Resuscitarea

Question 1

Stopul respirator- cauze

Answer 1

• aspirare de corpi straini
• laringita acuta subglotica/ epiglotita
• pneumo/hemotorax, pneumoperitoneu
• status asmatus
• pneumonie/ bronhopneumonie
• EPA
• intoxicatii acute

Question 2

Stopul cardiac cauze

Answer 2

• fibrilatia ventriculara, TV fara puls, asistola
• hipo/hiperK
• hipoglicemia
• socul hipovolemic, anafilactic, cardiogen
• embolia pulmonara
• acidoza metabolica
• edemul cerebral
• status epilepticus
• trauma cranio-vertebrala, vertebro-medulara
• arsuri
• inec
• electrocutare
• hipotermie

Question 3

Airway

Answer 3

• deschidere cai aeriene=> extensia capului+ subluxatia mandibulei
• trauma=> subluxatia mandibulei
• dezobstructia cailor aeriene => tuse eficienta=> incurajare
  tuse inefiicienta=> manevra Sandwich/ Hemlich

Question 4

Manevra sandwich

Answer 4

plasare sugar in decubit ventral, cu capul mai joc decat toracele => 5 lovituri interscapulare apoi plasarea in decubit dorsal=> 5 compresiuni torace sub linia mamelonara

Question 5

Manevra Heimlich

Answer 5

5 lovituri interscapulare urmate de 5 compresiuni abdominale

Question 6

Breathing

Answer 6

• pacient inconstient care respira=> plasare in pozitia laterala de siguranta, reevaluare
• pacient inconstient care nu respira=> 5 respiratii salatoare

Question 7

Circulation

Answer 7

• verificare puls la artera femurala/ brahiala la sugar, artera carotida la copilul mare
• puls prezent=> pzitia laterala de siguranta, reevaluare
• fara puls => compresiuni toracice cu plasarea mainilor incrucisate (2 degete sugar) in 1/2 inferioara a sternului=> decompresia toracelui cu 1,5-2,5 cm la sugar, respectiv 4-5 cm la copilul mare => 100-120 compresii pe min cu ritm 15:2

Question 8

ALS- deschidere cai aeriene

Answer 8

• dispozitive oro-traheale
• masca laringriana
• sonda nazo-faringiana
• IOT
• cricotiroidostomie

Question 9

IOT

Answer 9

formula de calcul sonda=> v/4+3.5 cm
deteriorare brusca=> deplasare sonda, obstructie sonda, defect sonda, pneumotorax, sonda defecta, intubare in stomac

Question 10

Abordul intraosos

Answer 10

• plasare gamba in flexie si usoara pronatie
• la 1 cm sub platoul tibial
• se mentine maxim 24 h

Question 11

Adrenalina

Answer 11

• f 1mg/ml
• doza= 0,01 mg/kc/doza
• resuscitare ( asistola), bradicardie sinusala/jonctionala, socul anafilactic, hipoTA, laringita si bronsiolita ( nebulizare)
• sugar < 10 kg => 1 f+9 ml SF => 1mg/10 ml=> 0,1 mg/kgc/doza
• repetare la 3-5 min

Question 12

Regula lui 6

Answer 12

• perfuzie continua
  nx6xG (kg) ml subt+ xml SF 0,9%= 100 ml sol.
  n= 0,1 pentru Adrenalina/ Noradrenalina
  1 pentru Dobutamina
  10 pentru Xilina

Question 13

Atropina

Answer 13

• f 1mg/ml
• doza= 0,02 mg/kgc/doza
• repetare la 5 min
• utilizare: bradicardie sinusala si intoxicatia cu organofosforice ( sialoree, fasciculatii, midriaza fixa)

Question 14

Adenozina

Answer 14

• fl 6mg/2 ml
• doza= 0,1 mg/kgc bolus apoi 0,2 mg/kgc la 5 minute de 3 ori
• TPSV

Question 15

Amiodarona

Answer 15

• f 150 mg/3 ml
• doza= 5 mg/kgc bolus apoi in pev cu glu 5%
• indicatii: TPSV care nu cedeaza la Adenozina, FV, TV fara puls

Question 16

Ca gluconic 10%

Answer 16

• f 94 mg/ml
• doza= 5-7 mg/kg/D=> 0,5 ml/kgc/doza
• indicatii: hipocalcemie dovedita, hiper Mg, hiper K, intoxicatia cu blocante de Ca

Question 17

Bicarbonat de sodiu 8,4%

Answer 17

• fl 84 mg/ml
• Doza = 1 mmol/kgc/ doza
• indicatii:- resuscitare prelungita, acidoza severa, intoxicatia cu antidepresie triciclice ( antidot)

Question 18

Glucoza 10%

Answer 18

• fl 250/500 ml
• doza= 3-5 ml/kgc bolus apoi PEV cu 6-8 mg/kgc/min=> 3,6-4,8 ml/kgc/h

Question 19

Lidocaina

Answer 19

• f 100 mg/10 ml
• doza=> 1 mg/kgc bolus apoi pev 20-50 microg/kgc/min
• FV rezistenta la defibrilare, TV fara puls ( alternativa la amiodarona)

Question 20

MgSo4 20%

Answer 20

• fl 20g/ 10 ml
• doza= 20-30 mg/kgc=> 0,2-0,3 ml/kg
• hipoMg dovedita, torsada varfurilor , astmul bronsic rezident la betablocante( linia a 4)