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心肺复苏需要了解的药物 / Medication needs to know for ACLS

(2013-06-01 09:10:48) 下一个


图来自http://www.stlukesonline.org

  • Adenosine: all stable, fast rhythm, 6mg with 20 CC NS after, raise arm, can do again with 12mg

  • Atropine (block vagal nerve): stable, slow rhythm, 0.5-1mg IVP, 3mg max

  • Amiodarone: stable ventricular problems: V-fib, V-tach, 150mg for stable pat, 300mg for unresponsive , no pulse pt

  • Aspirin: for chest pain, 325mg, or 4xASA 81mg, chew, ask pt if have allergy before giving

  • Diltiazem: second line for SVT, 0.25mg/kg IV X 1

  • Dopamine: check fluid 1st, increase Bp and contractility, 5mg/kg/min

  • Epinephrine (1:10): increase peripheral constriction, increase sensitivity for shock, also for bradycardia, 1st given after 1st cycle of CPR, , 1mg q3-5 min

  • Lidocaine: V-fib, V-tach, 1mg/kg (one box)

  • Magnesium: Torsads, v-fib, low Mag serum level,

  • Morphine: Chest pain

  • Naloxone (Narcan): reverse narcotic overdose, 2mg once IV

  • Nitroglycerine: chest pain, rule out right heart infarction, EKG first, no ED (Like Viagra) drugs for the past 2-3 days, BP at least 90mmHg, 0.4mg x3 q 3min

  • Sodium Bicarb, acidosis, can use hyperventilation, 1meq/kg

  • Versed (Midazolam): premed for electrotherapy

  • NS: 20cc/kg bolus, 1-2 L for Hypotension

    Defibrillation: Defibrillator for the dead (200J)
    Cardioversion for fast heart rate (100, 200, 360J)
    Pacing for the slow heart rate


    Captography (35-45): used to
      1. ET tube in the right spot or not;
      2. >0, <10, poor CPR, >10: good CPR;
      3. Sudden >35, ROSC (return of spontaneous contraction, also Bp>90, O2 > 92 )

H's & T's

  • Hypovolemia-NS
  • Hypoglycemia-D50
  • Hypoxia-oxygen
  • Hypothermia
  • Hypo/hyperkalemia
  • Hypo-Magnesium
  • Tension Pneumothorax
  • Tamponade
  • Toxins
  • Thrombosis: Heart and lung

While doing CPR: O2, NS, Epi, D50, Narcan, Mg, Bicarb etc.

Stroke: Acu check plus EKG, no need BP lower meds

以上仅供本人参考



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