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Rol: de a pregtii studenii pentru a putea interaciona medical cu pacienii
absena achiziiei abilitii
pericliteazd.p.d.v. medical
pacientulabsena achiziiei abilitii
pericliteaz reputaia de
halat alb
absena achiziiei abilitii
limiteaz major posibilitatea
studentului de a activa lanivel clinicSplarea medical a minilor
(ap i spun; soluii alcoolice)Msurarea tensiunii arteriale
Injecia intramuscular
deltoid
Masajul cardiac externDeterminarea glicemiei
utiliznd glucotestulInjecia subcutanat
Manevra HeimlichEfectuarea
electrocardiogramei
Plasarea pacientului n poziielateral, decubit dorsal, ventral, Fowler,
Simsn pat.
Asistarea pacientului pentru a
sta la marginea patuluiPoziia lateral de siguran
Injecia intramuscular
fesierul ventral
Administrarea oxigenoterapiei
Recoltarea unei probe de
snge venos. Injecia
intravenoas
Asistarea pacientului inlocomoie un asistent.
Intervenia n cazul dezechilibrrii
pacientului.
Efectuarea peackflowmetriei.
Administrarea medicaiei
inhalatorii
Administrarea medicaiei orale
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i
m
p
o
rt
a
n
egal
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Rol: de a pregtii studenii pentru a putea interaciona medical cu pacienii
absena achiziiei abilitii
pericliteazd.p.d.v. medical
pacientulabsena achiziiei abilitii
pericliteaz reputaia de
halat alb
absena achiziiei abilitii
limiteaz major posibilitatea
studentului de a activa lanivel clinicSplarea medical a minilor
(ap i spun; soluii alcoolice)Msurarea tensiunii arteriale
Injecia intramuscular
deltoid
Masajul cardiac externDeterminarea glicemiei
utiliznd glucotestulInjecia subcutanat
Manevra HeimlichEfectuarea
electrocardiogramei
Plasarea pacientului n poziielateral, decubit dorsal, ventral, Fowler,
Simsn pat.
Asistarea pacientului pentru a
sta la marginea patuluiPoziia lateral de siguran
Injecia intramuscular
fesierul ventral
Administrarea oxigenoterapiei
Recoltarea unei probe de
snge venos. Injecia
intravenoas
Asistarea pacientului inlocomoie un asistent.
Intervenia n cazul dezechilibrrii
pacientului.
Efectuarea peackflowmetriei.
Administrarea medicaiei
inhalatorii
Administrarea medicaiei orale
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Sala I
post splare medical a minilor
Necesar dotare:
chiuvetcu alimentare apcaldi sisteme de scurger e
distribuitor erveelehrtie
distribuitor spunlichid acionatprin celulfotoelectric
distribuitor soluiihidratante piele acionatfotoelectric
distribuitor prosoape hrtie acionatprin celulfotoelectric
co gunoi pentru deeuriinfecioase
distribuitor soluiialcoolice de splare mini
Necesar consumabile:
erveele hrtie - necesar per manevr:5; per semestru:30 cutii a cte200
spun lichid - necesar per manevr:10ml; per semestru:3 recipientea cte5 l
soluie hidratant - necesar per manevr:5ml;per semestru:2 recipientede5l
prosoape hrtie - necesar per manevr:4; per semestru:80 pachetea cte 330buc.
saci gunoi pentru deeuri infecioase - necesar per semestru:70
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post determinare tensiune
arterial
Necesar dotare:
distribuitor soluiialcoolice de splaremini
sfigmomanometru
canapea consultaie*
msumedical reglabilpe nlime*
manete tensiometru diverse mrimi
distribuitor erveeledezinfecie
stetoscop Littmann 3M 3200 Electronic Bluetooth *
computer cuplacde sunet irecepie prin bluetooth *
Necesar consumabile:
erveele hrtie - necesar per manevr:5;per semestru:30 cutii a cte200
saci gunoi pentru deeuri infecioase - necesar per semestru:70
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post injecia intravenoas
Necesar dotare:
manechin didactic - manevrmedical
msumedicalreglabilpe nlime
flacon didactic medicaie injectabil
cogunoi pentru deeuriinfecioase
distribuitor soluiialcoolice de splaremini
Necesar consumabile:
seringi -necesar per semestru:800
ace sering necesar per semestru 800 / 1600
ace extragere soluie din flacon necesar per semestru 800 *comprese sterile tifon 4/2 cm - necesar per manevr:1;necesar per semestru:800
soluie alcool sanitar -necesar per semestru:4 flacoanede 1 litru
saci gunoi pentru deeuri infecioase - necesar per semestru:70co gunoi deeuri neptoare- necesar per semestru:10
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post electrocardiografie
Necesar dotare:
sistem electrocardiografie
canapea consultaie
distribuitor erveelehrtie
co gunoi pentru deeurinepericuloase
distribuitor soluiialcoolice de splare mini
Necesar consumabile:
erveele hrtie - necesar per manevr:12;per semestru:48 cutii a cte200
caiet registru ecg -necesar per semestru:1
hrtie ecg -necesar per semestru:10 pachete
erveele soluie degresant - necesar per manevr:6;necesar per semestru:48seturi
saci gunoi pentru deeuri nepericuloase - necesar per semestru:70
soluie alcoolic splare - necesarpermanevr: 10ml;persemestru:4 recipientede 5 l
post peackflowmetrie, medicaie inhalatorieNecesar dotare:sistem peackflowmetrie imedicaieinhalatorie
canapea consultaie
distribuitor erveelehrtie
co gunoi pentru deeurinepericuloase
distribuitor soluiialcoolice de splare mini
Necesar consumabile:
erveele hrtie - necesar per manevr:12;per semestru:48 cutii a cte200
saci gunoi pentru deeuri nepericuloase - necesar per semestru:70
soluie alcoolic splare - necesarpermanevr: 10ml;persemestru:4 recipientede 5 l
post administrarea medicaiei orale
Necesar dotare:
pat spital
dulap mobil medicaie
msureglabilpe nlime
recipient ap
flacoane medicaie, scop didactic
fi prescripieterapie didactic
suport plastic mobil
cogunoi pentru deeurinepericuloase
distribuitor soluiialcoolice de splaremini Necesar consumabile:
bomboane tip pastile necesar per manevr:1;necesar per semestru:800
phrele administrare medicaie or al - necesar per manevr:1; per semestru:800
pahar administrare lichide- necesar per manevr:1; per semestru:800
saci gunoi pentru deeuri nepericuloase - necesar per semestru:70
soluie alcoolic splare - necesarpermanevr: 10ml;persemestru:4 recipientede 5 l
4050
m2
(6 m x 7,5 m)
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Sala II
post determinare glicemie prin
glucotestNecesar dotare:sistem glucotest
canapea consultaie
msureglabilpe nlime
co gunoi pentru deeuriinfecioase
distribuitor soluiialcoolice de splare mini
Necesar consumabile:
teste glicemie- necesar per manevr:1; per semestru:800
lancelete- necesar per manevr:1 per semestru:800
erveele soluie antiseptic- necesar per manevr:2; per semestru:8 seturi a cte200buci
comprese tifon 2/2 cm - necesar per manevr:1;necesar per semestru:800
co gunoi deeuri neptoare -necesar per semestru:10
mnui de unic folosin- necesar per manevr:1; per semestru:8 pachetea cte100buc.
saci gunoi pentru deeuri infecioase - necesar per semestru:70
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post asistarea pacientului in locomoie un
asistent. Intervenia n cazul dezechilibrrii
pacientului. Asistarea pacientului pentru a sta la
marginea patului
Necesar dotare:
distribuitor soluiialcoolice de splaremini
canapea consultaie/ pat spital reglabil pe nlime
centursusineretransfer
cruciorcu rotile *
Necesar consumabile:
erveele soluie antiseptic- necesar per manevr:1;per semestru:4 seturi a cte200buci
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post recoltarea uroculturii
metoda caterismului vezical
Necesar dotare:
manechin didactic - manevrmedical
co gunoi pentru deeuriinfecioase
distribuitor soluiialcoolice de splaremini
Necesar consumabile:
trus cateterism vezical necesar per semestru 800
mnui de unic folosin / sterile - necesar per semestru:800 perechi
saci gunoi pentru deeuri infecioase - necesar per semestru:70co gunoi deeuri neptoare- necesar per semestru:10soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post Injecia intramuscular
fesierul ventral
post injecia subcutanat
post injecia intramuscular deltoid
4050
m2
(6 m x 7,5 m)
Necesar dotare:
manechin didactic - manevrmedical
msumedicalreglabilpe nlime
flacon didactic medicaie injectabil
co gunoi pentru deeuriinfecioase
distribuitor soluii alcoolice de splaremini
Necesar consumabile:
seringi -necesar per semestru:800
ace sering necesar per semestru 800 / 1600
ace extragere soluie din flacon necesar per semestru 800*
comprese sterile tifon 4/2 cm - necesar per manevr:1;necesar per semestru:800soluie alcool sanitar -necesar per semestru:4 flacoanede 1 litru
saci gunoi pentru deeuri infecioase - necesar per semestru:70
co gunoi deeuri neptoare- necesar per semestru:10
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
Necesar consumabile:
seringi -necesar per semestru:800
ace sering necesar per semestru 800 / 1600
ace extragere soluie din flacon necesar per semestru 800 *
comprese sterile tifon 4/2 cm - necesar per manevr:1;necesar per semestru:800
soluie alcool sanitar -necesar per semestru:4 flacoanede 1 litru
saci gunoi pentru deeuri infecioase - necesar per semestru:70
co gunoi deeuri neptoare- necesar per semestru:10
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
Necesar dotare:
manechin didactic - manevrmedical
msumedicalreglabilpe nlime
flacon didactic medicaie injectabil
co gunoi pentru deeuri infecioase
distribuitor soluii alcoolice de splare mini
Necesar dotare:
manechin didactic - manevrmedical
msumedicalreglabilpe nlime
flacon didactic medicaie injectabil
cogunoi pentru deeuriinfecioase
distribuitor soluiialcoolice de splaremini
Necesar consumabile:
seringi -necesar per semestru:800
ace sering necesar per semestru 800 / 1600
ace extragere soluie din flacon necesar per semestru 800*
comprese sterile tifon 4/2 cm - necesar per manevr:1;necesar per semestru:800
soluie alcool sanitar -necesar per semestru:4 flacoanede 1 litru
saci gunoi pentru deeuri infecioase - necesar per semestru:70
co gunoi deeuri neptoare- necesar per semestru:10
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
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Sala III
post efectuarea bii la un pacient adult
Necesar dotare:
chiuvetcu alimentare apcaldi sisteme de scurger e
pat medical / canapea consultaie
manechin medical *
prosoape bumbac
foarfec
co gunoi pentru deeurinepericuloase
cocolectare materiale textile refolosibile
distribuitor soluiialcoolice de splare mini
Necesar consumabile:
erveele hrtie - necesar per manevr:5; per semestru:30 cutii a cte200
spun solid - necesar per semestru:3
soluie hidratant - necesar per manevr:5ml;per semestru:2 recipientede5l
role cearceaf unic folosinnecesar per semestru:10 role
rol tifon - necesar per semestru:3 role
prosoape hrtie - necesar per manevr:4; per semestru:80 pachetea cte 330buc.
saci gunoi pentru deeuri infecioase - necesar per semestru:70
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post Plasarea pacientului n poziie decubit dorsal,
ortopneic, lateral , decubit ventral, Sims, Fowler
Necesar dotare:
manechin didactic - manevrmedical*
canapea consultaiemedical
sistem oxigenoterapie
distribuitor soluiialcoolice de splaremini
Necesar consumabile:
sonde nazale ochelar necesar per manevr:1;necesar per semestru:800
tub oxigen necesar per semestru:1
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post masaj cardiac extern
Necesar dotare:
manechin didactic manevrmedical
Necesar consumabile: -
post manevra HeimlichNecesar dotare:manechin didactic manevrmedical
Necesar consumabile: -
post poziia lateral de siguran
Necesar dotare: -
Necesar consumabile:
manechin didactic manevr medical
3040
m2
(6 m x 5,5 m)
Necesar dotare:
pat medical reglabil n nlime
lenjerie pat medical
manechin medical *
perne medicale n numrde minim 6
ptur
msumedical
distribuitor soluii alcoolice de splare mini
Necesar consumabile:
soluie alcoolic splare - necesarpermanevr: 5 ml;persemestru:2 recipientede 5 l
post administrarea oxigenoterapiei
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23
4
7
5
689
110
1113
1512
14
23
4
7
5
689
110
1113
1512
14
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80% = nota 10;
70 ....... < 80% = nota 9;
65 ....... < 70% = nota 8;60 ....... < 65% = nota 7;
55 ....... < 60% = nota 6;
50 ....... < 55% = nota 5;
< 50% = nota 4;
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Organizare:
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Organizare:
30 Septembrie
brouricujurmntul
deschidere D-na Decan
discurs D-na Dr. Antohe - efDisciplinNursing cembracprimul
student cea mai mic not de trecere i apoi progresiv seimbrac alturi de o mbriare, pn la cel cu nota cea mai
mare care are un discurs de 5 min. max.
Discurs conclusiv D-na Decan
responsabilizeaz
integreaz n breasl, n universitate (se vd toi, se mbrieaz la preluarea
halatului, toi n alb etc.)
ierarhizeaz stimulnd competitivitatea
contientizeaz
stimuleaz o bun performan de studiu i achiziie de abiliti de nursing
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Resuscitarea medical
n condiii bazale
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CPR is not 100% successful, but it is the only alternative.
You can live without water for a few days and without food for a few weeks.Without air, though, you'll suffer brain damage within a few minutes and die afterabout ten minutes. Breathing, then, would be a pretty good thing about whichto become an expert.
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Basic life support (BLS) comprises the elements: initial assessment,then airway maintenance, expired air ventilation (rescue
breathing), and chest compression. Basic life support implies that noequipment is employed; where a simple airway or facemask formouth to mouth ventilation is used, this is defined as "basic lifesupport with airway adjunct".
The purpose of BLS is to maintain adequate ventilation and
circulation until means can be obtained to reverse the underlyingcause of the arrest. It is therefore a "holding operation",although onoccasions, particularly when the primary pathology is respiratoryfailure, it may itself reverse the cause and allow full recovery. Failureof the circulation for three to four minutes (less if the victim is initially
hypoxaemic) will lead to irreversible cerebral damage. Delay, evenwithin that time, will lessen the eventual chances of a successfuloutcome. Emphasis must therefore be placed on rapid institution ofbasic life support by a rescuer, who nonetheless should follow therecommended sequence of action.
Early Ages - Flagellation Method
Early Ages - Heat Method
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y g
1530 - Bellows Method
1711 - Fumigation Method
800 BC.Elijah's mouth to mouth."...And he went up, and lay uponthe child, and put his mouth upon his mouth, and his eyes uponhis eyes, and his hands upon his hands; and he stretched himselfupon the child; and the flesh of the child waxed warm."1 This first
recorded event has been the gate through which all of us havetraveled.
1770 - Inversion Method 1803 - Russian Method
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1773 - Barrel Method
1812 - Trotting Horse Method
1950 - Mouth-to-Mouth Resuscitation
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1973 - CPR practice for the population1992 - New reanimation method - the ACD method
1990's - New reanimation method - the VEST reanimation
1990'er - New reanimation method - theabdominal resuscitation
1998 - Early defibrillation
1960 - 1999 Devices for CPR
2000 Optimised CPR Resuscitation -
Animax
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1961
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1991
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1992
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2000
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2005
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http://www erc edu/
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1 E f t f d i ti
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1. Ensure safety of rescuer and victim
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Nurse leddefibrillationParamedic
Medic (oricare)
Familia
Hospital based medical emergency team
Martorbunul samaritean
Cine efectueazaRCR?
contient
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manevre
diagnostic
contient
comatos
cu funcii vitale prezervate
n stop cardiorespirator
respiraie =circulaie
asistena respiraiei
asistena circulaiei
Timpii mori
Perioadedeasistenefectiv
Durat Eficien
Sequence of actions for adult basic life supportFor the purposes of these guidelines an adult is considered a
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For the purposes of these guidelines an adult is considered aperson aged 8 years or over.
1. Ensure safety of rescuer and victim
2. Check the victim and see if he responds:Gently shake his shoulders and ask loudly: "Are you all right?"
A. If he responds by answeringor moving:
Leave him in the position inwhich you find him (provided
he is not in further danger) Check his condition Get assistance if needed Reassess him regularly
B. If he does not respond:Shout for help
Unless you can assess him fully in the positionyou find him, turn the victim on to his back andthen open the airway:
Place your hand on his forehead andgently tilt his head back keeping yourthumb and index finger free to close his
nose if rescue breathing is requiredRemove any visible obstruction from thevictims mouth, including dislogeddentures, but leave well fitting dentures inplaceWith your fingertips under the point of
the victim's chin, lift the chin to open the
Keeping the airway open, look, listen and feel for breathing (morethan an occasional gasp or weak attempts at breathing):
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g p p g)Look for chest movementListen at the victim's mouth for breath soundsFeel for air on your cheek
A. If he isbreathing normally:Turn him into the recoveryposition
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Keeping the airway open, look, listen and feel for breathing (morethan an occasional gasp or weak attempts at breathing):
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g g)Look for chest movementListen at the victim's mouth for breath soundsFeel for air on your cheek
A. If he isbreathing normally:Turn him into the recoveryposition
B. If he is notbreathing or is onlymaking occasional gasps or weakattempts at breathing:Send someone for help or, if you are
on your own, leave the victim and gofor help; return and start rescuebreathing as below
Turn the victim onto his back if he isnot already in this position
Send or go for helpCheck for continuedbreathing
Give 2 slow, effective rescue breaths, each of which makes the chestrise and fall:
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Ensure head tilt and chin liftPinch the soft part of his nose closed with the index finger andthumb of your hand on his foreheadOpen his mouth a little, but maintain chin liftTake a deep breath to fill your lungs with oxygen, and place yourlips around his mouth, making sure that you have a good sealBlow steadily into his mouth whilst watching his chest; take about 2seconds to make his chest rise as in normal breathingMaintaining head tilt and chin lift, take your mouth away from thevictim and watch for his chest to fall as air comes outTake another breath and repeat the sequence as above to give 2
effective rescue breaths in all
cu excepia victimelorde:
intoxicaii;
nec;
patologietraumatic;
copii;
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If you have difficulty achieving an effective breath:
Recheck the victim's mouth and remove any obstructionRecheck that there is adequate head tilt and chin liftMake up to 5 attempts in all to achieve 2 effective breathsEven if unsuccessful, move on to assessment of the circulation
4. Assess the victim for signs of a circulation:Look, listen and feel for normal breathing, coughing or movement by thvictimOnly if you have been trained to do so check the carotid pulse
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With your middle finger on thispoint, place your index finger on the
sternum itselfSlide the heel of your other handdown the sternum until it reachesyour index finger; this should be themiddle of the lower half of the
If you are confident that you havedetected signs of a circulation:Continue rescue breathing untilthe victim starts breathing on hisown
About every 10 breaths (or aboutevery minute) recheck for signs of acirculation; take no more than 10
seconds each timeIf the victim starts to breathe
normally on his own but remainsunconscious, turn him into therecovery position. Be ready to turnhim on to his back and re-start
rescue breathing if he stopsbreathing
victimOnly if you have been trained to do so, check the carotid pulseTake no more than 10 seconds to do this
If there are no signs of a circulation,or you are at all unsure, start chestcompressions:With your hand that is nearest thevictim's feet, locate the lower half othe sternum (breastbone):
Using your index and middlefingers, identify the lower rib edgenearest to you. Keeping your fingerstogether, slide them upwards to thepoint where the ribs join the
sternum.
Pulse check requires too much time
Rescuers are wrong about a pulse check
35% of the time Some victims of cardiac arrest are
missed because rescuers think a pulseis present when it isnt
Lay rescuers should check for signs ofcirculation (normal breathing, coughing,or movement after 2 breaths)
Masajul cardiac extern
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Push hard
Push fast
Dontstop
Change hands
Depresie stern 5-6 cm.
Rata de 100/min este esentiala.
Pauzele scad perfuzia miocardica.
Dupa 3 min de RCR performantele
se reduc semnificativ.
linia umerilor
linia sternului
900
centrul toracelui
unic zon decontact/compresiune
European Resuscitation Council Guidelines for Resuscitation 2005
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Some rescuers are reluctant to give mouth-to-mouth breaths to strangers
Something (chest compressions alone) isbetter than nothing
In some studies of adultcardiac arrest for shortperiods, compressions only may be effective
Compression-only is recommended fordispatcher-assisted CPR or when the rescueris unable or unwilling to perform rescuebreathing
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CCcompresie cardiaca
MMV
ventilatie gura-la-gura
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In Olanda, unde RCR se practica in secventa CAB (Chest
compresion , Airw ay, Breathing) rata de supravietuire este
comparabila cu cea din SUA.Simoons ML et al. Eur Heart J 1990; 11(suppl): 92.
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Hightower D et al. Decay in quality of closed-chest
compressions over time. Ann Emerg Med 1995; 26: 300-303.
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3 x 2 x
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Previous guidelines included a complex set ofskills to relieve foreign-body airway obstruction
(FBAO) in an unresponsive victim The skills were difficult to teach, learn, and
remember
Inclusion of complex skills in CPR courses
reduced retention of all skills The recommendations have been simplified
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Lay rescuer is much more likely to treat avictim unresponsive from cardiac arrestthan a victim unresponsive from FBAO
Sudden cardiac arrest250,000 deaths/yr
FBAO3,200 deaths/yr Chest compressions may relieve FBAO
If adult choking victim becomesunresponsive:
Contact EMS Begin steps of CPR
Look for (and remove) obstructing object
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Manevra Hemlich
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conscious victim:
back slapping
abdominal thrusts
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unconscious victim:
perform chest
compressions
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