5H- hipoxia,hipovolemia,hiperkaliemia-hipoK,hipotermia hiperionia

5T- Pneumotorax compresiv,tamponada cardiaca, toxice, trombembolism pulmonar,

tromboza coronariana
Activitate fara puls- colaps,incosnt,resp agonal, EKG- orice ritm.
Aer- (fara supliment O2)10ml/kg 1 sec, 700-1000 ml/sec; (cu supliment O2) 6-7
ml/kg 1sec;400-600ml/sec;Oxigen-(copii) 6-8ml/kg/1min (adult) 3-4 ml/kg/min
Allgower – 0.8- hemoragie 10-20%; 1.5- 30-50 %. 1- 20-30%, 2- 50%.
AMBU- NN 250 , sugari 450-50 copii 600-1000 maturi 1500-2000
Amiodarona- dupa soc 3 300mg,dupa soc 5 150 mg, bolus de 20-30 ml sol
fiziologica *TV fara puls,FV * creste durataPA, creste PR,scade conductibi nod AV,
stabiliz MB (copii) 5 mcg /kg iv
Anafilaxia- sindrom, sistemic; r.imunologic/idiopatic/non imuna;*deces 30-35 min;
10-19 ani; (incid) atopia,gen,calea adm,astm (faze) sensib,
patokimic,patofiziologic; (patofiziologik) creste permiab, spasm m netezi,
vasodilatare periferica (imuna) Proteine, alimente (non imun) anestezice
locale,coloranti, derivati sange (non imun) complement, histamina, a arahidonic
(clinic) hemodinamica, asfixica, cerebrala, cutaneo (pronostic) bradicardia, hTA
(abdominal) edem buze+limba (cerebral) cefalee, anxietate, convulsii,sentim
moarte (diagn) anamneza,clinic,triptaza, metilhistamina (tratam) prednisolon,
hidrocortizon, metilprednisolon, sulfat Mg, eufilina, salbutamol, clofenamina (NU)
CaCl, dexametazon (epinefrina copii ) 1 mcg, (cristaloizi copii) 20 ml/kg
(hidrocortizon) 0-6 luni 25 mg; 6ani-12ani 100; 12>ani 200mg
Anginos- dispnee,oboseala,disritmii,diaforeza.*vertij,palpitatii,durere
mandibula/mani,sincopa.*presiune,constringere,greutate,arsura.
Anticoagulante – heparina,enoxaparina,nodroparina,bivalirudina
API- crescendo, de repaos, novo, post infarct
Arsuri – (superficiale) gr 1 2 3A (profund) 3B 4 * (soc postcombust) -15% *
(spala) 20% (volemic) 15% ,copii- 10%; (gr 1) eritem,edem sup; (gr 2) flictene sero
citrin (gr3) flictene hemoragice (cifra 9) cap 9% mb toracic 9%;mb pelvic 18%
perineu 1% trunchi post 18% trunchi anterior 18%
Aspirina- 162-325
Atropina- BAV gr 3
AVC- (ischemice) aterotrombotice, cardioembolice,lacunare *24 ore * varsta >60
ani, ateroscleroza, progresiv, absenta tulb vegetative * abs coma, prezenta flux
carotidian(hemoragic) varsta <60,HTA,debut brusc, coma* tulb vegetative, cefalee,
deficit neurologic (complicatii) ramolisment, resingerare,convulsii, spasm vascular
ziua 3-14 (lant supravietuire) identif acces- promt avc-transport- suport vital (112)
hemipareza, hemiparestezii, tulb limbaj, cecitate (CINCINATI) pareza faciala,
pareza mana, deregl vorbire

Beta bloc- (contra) bradicard <60,insuf VS cu EPAC, astm/bpoc, indus de cocaina,

hipotens,soc cardiogen *(efect)
antiischemic,antiaritmic,hipotens,antitahicardic.(stemi)
Bloc Ca – (stemi) aritmii v;simp anginoase la contraind beta bloc, HTA,IMA
cocaina, HTA,bloc AV 2-3* (contra) boala nod sinusal,hipersesibil,ICC,soc
cardiogen, bloc AV 2-3
Bradicardia- ritm peri stop, stimulare vagala, s HT craniana, intox cu digoxina
(hipoxie, copii) ventilatie,compensare volemica, adrenalina 10 mcg,adrenalina 0.05
-2 (vagala)ventilare,atropina 20 mcg,atropina repetat la 5 min
Clopidrogrel – 300
CO-incolor, nu irita, este mai usor (intox) usoara <30 % medie 30-40% severa
>40% (intox <30 %) cefalee dispnee greata (intox 30-40%)
cefalee,greata,oboseala,dispnee efort (intox >40%) cefalee, oboseala, tahicardie
(tratam) evacuarea din mediu, Oxigen, intub entotrah, oxigen hiperbar (COHb)
COHB>25% / >15% gravide (O2 hiperbar) convulsii, confuzie,ischemie, simpt
persistent
Compresiune- hemotorax, kilotorax,lez mediastin * pneumotorax, lez diafragm,lez
cardio pericard
Debit cerebral- 750-850 ml
Deces prespital – FV,tahicardie fara puls, asistolia; *recunastere,apel
tardiv,pregatire insuf;dotarea.
Defibrilator- (bifazic) 150-200 120-200
Dezobstructie- (inf) intubare orotraheala,intub
nazotraheala,cricoitiriotomie+stomie,traheostomie,aspirare traheobronsica (sup)
Safar, aspirare orofaringe,extragere cu pensa, intub ororafinge, obturator esofag,
masca laringiana, intub nazofaringe (inf,invaziv)
traheotomie,conitom,conistom,intub endotrah*(super,fara) cricoitiriotomie+stomie
(1-8 ani) 5 lov interscapulare, 5 compresiuni abdominale / 5 toracice sub lini
intermamelonara (inconstient copil) 5resp salvatoare+ PCR 5 cm, verificam (sugar
inconstient)5 resp salvator, PCR 4cm
Diureza- (hipovolemie) sugar <1 ml kg h*70-100ml/h; copil- 1.0 ml/kg/h; NN
2.0ml; (N,adult) 50 ml/h
Durere- (iradiere) gat/mandibula, umar s mana s, epigastru. (femei)
gat,umar,superior torace. *atipic-femei,dz,postoperator,dementa, IRA,virsta

Electrocutare- (stop resp) inhibare centru resp bulbar, contractura tetanica,

paraliziei prelungite
Epinefrina – 1 mg din sol 1:10000; prima doza dupa al 2 soc,la fiecare 3-5 min *
ritm socabil/non socabil, dupa 2 soc (0-6 luni) 150 (6 luni -6 ani) 150 (6 ani-12 ani)
300 (>12 ani)500 (soc la copii) 1mcg (asistolie) 10 mck/kg (stop card copii ) 0.01
mg/kg (FV/TV copii) 0.1 mg/kg
FAST- asimetria fata, alunecare in jos a manei, vorbire neinteleasa, timpul apel 112
Fibrilatie V- (faze) electrica/ischemie, circulatorie,metabolica.*(clinic) colaps
circul,inconstient,resp agonala/stop resp,convulsii. (ekg) unde fine+mari. * frec 150-
500,unde fine/mari
Fibrinolitic- alteplaza,streptokinaza,tenekteplaza,*reteplaza
Flutter V- 200-350 ;TV monomorfa, aspect sinusoidal, disritmie transzitorie
Fracturi – (probabil)durere+impoteta, deformare, echimoze,scurtare* (sigure)
mobilitate anormal, discontinuitate,crepitatie, radiologic.
FV- electric 0-4 ; circulatory 4-10; metabolic 10>>;
Hemoragia subarahnoidiana- debut brutal. cefalee localizata, obnubilare coma
*oftalmopareza, iritatie meningiala, HTA, crize comitiale
Hemoragii- 1- 10-15%; 2- 15-30%; 3- 30-40%; 4->40% ; * 1-750 ml; 2-750-1500
ml; 4- >2000ml
Hemotorax- (hemoragie) parietala,pulmonara,mediastinala,abdominala * mic-250-
500;mediu 500-1500 masiv >1500 ml. (masiv,clinic) soc,deviatie
trahee,abolire,diminuare (masiv rx) opacitate likid,deplasare cord, colabat (masiv
punctie) sp 4-5 axilar mediu sp 6-7 axilar post
Hiperkaliemie- (ekg) creste PR, T inalt plat, plat absent P , creste QRS
Hipertensiune craniana- 15-20 adult.
Hipoperfuzie- hipovolemic posttraumatic, cardiogen traume cutie toracice,
neurogen trtaume medulare
Hipotermia- (primele 3 stadii)constient+frison, constienta alterata fara frison,
inconstient (ultimile 3) inconstient, absenta respir, deces
HTA- (obiectiv, cu fibrinolitic) <185-110 (fara fibrinolitic) 220/120

IMA- transmural, nontransmural.*microscpop,mic,mijlociu 10-30,mare 30.

Imersie/Submersie- imersie= fata si caile aeriene acoperite de apa; submersie =tot
corpul sub nivel apa
Inec- (pronostic) copil >3ani, suport bazal precoce, submersia <10 min (fizpat)
apnee voluntara+laringospasm, hipoxia+hipercapnie, aspirare apa, pierdere
constienta (DAE) uscat, maxim 3, 30:2, 360j 200j .
Inhibitorii glicoproteinei 2b/3a – abciximab,eptifibatide,tirofiban
Intub endotraheale-incap de a asigura securitatea, incap de a ventila, semne de
afectare a cai aeriene, suport ventilat indelungat * laringoscop+sonda endotrah+
conductor realabil+ set intubare
Intub nazofaringe- mentinere permiabil cind cale oro nu e *Robertazzi, Wendel
Intubare orofaringiene- mentinere permiabil neintubat+ fara reflec gat,blocare
muscatura (contra)constient,reflex+ *Gudel, Safar, Berman, Lifeway

Killip- 1- fara insuf VS ;2 – semne moderate de insuf VS ,raluri < 50% Zg3+; 3-
raluri >50%,dispnee,edem pulmonar; 4- soc cardiogen TAs<90,hipoperfuzie.
Lant supravietuire- (cardio) recunoastere, PCR,defibrilare 3-5 min,* suport vital
avansat,* prevenire.*asistenta post resuscitare (copii, primele 3 ) prevenire,
recunoastere, apel 112 (ultimile 3) 112, suport avansat, asistenta postresuscit
Letal – acidoza, coagulopatie, hipotermie
Lidocaina- i/v sau intraosos,in lipsa amiodaronei, 1-1.5 mg/kg bolus,repeta la 5-10
min 0.5-.0.75 mg/kg * in FV TV fara puls in lipsa amiodaronei
Management avansat aerian- cricoitiroidostomia chirurgical,intub
orotrah,cricotiroidostomia ac;
Masca laringe – dificultati masca faciala, intubare deficila, interventii cu anestezie
scurta, (contra) personal neinstruit, risc de aspiratie
Metoprolol – 50 ; STEMI 5 mg;
Moartea subita- nontrauma,neasteptat,cauze cardiac, pina la 1 ora. *(temporal)
prodrom,debut,stop card,moarte biologic *(disritmii) FV si flutter V,tahicard V fara
puls, asistolia,dislocatia electromec.
Morfina- stemi 2-4; nstemi 1-5
Nitroglicerina – 0.3-0.5. Partial-absent (stemi,nstemi) cedeaza (api)
*(contra)hTA,bradicardie,IMA VD,inhib fosfodiesteraza.
NORME- NN fr 25-50 ps120 170 tas65-75 ; sugar 6-12 luni fr20-40 ps 110-160 tas
70-75; copii 5 ani fr 20-30 ps80-135 tas 80-90 ; adolescent fr 12-24 ps 60-110 tas
90- 105 (PREsiune Craniana) NN 2 1an-5 7ano 6-13 adult 2-15

Obstructie –(totatala) 2 min (apnee) 2-6 min (stop card) 5-10 min ;
diastola,asistolie *usoara/severa*- retractie sternala;inconstient,imposib de
vb,stridor.*(except) coloratia normocrom (superior) traume, corpi straini,infectii,
cade limba, edem (inferior) aspiratei likide, corp strain, infectii, edem acut , crup si
bronsiolita(partiala) tuse eficienta,respir+ constient, poate vorbi (toatala) nu poate
vb, inconstient, tuse silentioasa
Ocluzie partiala- moarte,ischemie silent,API,NSTEMI
Ocluzie totala – moarte+ stemi
Oxigenoterapie- dispnee,Stemi, o2 < 90; raluri.
Pantaloni anti soc- hemoragii sub diafragm, soc ce nu rs la compensare volemica
Pneumotorax compresiv- (rx)colabat,hipertransp,parte sanatoasa.
Pneumotorax deschis- pansamnet ocluziv *(clinic) marca trauma torace,
traumatopnee, tulb respir, dispnee-polipnee
Prinzmetal – vasospastica, orar fix, fumatori, duce la moarte subita ; * 12-8
dimineata,durere >>30 min;progresiv creste,50%FV.
Punct J- treb 2 deriv concordante; > 1 alte V2 V3; > 2.5 la barbati 40ani in V2 V3;
>1.5 la femei in V2 V3
Quinke- adrenalina, difenhidramina, hidrocortizon, salbutamol
Respiratii-NN : 20-30r/min , sugar 20 ; (1-8 ani)15 resp; ( 8-15 ani) 12 resp; (>15
ani) 10resp;

Soc cardiogen –IC, aritmii, contuzia miocard , valvulopatii,

Soc distribuitiv- sepsis, anafilaxia, neurogen, vasodilatatoare ; leziuni maduva
spinare,
Soc hipovolemic- compensator- reflex baroreceptor, angiotenzina,vasopresina,rs
SNC * gr 1- tahicardie,allgower 0.5-0.8 ,anxietate.* (gr 1)
oxigenoterap,hemostaza,compensare cu cristal,sedare. *(gr 2) hTA orto,tegumente
palide, hemoragie 750-1500*(gr 2) tahicardie,TA scazut, resp 20-
25,anxietate.*oxigen,hemostaza,compensare cu cristal,analgezie. (gr 3)tahicardie
120,hTA, prabusire PVC.*hTA,tegumente palide,allgower 1.5-
2.*ABC,oxigen,compensare volem,hemostaza,imobil,sedare. (gr 4) hTA 50-60,
anurie,coma* resp slaba >35,anurie,coma,acidoza met si alcaloza resp.
*ABC,oxigen,intubare,compensare TAs 120,analgezie *(gr 4,trauma craniu)
intubare,imobilizare,compensare cu TAs 100 (cauze) hemoragie, arsuri, peritonite,
pierderi likide stome, ocluzie intestin (tipuri)hemoragic, deshidratare, combustional)
Soc- hipovolemic, distribuitiv,cardiogen, obstruciv
Soc obstructiv- hemopneumotorace sufocant, vicii congenitale, volet costal,
tamponada card, embolism pulmonar
Socabil – FV,tahicardia V fara puls, torsada virfuri (non socabil ) asistolia, activ
fara puls
Spalaturi gastrice- 200-250 ml; (NU) intox cu organofosforice (decontaminare)
carbune activat 1h, lavaj 1 h.
STEMI- matinal, status anginos/asmatic/gastralgic.
(precipitant)efort,stres,interventii,cocaina.*(ekg)>1 mm avl D3 aVR; >1mm V4 V6;
>2mm V1 V3,vloc ram stang.
Stop cardio resp - (Diagn) pierdere constiinta,apnee,atonie *(exceptie) EKG
sinusal/pacient nu rs la stimul verbal* reflex fotomotor absent,midriaza,traseu
izoelectric EKG (pediatric) detresa resp, soc, aritmii
SVB- (A) recunoastere obstructie,management,ventilatie
Tahicardia V- nesustinuta <30 sec,sustinuta >30 sec ;(QRS) monomorf,polimorf
(fara puls) succesiune 3 complexe, originara bifurcatie His,boala coronar ichemica
*(fara puls) 100-250, nu exista relatie P qrs,P pe ekg, qrs >0.12 sec

Tamponada cardiaca- paloare,hTA,turgescenta vene,abolirea zg. Beck- semne

EKG de ischemie,hTA cu disp puls, creste umbra cardiaca
Torsada virfuri- sulfat de Mg * TV monomorf, QT prelungit, 120-250
Traume toracice – obstructia, pneumotorax deschis, pneum.sufocant; * tamponada
card,volet costal * hemotorax masiv (risc potential) hemotorax mic/mijloc, ruptura
diafragm si hernia, contuzia cord;* (risc potential) contuzia pulmon, leziuni
traumatice esofag,ruptura cai aeriene; pneumotorax simplu;ruptura diafragm.
(frecvent) emfizem,fracturi coaste,fract stern; contuzia perete torace (inchise)
contuzii perete, fracturi si luxatii (deschise) plagi nepenetr+penetrant+ organe
mediastin (sindroame) detresa resp, dezechilibru hidroelectr, acido bazic, toxico
infect.
Tub laringian-inconstient, reflex fund gat abs, tentative fara succes (contra) reflex
+,patologie esofag, ingestie caustice,traume cai aeriene
unda Q –(ima) transmural; Stemi
Victime traumatizate- arsuri termice/electrice/inec/coma E?
Volemie- prematur 100 ml/kg, NN 90ml/Kg, copil 80ml/kg,adult 60-70 ml Kg.
*(repartizare) 75-84 sistemic, 65-75 venule, 12-15 plamani. * copil 5 ani-1600 ml,
10 ani- 2400 ml, adult -5000 ml. * NN termen- 230-260 ml, 1an-800 ml, 5ani-1440-
1600 ml, adult- 5000ml.
Volet costal – (ira) scade spatiu toracic, pierde rigiditate,alterare respiratie *resp
paradoxala *(rx) volet,resp paradox,balans mediatin