Escolar Documentos
Profissional Documentos
Cultura Documentos
SUPPORT(ACLS) - 2010
Technique ..?
MONITORING DURING CPR
Physiologic parameters
Monitoring of PETCO2 (35 to 40 mmHg)
Coronary perfusion pressure (CPP) (15mmHg)
1. Ventricular fibrillation(VF),
2. Pulseless ventricular tachycardia (VT),
3. Pulseless electric activity (PEA), and
4. Asystole.
Hypoxia Toxins
Hypovolemia Tamponade (cardiac)
Hydrogen ion(acidosis) Tension pneumothorax
Hypo-/hyperkalemia Thrombosis, pulmonary
Hypothermia Thrombosis, coronary
DEFIBRILLATION
Defibrillation is defined as termination of VF for
at least 5 seconds following the shock.
anteroposterior,
anterior-rightinfrascapular
Shock Energy
Biphasic : Manufacturer recommendation
(eg, initial dose of 120-200 J), if unknown, use
maximum available.
Second and subsequent doses should be
equivalent, and higher doses may be considered.
Monophasic : 360 J
1-SHOCK PROTOCOL VERSUS 3-SHOCK
SEQUENCE
Evidence from 2 well-conducted pre/post design
studies suggested significant survival benefit
with the single shock defibrillation protocol
compared with 3-stacked-shock protocols
B – Bleeding/ DIC
E – Embolism( pulmonary, coronary , amniotic )
A – Anesthetic complications
U – Uterine atony
Recommendation
When the gravid uterus is large enough to cause
maternal hemodynamic changes due to
aortocaval compression,
emergency caesarean section should be
considered, regardless of fetal viability
Several case reports of emergency cesarean section in
maternal cardiac arrest indicate a return of
spontaneous circulation or improvement in maternal
hemodynamic status only after the uterus has been
emptied.