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