2010 CPR ECC - ACLS 1966 CPR 50 2005 2010 Basic Life Support, BLS A-B-C Airway, Breathing, Chest compressions C-A-B Chest compressions, Airway, Breathing 1. cardiac arrest ventricular fibrillation, VF pulseless ventricular tachycardia, pulseless VT defibrillation 2. A-B-C C-A-B 30 18 3. 4. A-B-C 4 100 3
Adult Advanced Cardiovascular Life Support, ACLS return of spontaneous circulation, ROSC ACLS 2010 CPR 2005 1. continuous quantitative waveform capnography 2. recoil 3. Pulseless Electrical Activity, PEA Asystole Atropine 4. 5. Chronotropic drug 6. QRS regular monomorphic wide-complex tachycardia Adenosine ACLS Adjuncts Airway Control and Ventilation 100% 1 600c.c. 30 2 cricoid pressure bag-mask oropharyngeal airway gag reflex nasopharyngeal airway 5
30% VF pulseless VT 30:2 100 6-8 8-10 endotracheal intubation 6-25% 64-100% sensitivity 100% specificity Class I supraglottic airway laryngeal mask airway, 6 100 3
LMA esophageal-tracheal tube, Combitube laryngeal tube 2010 6H6T 5H5T Trauma 5H Hypoxia Hypothermia Hypovolemia Hydrogenion, acidosishyper-/hypokalemia 5T Thrombosis, coronarytamponade, cardiacthrombosis, pulmonarytension pneumothorax Toxins ACLS Management of Cardiac Arrest VF pulseless VT pulseless electric activity, PEA asystole defibrillator ACLS Class I 2 monophasic 360 J biphasic 120-200 J 7
partial pressure of end-tidal CO2, PETCO2 35-40 10 central venous oxygen saturation SCVO2 60-80% <30% Intraosseous infusion, IO lidocaine epinephrine atropine naloxone vasopressin amiodarone 2-2. 5 Epinephrine Vasopressin 40 units 8 100 3
Amiodarone Lidocaine Amiodarone Lidocaine Amiodarone 1.5 mg/kg 5-10 0.5-0.75 mg/kg 3 mg/kg Magnesium sulfate torsades de pointes Atropine Sodium bicarbonate Robert W. Neumar, Charles W. Otto, Mark S. Link, et al. Part 8: Adult Advanced Cardiovascular Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010; 122[suppl 3]:S729 -S767. 9
醫學新知 附圖 對心跳驟停的起始處理流程 10 100 年 3 月號
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