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RC (UK) CĂILE DE ADMINISTRARE A MEDICAMENTELOR ÎN TIMPUL RESUSCITĂRII CARDIOPULMONARE

Caile de Administrare Curs Fmam

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Text of Caile de Administrare Curs Fmam

RC (UK)CILE DE ADMINISTRARE A MEDICAMENTELOR N TIMPUL RESUSCITRII CARDIOPULMONARERC (UK)Obiectivenelegee! nece"it#ii $bineii %n%i !cce" int!ven$"Revi&%ie! ec'i(!)ent%l%i *$l$"itL$c%ile (e*e!te (ent% !cce"%l ven$"nelegee! c$)(lic!iil$ c!e ($t "%veniRC (UK)Av!nt!+ele !cce"%l%i ven$"A,)ini"t!e! )e,ic!)entel$A,)ini"t!e! *l%i,el$Rec$lt!e! ($bel$ ,e "-ngeInt$,%cee! c!teteel$ ,e (!cingRC (UK)Acce"%l ven$" (ei*eicE.te)it!te! "%(ei$!#/P!te! ,$"!l# ! (!l)ei/Anteb!0 *$"# !ntec%bit!l#1-t/2en! +%g%l!# e.ten#RC (UK)C$)(lic!ii !le !cce"%l%i ven$" (ei*eicI)e,i!teE3ec%l c!n%l#ii venei4$)!e! 'e)!t$)%l%iE.t!v!&!e! )e,ic!)entel$0 ! *l%i,el$Peic$l ,e !*ect!e ! "t%ct%il$ 5nvecin!teE)b$lie g!&$!"#4!g)ent!e!6%(ee! c!n%lei "!% ! !c%l%iT!,iveT$)b$*lebit# Cel%lit#RC (UK)Acce"%l ven$" cent!l2en! +%g%l!# inten#2en! "%bcl!vic%l!#RC (UK) 2en! +%g%l!# inten# ,e!(t#Ate! c!$ti,# c$)%n# ,e!(t#C!til!+%l ti$i,i!n2en! "%bcl!vic%l!# ,e!(t#2en! "%bcl!vic%l!# "t-ng#RC (UK)C$)(lic!ii !le c!n%l#ii venel$ cent!leP%ncie !tei!l#7e)!t$)7e)$t$!.Pne%)$t$!.E)b$lie g!&$!"#Peic$l ,e !*ect!e ! "t%ct%il$ 5nvecin!teAit)iiRC (UK)A,)ini"t!e! t!'e!l# ! )e,ic!)entel$I)($"ibilit!te! c!n%l#ii ven$!"eNece"it!te! t%b%l%i t!'e!l in "it%A+%"t!e! ,$&ei 3i ! v$l%)%l%iDi"(e"i! 5n !b$ele b$n3icRC (UK)A,)ini"t!e! t!'e!l# ! )e,ic!)entel$Me,ic!)ente c!epot *i !,)ini"t!te en,$t!'e!l8E(ine*in!Li,$c!in!At$(in!N!l$.$n! Me,ic!)ente c!e nu pot *i !,)ini"t!te en,$t!'e!l8A)i$,!$n#9ic!b$n!t ,e "$,i%C!lci%RC (UK)nteb#i:RC (UK)Re&%)!tD!c# !vei l! 5n,e)-n# $ c!n%l# ven$!"# (ei*eic# *%nci$n!l#0 *$l$"ii;$ ,e l! 5nce(%t2enele cent!le e(e&int# ce! )!i b%n# !legee0 ,!c# "it%!i! (e)ite0 ,! *ii !teni l! c$)(lic!iiC!le!en,$t!'e!l# ($!te *i *$l$"it# c% !+%"t!e! c$e"(%nt$!e ! ,$&el$RC (UK)LINII D>0 4>A>C>E>P>P$*e"$ A"$ci!t ,e C'i%gie 3i Me,icin# ,e Ugen#Diect$ !l Cent%l%i Inten!i$n!l ,e Me,icin# ,e Ugen#M>S> 7e"'e? Me,ic!l CentePenn St!te Unive"it?7e"'e?0 Penn"?lv!ni!0 USARC (UK)[email protected] CORECT A 4LUIDELOR I2Pe+%,ec#i8; S4 ("e%l *i&i$l$gic) e"te )!i b%n ,ec-t RL (Ringe l!ct!t); I2 e"te )!i bine ,ec-t PO; E"te c$ect# !,)ini"t!e! 5n b$l%" ! gl%c$&ei AB; 7i($C!le)i! teb%ie !(i, t!t!t#; DEE )l 6 $# t!te! ,e"'i,!t!e!; 9$l%"%ile ,e *l%i,e ($,%c in"%*icien# c!,i!c# c$nge"tiv# RC (UK)[email protected] CORECT A 4LUIDELOR I2n!inte ,e 5nce(ee! t!t!)ent%l%i I2 5nteb!i;v# ,!c# !ce"t! e"te c% !,ev#!t nece"!C$)(lic!ii ((e ,i!($&itiv%l %)#t$)M%lte )e,ic!)ente "%nt l! *el ,e e*ic!ce PO8; !)in$*ilin!; "te$iⅈ ben!,?l (,i('en'?,!)ine); !ntibi$ticele; !nti!lgiceleU&%!l0 ,!c# (!cient%l n% (e&int# v#"#t%i "e (e*e# !,)ini"t!e! PORC (UK)COMPLICAFIILE TERAPIEI I2In*ecii; G HE>EEE c!&%i 6 !n 5n S>U>A>; !($.i)!tiv DE>EEE ,e ,ece"e 6 !n; *ecven# $bi"n%it#8I ; A B ,!c# J HK $eK ; DE B ,!c# LI ; MN $eG DE B ,!c# G MN $e; eg%l! ,e b! (ent% (evenie8 "c'i)b!e! t%t%$ c!teteel$ 5n intev!l ,e HK ; LI $eRC (UK)ALTE COMPLICAFIIT$)b$*lebite nein*eci$!"e c!e ($t (eiclit! !cce"%l ven$" %ltei$Nec$&e ti"%l!e (in e.t!v!&!e! )e,ic!)entel$ "!% *l%i,el$Alegii "!% ec&e)e ,e c$nt!ct0 ,!t$!te ben&il$ !,e&ive %tili&!te l! *i.!e! c!teteel$E)b$lii g!&$!"e 3i 'e)$!gii 5n c!&%l ,ec$nect#ii liniil$ ven$!"eE)b$lie ,e c!tete ; ($!te nece"it! t!t!)ent c'i%gic!lS%(!5nc#c!e v$le)ic# 6 ,e&ec'ilib% elect$liticRC (UK)CONFINUTUL 4LUIDELOR PENTRU TERAPIA I2D> [email protected] A BA B gl%c$ 5n !(#AE g 6 LIEE c!l$ii 6 L(7 O H0AIAI )O") 6 LRC (UK)CONFINUTUL 4LUIDELOR PENTRU TERAPIA I2I> SERUL [email protected] B N!ClDAH )EPN! 6 LDAH )EP Cl 6 LQEK )O") 6 L(7 O H ; An% *%ni&e! !(# libe# RC (UK)CONFINUTUL 4LUIDELOR PENTRU TERAPIA I2Q> RIN1ER LACTATDQE )EP N! 6 LDEM )EP Cl 6 LH )EP K 6 LQ )EP C! 6 LIK )EP l!ct!t 6 LILQ )O") 6 L(7 O N0A ; L*%ni&e! DEE )l !(# 6 L "$l%ie RingeRC (UK)CONFINUTUL 4LUIDELOR PENTRU TERAPIA I2H> SOLUFIE N!Cl E0HA BLL )EP N! 6 LLL )EP Cl 6 LDAH )O") 6 L(7 O H ; A*%ni&e! HAE )l !(# 6 L "$l%ie N!Cl E0HA BRC (UK)CONFINUTUL 4LUIDELOR PENTRU TERAPIA I2A> [email protected] A B CU N!Cl E0HA BAE g (IEE Kc!l) gl%c$ 6 LLL )EP N! 6 LLL )EP Cl 6 LHEN )O") 6 L(7 O H0ERC (UK)CONFINUTUL 4LUIDELOR PENTRU TERAPIA I2N> [email protected] A B 6 N!Cl E0DK BAE g (IEE Kc!l) gl%c$ 6 LQH )EP N! 6 LQH )EP Cl 6 LQID )O") 6 L(7 O H0ERC (UK)CONFINUTUL 4LUIDELOR PENTRU TERAPIA I21l%c$ DE B 5n !(# (DEE g 6 LR HEE Kc!l 6 L)1l%c$ A B c% RL (AIA )O") 6 L)1l%c$ A B c% S4 (ANE )O") 6 L)RC (UK)CONFINUTUL 4LUIDELOR PENTRU TERAPIA I2K> N!Cl Q B 7IPERTONADQ )EP N! 6 LADQ )EP Cl 6 LDEIN )O") 6 L4$l$"ii ,$! 5n c!&%i ,e 'i($n!te)ie !g!v!t# ,e c$nv%l"ii "!% 5n in"t!bilit!te! 'e)$,in!)ic#RC (UK)ALE1EREA 4LUIDELOR I2PRINCIPII 1ENERALE DE SELECFIEC$nin%t%l ,e N!O")$l!it!te!(7C!ntit!te! ,e !(# *%ni&!t#Nece"!%l ,e gl%c$ (c!l$ii)R!t! ,e !,)ini"t!e !ntici(!t#RC (UK)RIN1ER LACTATDe elecie (ent%8D> Oice "it%!ie c!e nece"it# b$l%" in+ect!t !(i, 3i 5n c!ntit!te )!eI> Nece"! ,e v$l%) ce"c%t 3i (el%ngit (!"%i)Q> Aci,$ %3$!# "(e )$,e!t# ,!t$!t# ,e(leiei v$le)iceH> Iig#i $*t!l)ice ("$l%ie c% (7 ne%t%)Se ($t !,)ini"t! (e"te HE L RL 6 IH $e *## )$,i*ic!e! i$n$g!)eiRC (UK)CONTRAINDICAFII RLIn"%*icien! en!l# (,in c!%&! c$nin%t%l%i 5n K)Nece"it!te! )enineii glice)ieiNece"! ,e !(# G DEE )l 6 LN$t#8Acidoza lactic nu este o contraindicaie pentru administrarea de RL !T!n"*%&ii (: ($,%ce c$!g%l!e (e !cee!3i linie ven$!"#)De ein%t8RL este frecvent preferat SF n deshidratrile acute !RC (UK)SER [email protected] !,)ini"t!t 5n8/De(lei! v$le)ic# l! (!cienii c% in"%*icien# en!l# "!% "t!e ne(eci&!t# ! *%nciei en!le/7i($n!te)ie )$,e!t#0 ,!t$!t# ,e(leiei v$le)ice/2e'ic%l *l%i, (ent% t!n"*%&ii (e !cee!3i linie/Me,i% ,e ,il%ie (ent% *enit$in! I2RC (UK)SER [email protected] CONTRAINDICAFIIn c!& ,e !,)ini"t!e (el%ngit# "e ($,%ce !ci,$ 'i(ecl$e)ic# 3i 'i($C!le)ieNece"it# "$l%ie t!)($n ((7 N!Cl E0M B O H)Nece"it# )eninee! ($t!"e)ieiSen"ibilit!te! l! N! (ICC ; in"%*icien! c!,i!c# c$nge"tiv# "!% 7TA)Nece"it# )eninee! glice)ieiRC (UK)N!Cl E0HA B SAU E0DK BUtile c-n, (!cient%l e"te "en"ibil l! 5nc#c!e! "!lin#Util# c-n, (!cient%l nece"it# 5nc#c!e v$le)ic#S%b *$)# ,e N!Cl E0HA B S 1l% A B "!% N!Cl E0DK B S 1l% A B S ($t!"i% e!li&e! )eninee! ,e lic'i, 5n (!t%l v!"c%l!RC (UK) [email protected] AB CONTRAINDICAFIIOi ,e c-te $i e"te nece"! %n b$l%" !(i, (c! b$l%" i,ic# glice)i! l! G MEE )g 6 ,L c'i! l! (!cieni ne,i!betici)9$l%"%l !(i, ,ete)in#8D> 7i($n!te)ieI> 7i($C!le)ieQ> 7i(eglice)ieRC (UK)DEPLEFIA DE POTASIU I8 2! incec! 5nc!n%l!e! %nei vene "e l! nivel%l b!%l%iPe"$!n! n>Q8 2! 5ncec! 5nc!n%l!e! %nei vene l! nivel%l )e)b%l%i in*ei$ Pe"$!n! n>H8 2! int$,%ce lini! int!$"$!"# 5n )e)b%l in*ei$ c$nt!l!te!lN$t#8 T$!te cele H !ci%ni "e v$ 5nce(e "i)%lt!n 3i i)e,i!t ,%(# "$"ie! (!cient%l%iRC (UK)CONTRAINDICAFIILE A9ORDULUI INTRAOSOSIn*eci! &$nei (%nci$n!teS%"(ici%ne ,e *!ct%# l! nivel%l $"%l%i l%ng !l )e)b%l%i (%nci$n!tP%ncii !le !cel%i!3i $" 5n !ntece,enteO"te$gene i)(e*ect#RC (UK)CE SE POATE ADMINISTRA PE CALE INTRAOSOAS2$l%) ; lic'i,e I20 "-nge0 (l!")#0 etc>T$!te )e,ic!)entele e"%"cit#ii c!,i$(%l)$n!eMe,ic!)ente 'i(et$ne (bic!b$n!t ,e "$,i%0 cl$%# ,e c!lci%0 ,e.t$ AEB)Me,ic!)ente U"cle$&!nteV (tet!ciclin#0 eit$)icin#0 ,i!&e(!)0 ,i*enil'i,!nt$in#0 etc>)Antibi$ticeMe,ic!)entele !,)ini"t!te (e linie int!$"$!"# tec (in "in%"$i,ele )#,%vei "(e cic%l!i! cent!l# )!i !(i, ,ec-t (in venele (ei*eiceRC (UK)TE7NICA DE INSERFIE A ACULUI INTRAOSOS4$l$"ii !c int!$"$" "(eci!l "!% %n !c "(in!l (c% )!n,enR ,e $bicei DK1R !cele )ici "e in,$!ie %3$)Peg!tii &$n! ,e (%ncie/ I c) "%b t%be$&it!te! tibi!l#/&$n! !lten!tiv# e"te D6Q in*ei$!! ! *e)%%l%i0 !ntei$S(i+inii egi%ne! ($"tei$!# ! )e)b%l%i c% %n ($"$( Ane"te&ie l$c!l# ,!c# (!cient%l e"te c$n3tient 3i ti)(%l (e)ite Se v! int$,%ce !c%l vetic!l c% )i3c#i ,e $t!ie *e)e (-n# c-n, int# !c%l ()$)ent 5n c!e !c%l (enete! c$te.%l $"%l%i)A"(i!i c% $ "eing#RC (UK)TE7NICA DE INSERFIE A ACULUI INTRAOSOSD!c# e"te bine int$,%" !c%l v! *i *i. 5n $" 3i n% "e v! )i3c!D!c# !"(i!e! e"te neg!tiv#0 "e v! int$,%ce $ c!ntit!te )ic# ,e lic'i, 3i "e v! %)#i ,!c# e.i"t# e.t!v!&!e ("e t%)e*i! (ici$%l)D!c# n% e.i"t# e.t!v!&!e "e v! !,)ini"t! lic'i,%l 5n c!ntit!te! nece"!#Se v! *i.! !c%l c% b!n,!+ 3i le%c$(l!"tSe v! "c$!te !c%l int!$"$" ,%(# ce "e $bine %n !cce" I2 "t!bilRC (UK)DENUDAREA 2ENOASIn,ic!t# ,!c# !lte incec#i ,e !cce" int!ven$" e3%e!E"te ! nece"!# ,!c# "e e!li&e! c$ect !cce"%l int!$"$" "!% cent!l1e% ,e e*ect%!t c'i! ,e c#te )e,icii c% e.(eien#Inci,en# )!i )!e ,e in*ecie 3i $cl%&ie ven$!"# ,ec-t 5n c!&%l !cce"%l%i int!ven$" (ec%t!n