Lecture 1 Emrgency Medicine

U.M.F. “Gr. T. Popa” Iaşi

Emergency Medicine Ass.Prof.Diana Cimpoeşu MD,PhD

2008

Check the victim for a response

A-Head tilt and chin lift B- Look,listen, feel

Circulation

Blow into the mouth whilst waching for rise the chest

30:2 Chest compresion:ventilation

Emergency Medicine    

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1990-SMURD Tg. Mureş 1993 – 3 years residency 1999 - 5 years – a new curricula Emergency Medicine - course: Iaşi,Tg. Mureş, Cluj, Craiova, Oradea Europa: Great Britain, Belgium – ESEM, USA: “history” - American Academy of EM

Lectures 

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Cardiopulmonary resuscitation/Guidelines 2005 Shock-general approach Shock-types of shock Enviromental emergencies Trauma-general management Toxicology/unconscious patient

Emergency Medicine – Cardiopulmonary Resuscitation Intensive Care

Cardiology

Cardiopulmonary Resuscitation Pediatry Surgery Emergency Medicine

Neurology

Cardiopulmonary Resuscitation-European Resuscitation Council Guidelines for Resuscitation 2005   

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Chain of Survival Adult basic life support Adult advanced life support - ACLS, ATLS, PALS Post-resuscitation care

ERC Chain of Survival

Adult BLS and use of automated external defibrillators

Jaw thrust

Foreign body obstruction treatmentmild ostruction

Recovery position

Endotraheal tube

“ Either bag- valve mask

alone, or in combination with tracheal intubation, is acceptable for ventilation during CPR by prehopital providers”

COMBITUBE Michael Frass, MD Professor of Medicine Internal Medicine Innere Medizin Allgemeines Krankenhaus Wien

VF/ VTah pulsless

Assess rhythm

+/- Chech pulse ShockableVF/pulslessVTa h

Shock 360 j

CPR 30:2 2 min

VF/pulselessVTah

Defibrillation

Amiodarone

•Volum of 20 ml, after the third shock •repeat 150 mg •after 900 mg in 24 h

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Lidocaine

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Asystola

Sinus rhythm PEA

Assess rhythm

+/- Chech pulse

Asystole Pulseless electrical activity

Nonshockabl e Non-FV/TV CPR 30:2 for 2 min*

Non VF / VT Adrenaline 1mg every 3-5 min Atropine: single dose 3mg

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Reversible Causes   

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Hypoxia Hypovolemia Hypo/hyperkalem ia Hypothermia

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Tension Pneumotorax Tamponade cardiac Toxics Thrombosis (coronary or pulmonary)