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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