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RESUSCITAREA CARDIORESPIRATORIE

PENTRU ASISTENTE
MEDICALE
Conf. Dr. Daniela Ionescu

RCP
Cnd?
Stop

cardio-respirator
Cnd exist indicaie medical
OBS!!!! Do not resuscitate order
(DNRO)
Asistentele n UK, Australia
etc pot

DNRO

decide
Romnia nu exist legal

NU se resusciteaz n condiii
de:
decapitare
descompunere
rigiditate
lividiti

de decubit
incinerare
traumatisme masive al creierului
i inimii, incompatibile cu viaa

STOP-CARDIORESPIRATOR
Cauze

Cauze

Fibrilaia

Afeciuni

cardiace
ale SCR:

ventricular
80%
Asistolia
Disociaia
electro-mecanic

medicale
frecvente:

cardiace
Accidente
Hemoragii masive
Intoxicaii,
supradozaje
sepsis

FIZIOPATOLOGIE
Stop cardiac
cerebral
respirator

Debit
cerebral

Suferin
4 min
+4-10

mindeces
Debit
alte organe

Leziuni cardiace
Leziuni renale
Alte organe

Concluzie

timpul pn la
de

RESUSCITARE

TREBUIE REDUS LA MINIMUL POSIBIL

TABLOU CLINIC

Pacient

incontient
Apnee (gasping)
Fr puls - CAROTID - 15
secunde pe o singur parte

PROTOCOL DE
MANAGEMENT
Verific dac rspunde
2. Cheam ajutor/ medici
3. Aezai pacientul n decubit dorsal
OBS!! Dac exist suspiciune fractur de
coloan
se mic n ax de ctre dou
persoane
4. Dezobstrucia cii aeriene
- Hiperextensia capului
5. Verificai dac persoana respir (privii,
ascultai, simii)
6. Dac nu respir RCP
1.

PROTOCOL DE RESUSCITARE
2 respiraii gur la gur / masc cu
balon Ruben
NB!! Expansiune torace
2. MCE (se numr cu voce tare)
- podul palmei n 1/3 medie stern
- 3-5 cm deplasare sternal
- 80-120/ min
PREGTII DEFIBRILATORUL!!
3. Se continu RCP 30 compresiuni/2
respiraii
1.

ALGORITM DE
RESUSCITARE

Sumar al modificarilor protocolului in


2010

Adult basic life support

The following changes in the basic life support (BLS) guidelines have been
made to reflect the importance placed on chest compression, particularly
good quality

compressions, and to attempt to reduce the number and duration of pauses


during chest compression:

When obtaining help, ask for an automated external defibrillator (AED),


if

one is available.

Compress the chest to a depth of 5-6 cm and at a rate of 100-120 min1.

Do not stop to check the victim or discontinue CPR unless the victim
starts to show signs of regaining consciousness, such as coughing, opening
his eyes, speaking, or moving purposefully AND starts to breathe normally.

Teach CPR to laypeople with an emphasis on chest compression, but

include ventilation as the standard, particularly for those with a duty of care.

The use of Automated External


Defibrillators

There are no major changes to the sequence of actions for AED users in
Guidelines 2010. The following changes are aimed mainly at increasing
the use of AEDs along with clarification on when to stop CPR:

An AED can be used safely and effectively without previous training; its
use should not be restricted to trained rescuers. Training should
however be

encouraged to help improve the time to shock delivery and correct pad

Placement

Short video/computer self-instruction courses, with minimal or no


instructor coaching, combined with hands-on practice can be
considered as an effective alternative to instructor-led BLS and AED
courses. Such courses should be validated to ensure that they achieve
equivalent outcomes to instructor-led courses

When using an AED minimise interruptions in chest compression.


Do not stop to check the victim or discontinue CPR unless the victim
starts to show