-
SuportulSuportul vital devital de bazbaz pediatricpediatric
Dr. TatianaDr. Tatiana CiomCiomrtanrtan
20142014
Pediatric Chain of survivalPediatric Chain of survival
Berg M et al. Circulation 2010;122:S862-S875
-
Pediatric Chain of survivalPediatric Chain of survival
Berg M et al. Circulation 2010;122:S862Berg M et al. Circulation
2010;122:S862--S875S875
2007 AHA Guidelines.2007 AHA Guidelines. PediatricsPediatrics
2006;117;e9892006;117;e989--e1004e1004
AlgoritmAlgoritm dede resuscitareresuscitareDiferenDiferenee
copilcopil -- adultadult
Stop cardiac asfixic(cel mai frecvent la copil)
Stop cardiac de orginecardiac (TV, FV)
(cel mai frecvent la adult)
MCE + Ventilaie MCEAABBCC
CCAABB
-
1 salvator: pentru COLAPS BRUSCactivai sistemul de urgen, aducei
DEA / defibrilatorul
2
Nu rspundeNu respir sau gasping
Activai sistemul de urgenAducei DEA / defibrilatorul
1
3Verificai pulsuln 10 secunde Are puls 1 respiraie la fiecare 3
sec.+ MCE dac pulsul este < 60/min cu
perfuzie periferic slab,n ciuda unei bune oxigenri i
ventilaii
Verificai pulsul la fiecare 2 min.
3a
Nu are puls
1 salvator: cicluri de 30 compresii toracice i 2 respiraii2
salvatori: cicluri de 15 compresii toracice i 2 respiraii
4
SuportulSuportul vital devital de bazbaz pediatricpediatric
Dup 2 min, activai sistemul de urgen i aducei DEA /
defibrilatorul(dac nu ai fcut-o deja)
Folosii DEA ct mai curnd posibil
5
Realizate de ctre personalul medical Topjian A, Berg R.
Circulation 2012;125:2374-2378
-
SuportulSuportul vital devital de bazbaz pediatricpediatric
Dup 2 min, activai sistemul de urgen i aducei DEA /
defibrilatorul(dac nu ai fcut-o deja)
Folosii DEA ct mai curnd posibil
5
ocabil Neocabil
Topjian A, Berg R. Circulation 2012;125:2374-2378
Verificai ritmulRitm ocabil?
6
Administrai 1 ocReluai imediat
MCE timp de 2 min
7Reluai imediat MCEVerificai ritmul la fiecare 2 min;continuai
pn vine echipa deresuscitare sau victima se mic
8
Realizate de ctre personalul medical
Salvatori neprofesioniti: Activai sistemul de urgen (chemai alt
salvator,chiar dac este neprofesionist),
Asigurai sigurana victimei i a salvatorului, Verificai rspunsul
la stimuli, Verificai respiraia, Evaluai necesitatea MCE - dac
victima nurspunde i nu respir, se presupune c este necesarMCE
SuportulSuportul vital devital de bazbaz pediatricpediatric
-
CirculationCirculation. 2000;102:I.
2000;102:I--253253--II--290290
Respir normal?
Privii, ascultai i simii dac respir normal
-
Poziie desiguran
Respir normal1
43
2
2007 AHA Guidelines.2007 AHA Guidelines. PediatricsPediatrics
2006;117;e9892006;117;e989--e1004e1004
Poziie de siguran
Respir normal
-
CirculationCirculation. 2000;102:I.
2000;102:I--253253--II--290290
Nu respir normal
Extensia capului +ridicarea brbiei
Atenie la cderealimbii posterior risc de obstruarea CRSPip
Guedel
mpingerea mandibulei anterior
PermeabilizareaPermeabilizareaccilorilor aerieneaeriene
superioaresuperioare
-
VentilaVentilaiaia gurgur lala gurgur
Pensai nasul Inspirai normal Punei buzele pe gura pacientului
Expirai timp de 1 secund verificai c
toracele se ridic Lsai toracele s revina la poziia iniial
Repetai
ERC guidelines. Resuscitation 2010; 81:1219ERC guidelines.
Resuscitation 2010; 81:121912761276
VentilaVentilaiaia gurgur lala gurgur
Nolan et alNolan et al ERC guidelines. Resuscitation 2010;
81:1219ERC guidelines. Resuscitation 2010; 81:121912761276
-
SuportSuport ventilatorventilator avansatavansat
Ventilaia cubalon i masc
Masca laringian
Berg M et al. Circulation 2010;122:S862-S875
VentilaVentilaiaia cucu balonbalon ii mascmasc
-
MCEMCE
Nolan et alNolan et al ERC guidelines. Resuscitation 2010;
81:1219ERC guidelines. Resuscitation 2010; 81:121912761276
-
CaracteristiciCaracteristici ale MCE deale MCE de
calitatecalitate frecven de minimum 100/min, profunzime de minimum
1/3 din
diametrul antero-post. toracic(4 cm la sugari, 5 cm la
copii),
dup fiecare compresie lsaitoracele s revin,
minimalizai ntreruperile, evitai ventilaia excesiv.
Berg M et al. Circulation 2010;122:S862-S875
MCE la sugarMCE la sugar 11 salvatorsalvator
-
Berg M et al. Circulation 2010;122:S862-S875
MCE la sugarMCE la sugar 22 salvatorisalvatori
MCE laMCE la copilcopil
Nolan et alNolan et al ERC guidelines. Resuscitation 2010;
81:1219ERC guidelines. Resuscitation 2010; 81:121912761276
-
Aspiraia de corp strin - tratamentEvaluai severitatea
Tuse ineficient Tuse eficient
IncontientPermeabilizai CRS5 respiraii salvatoareMCE
Contient5 x Manevra Heimlich(sugar lovirea spatelui,copil
compresieabdominal brusc
Facilitai tuseaVerificai continuueventuale semne dedeteriorare
sau pn lanlturarea obstruciei
-
ManevraManevra HeimlichHeimlich
http://www.nucleusinc.com
LaLa sugarisugarihttp://www.apollolife.com
ManevraManevra HeimlichHeimlichLa adultLa adult ii
copilcopil
http://www.allinahealth.org
http://anuandong.blogspot.ro
-
Vrst Palparepuls
MCE:Resp /Ritm
Poziie Respiraiisalvatoare
DEA
Sugar< 1 an
arterabrahial
15:2 /100/min
Vrful a 2 degetepe 1/3 inferioara sternului
Ventilaiegur lagur-i-nas
Nu
Copil1 an -pubertate
arteracarotid
30:2 /100/min1 salvator
Podul palmei pe1/3 inferioar asternului,degetele ridicate
Ventilaiegur lagur
DaPadele +programpediatric
SuportulSuportul vital devital de bazbaz pediatricpediatric--
rezumatrezumat --
** 2 salvatori: dac exist masc laringian sau SET sau
traheostomie,MCE cu 100/min continuu, simultan cu ventilaii 8
10/min.
http://stemlynsblog.org/paediatric-arrest-but-what-about-the-parents
