It is performed when there is no safe signs of death, when it is not about heavy injuries compatible with life (dekapitacija, iskrvarenje)
For successful resuscitation is required well-coordinated and well equipped team who will in time recognize the cardio and / or pulmonalni arest and access kardiopulmonalnoj reanimation.
It is therefore of great importance to educate medical personnel departments to identify possible cardiopulmonary arest and on how to act accordingly.
Apart from training of staff it is important that in every department, ambulances, and the cabinet, which are invasive species index a set of equipment for resuscitation and that every medical worker can use the same accessories.
Set for resuscitation must contain:
♥ defibrilator
♥ antišok therapy
♥ AMBU mask with different size masks
♥ various sizes arwaya, Tubus and laryngoscope
♥ syringes, needles of all sizes, systems for infusion systems for oxygen and catheter for the extractor fan of all sizes
♥ ECG machine or monitor with samoljepljivim electrodes (if monitoring is not installed on defibrilator)
♥ extractor fan and oxygen (in the event that the department is no central oxygen bottle must be always full)
DEFIBRILATOR - is a medical device that is used during the reanimation to correct heart rhythms (VT / VF SVT).
ANTIŠOK THERAPY - contains medicines that we use during the reanimation anafilaksije or medication must be in wheelchairs for resuscitation in one place and a certain number. After the use of medications should supplement
ANTI SOK TERAPIJASADRŽI:
♣ 0.9% NaCl 500 ml 2 bottles
♣ 0.5% glucose 500 ml 2 bottles
♣ aminophyllin 10 ml 5 amp.
♣ atropine 1 ml of 10 amps.
♣ calcium Sandoz 10 ml of 10 amps.
♣ adrenaline 1 mg 10 amps.
♣ NaHCO3 8.4% 10 amp.
♣ synopen 10 amp.
♣ dexamethasone 4 mg 20 amps.
♣ Lidocaine 10 amp.
AMBU-MASK used for lung ventilation. It is important that the size of mask closes the mouth and nose that would not have been a loss of air on the combination of mouth - the nose and the mask, which reduces lung ventilation.
ARWAY-its primary purpose is to prevent zapadanje language and thus relieves the respiratory tract and improves lung ventilation.
Endotracheal Tubus - is the direct link that connects the windpipe with the AMBU mask and allows 100% of lung ventilation and prevent the entry of želudčanog content in the lungs.
Tubus makes after successful reanimation connect the patient to the respirator.
Laryngoscope - the basic equipment during intubiranja. No intubiranje it would be impossible. He moves the root of language and lights the way honey. employee intubira (usually it is a physician anesthetist) to the trachea.
Other parts of a set of resuscitation in svakidašnjoj use in departments and they should not be specifically mentioned.
One of the important things in getting to the removal is that you should check for the resuscitation trolley, and if necessary amend them in order to prevent loss of time during reanimation.
European Council for Reanimation is 2005 yr. made so. ,, the chain of survival ", which consists of four interconnected ring that contribute to survival of patients who experienced cardiopulmonary arest.
Chain survival:
♠ first ring is the early recognition aresta, call a help but also prevent kardiopulmonalnog aresta.
♠ second ring chain includes an early implementation kardiopulmonalne reanimation to get on-time arrival to the professional team.
♠ third ring in the chain which is linked to the prthodne is early defibrilacija which serves to restart the heart.
♠ fourth ring includes postreanimacijsko care that seeks to restore the quality of life of patient who suffered cardiopulmonary arest.
According to new guidelines from the 2005 year. European Council for Reanimation cardiopulmonary reanimation is done in a way that the ratio of heart massage and artificial lung ventilation was 30:2 instead of efforts to 15:2 or 5:1 if one person performs resuscitation.
PROCEDURES DURING reanimation:
massage heart - running in a way that the soft palm of a hand unit at the center of the chest and cover ga other hand extended hand. Pelvic bone trying to squeeze 4-5 cm depth. During the massage the heart we need to determine how successfully we perform massage and according to the color of skin, narrowing of pupil, and the appearance of pulses on carotid artery.
Artificially breathing in hospital conditions is performed by first checking whether there is a foreign body in the respiratory tracks, if there is out ga. Until the arrival of the resuscitation team set arway, which is carried out artificial lung ventilation. After the arrival of the team for the resuscitation anesthesiologist or other health professional who is trained to introduce endotrahealnog Tubus intubira patients Tubus and then assume the role of arway - a
Medicaments - during kardiopulmonalne reanimation important is the use of medicines. The first drug choice is adrenaline. Applied in time intervals of 3-5 min. in repeated doses of 1 mg i.v. Adrenaline is given by asistolije, V.F. V.T. Waves, without a pulse and electrical activity. Furthermore, as one of the drugs atropine, which is used to treat asistolije or slow electrical activity without pulse, and gives a sudden, 3 mg of Bolus.
In addition to medicines in the treatment of choice vertikularne fibrilacije or tahikardije given amiodarone in the dosage of 300mg. Bolus in the next dose should be half less. The same treatment can be given, and Lidocaine in a dosage of 1 mg per kg / TT
Amiodarone and Lidocaine should not be combined together
ndefibrilator - one of the most common causes of delays is the heart ventrikularna fibrilacija where belt use defibrillator. Defibrilator indicates the application of DC current through the heart of patients with a disruption of letalnih stress.
FLOW cardiopulmonary reanimation on clinical ward
Slow and progressive physiological deterioration preceded by chance 80% kardiopulmonalnih aresta to hospital departments. It therefore needs to educate medical staff to recognize the arest and the time went with reanimation. When we find that the patient lost consciousness we need to calmly approach him and check out the vital functions (verification of vital functions should not take longer than 10 seconds) If you omit one of the vital functions should begin resuscitation.
Start resuscitation in a way that you loudly invite assistance. First, it is necessary to open the respiratory tract. In the event that there is a foreign body or any other content in the oral cavity it is necessary to remove, handle, finger, or suction, then set arway.
For successful resuscitation are required at least two medical officers, although the ideal was three. Two med. employees perform resuscitation in a way that one conducts an external heart massage, while others ventilira.
The third worker call the hospital for resuscitation, and brings the necessary equipment for resuscitation.
Connects oxygen, establish venous route (if not established) Set the self-electrodes without stopping the heart massage, navlači and gives medicines and connects patients to defibrilator.
When the patient is connected to defibrilator stables with heart massage and evaluates heart rhythm. If it is indicated is to be made defibrilacija.
After defibrilacije it is necessary to continue to massage the heart regardless of the heart rhythm to get a stop after a massage establishment pulse.
Doctor who is also leader of reanimation in the team's arrival for the resuscitation of patients and their reports on progress made and the disease to aresta.
The resuscitation continues with reanimation to appear vital function, or the expiration of 30 minutes from the beginning of reanimation.
With the successful reanimation the patient was moved to JIL for further monitoring and the existing equipment that is necessary until the normal functioning of vital functions.
ABORT cardiopulmonary reanimation
♦ If you can not establish a spontaneous circulation at the time of 30 minutes from the last touch pulse
♦ If you receive information about neizliječivoj disease
♦ if the period of aresta to the beginning of reanimation longer than 10 minutes
♦ if zjenice not react to light
♦ if the patient during the life of writing spoken to does not want to be ga reanimira
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