticaria,emesis). 2.Initial management 1）ABCs 2）Medicine:Epinephrine/Albuterol/H1-receptor antihistamine /corticosteroids: 3.Hypotension Trendelenburg position(head below feet)/normal saline/Epinephrine Respiratoty Emergencies hallmark of upper airway obstructionis: inspiratory stridor ; lower airway obstruction : cough ,wheeze , a prolonged expiratory phase. 1.Asthma 2.Upper respiratory tract obstruction 1)Epiglottitis 2)Croup 3)Foreign body aspiration Asthma Oxygen to keep saturation=95% Inhaled ?-agonists epinephrine SC or terbutaline corticosteroids very poor air movement /unable to cooperate no response after one nebulizer / steroid dependent 1．Assessment： HR, Brething Rate O2 saturation, peak expiratory flow rate use of accessory muscles , pulsus paradoxus (20mmHg difference in systolic BP for inspiratory vs expiratory ), dyspnea,alertness,color. 2.Initial management 3. Further management if incomplete or poor response 4. intubation:intubation of those with acute sathma is dangerous and should bu reserved for impending respiratory arrest continue nebulization therapy / space interval as tolerated additional nebulized bronchodilators aminophyline IV bolus ,then continuous infusion terbutaline load followed by continuous infusion magnesium IV/IM Upper airway obstruction