急危重症抢救给药途径.pptVIP

* ? 速度与激情 ?( 2010年心肺复苏指南) 2、心跳呼吸骤停是临床上最紧急的情况： ? ? (1)70%以上的猝死发生在院前。 ? ? (2)心跳停止4分钟内进行CPR-BLS，并于8分钟内进行进一步生命支持( ALS)，则病人的生存率43%。 ? ? (3)强调黄金4分钟：通常4分钟内进行心肺复苏，有32%能救活，4分钟以后再进行心肺复苏，只有17%能救活。 * * Choice选择 * * * * * * * The ARROW? EZ-IO? Intraosseous Vascular Access System is designed to be a safe, effective solution for fast vascular access when you’re facing difficult vascular access (DVA) challenges in emergent medical situations for adult patients for 24 hours. The system provides vascular access to the central circulation within seconds for the delivery of medications, intravenous (IV) fluids and blood products providing peripheral access with central performance. There are few contraindications to IO access, and they are all relevant to site selection: Trauma/Fracture (in the targeted bone) - If there is a fracture (or suspected fracture) in the bone in which the needle set is to be placed, an alternate site must be chosen. When IO access is placed in a fractured bone, fluid may extravasate into the surrounding tissue through the fracture. This can lead to complications including compartment syndrome. If a tibial fracture is suspected, both the proximal and distal sites are contraindicated as they share a common pathway inside the bone. However, if the patient has a fractured femur and an intact tibia, the tibial sites could be considered – circulation from the lower leg should be assessed to determine the appropriateness for IO vascular access. IO or attempted IO access in the target bone within the past 48 hours: Healing from intraosseous insertion generally takes approximately 48 hours and is required before another IO catheter can be safely placed in the same bone. Within 48 hours fibrin formation and clotting are sufficient to prevent infiltration/extravasation through the previous IO access hole. If IO access was attempted in the bone, the same consideration applies. Complete healing, to the point where the hole can no longer be detected by Xra