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LP Resuscitarea

cardiorespiratorie

Definitii:
Oprire respiratorie = absena micrilor
respiratorii.
Oprire cardiac (cardio-circulatorie) = tabloul
clinic generat de absena sistemic
(generalizat) a circulaiei.
opririrea primar respiratorii frecvent la sugar
i copil
primar cardiace frecvent la adult i btrn

Cauze de oprire respiratorie


nec, aspiraie de corpi strini,
inhalare de toxice, epiglotit,
strangulare
Coma de orice cauz, AVC
Electrocuie, traumatism, etc

Clinical signs of cardiac arrest

Pulseless central arteries


Loss of conscience
Respiratory arrest
Midriasis( late sign-90 sec)
muscular rigidity

Cauze
Infarctul miocardic
Tulburrile de ritm (infarct demiocard,
ischemie, tulburri electrolitice,etc.)
Hipovolemia (exsanguinare,
politraumatisme)
Embolia pulmonar
Tamponada cardiac

Primary cardiac arrest


respiratory arrest ( 30-60 sec)

Secundary cardiac arrest


first apneea
cardiac arrest (1-20 min)

Lanul supravieuirii
Acces precoce
SVB precoce
Defibrilare precoce
SVA precoce

Suportul vital bazal

Prima faz a RCR


Se practic fr echipament medical (cu minile goale)
Scoaterea victimei din mediul periculos
Evaluarea strii de contien
Alertarea serviciului medical de urgen (telefon 112)
Poziionarea victimei
Eliberarea cilor aeriene
Evaluarea respiraiei spontane (10 secunde)
Respiraia artificial (2 ventilaii)
Evaluarea pulsului (10 secunde)
Masaj cardiac extern (100/minut)
Continu secvena masaj:ventilaie 30:2
Defibrilarea automat extern

Suportul vital bazal


Management of airway
ELIBERAREA CILOR AERIENE Hiperextensia capului i nchiderea
gurii
Subluxaia anterioar a mandibulei
ndeprtarea corpilor strini solizi (deget crlig) sau lichizi (poziie lateral a capului
i deget nfurat n pnz)

Simple airway adjuncts (oropharyngeal or nasopharyngeal airways) are


often helpful, and sometimes essential, to maintain an open airway.

Ventilation
mouth-to-mouth ventilation
Mouth-to-nose
Mouth-to-tracheostomy

Circulation
-chest compresion

Ventilation

Ventilaia artificial gur-la-gur


Ventilaia artificial gur-la-nas
Ventilaia artificial gur-la-traheostom
Ventilaia artificial gur-la-gur i nas
Aerul expirat conine 16-18% O2
Evaluarea eficienei ventilaiei artificiale: observarea micrilor
toracelui

Deliver each breath over approximately 1 sec


give a volume of 500 ml
Ventilation rate: 10-12/min

During CPR with an unprotected airway, give two ventilations after each
sequence of 30 chest compressions.(30 compresions:2 ventilation)

mouth-to-mouth ventilation

circulation
-chest compresion - rate 100/min
- deep 4-5.5-6 cm

CPR
Compress at the center of the chest at the
nipple line
Compress the chest approximately 1.5-2
inches using heel of hands

New Recommendations
2 breaths chest compressions
All breaths (mouth-mouth, mouth-bag, bagmask) given over 1 sec see chest rise
Longer uninterrupted chest compression
Compression:Breath (30:2)
Push hard and push fast (100/minute)
2 min of compression before rhythm/pulse
check in pulseless arrest
Pulseless VF/VT: 1 shock (instead of stacked)

check pulse every 2 minutes