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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


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


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


pericliteazd.p.d.v. medical

pacientulabsena achiziiei abilitii

pericliteaz reputaia de

halat alb


limiteaz major posibilitatea

studentului de a activa lanivel clinicSplarea medical a minilor

(ap i spun; soluii alcoolice)Msurarea tensiunii arteriale


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


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 *


erveele hrtie - necesar per manevr:5;per semestru:30 cutii a cte200



post injecia intravenoas

Necesar dotare:

manechin didactic - manevrmedical

msumedicalreglabilpe nlime

flacon didactic medicaie injectabil

cogunoi pentru deeuriinfecioase



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


post electrocardiografie

Necesar dotare:

sistem electrocardiografie

canapea consultaie


co gunoi pentru deeurinepericuloase




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








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



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




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 folosinnecesar per manevr:1; per semestru:8 pachetea cte100buc.



post asistarea pacientului in locomoie un

asistent. Intervenia n cazul dezechilibrrii

pacientului. Asistarea pacientului pentru a sta la

marginea patului

Necesar dotare:


canapea consultaie/ pat spital reglabil pe nlime

centursusineretransfer

cruciorcu rotile *


erveele soluie antiseptic- necesar per manevr:1;per semestru:4 seturi a cte200buci


post recoltarea uroculturii

metoda caterismului vezical

Necesar dotare:





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:





distribuitor soluii alcoolice de splaremini




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


co gunoi deeuri neptoare- necesar per semestru:10





ace extragere soluie din flacon necesar per semestru 800 *

comprese sterile tifon 4/2 cm - necesar per manevr:1;necesar per semestru:800





Necesar dotare:




co gunoi pentru deeuri infecioase

distribuitor soluii alcoolice de splare mini

Necesar dotare:




cogunoi pentru deeuriinfecioase





ace extragere soluie din flacon necesar per semestru 800*

comprese sterile tifon 4/2 cm - necesar per manevr:1;necesar per semestru:800






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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


cocolectare materiale textile refolosibile



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.



post Plasarea pacientului n poziie decubit dorsal,

ortopneic, lateral , decubit ventral, Sims, Fowler

Necesar dotare:

manechin didactic - manevrmedical*

canapea consultaiemedical

sistem oxigenoterapie



sonde nazale ochelar necesar per manevr:1;necesar per semestru:800

tub oxigen necesar per semestru:1


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: -


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



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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