defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias,

8/14/2019 Defibrillation is the Definitive Treatment for the Life-threatening Cardiac Arrhythmias,

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Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias, ventricular fibrillation and ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of

electrical energy to the affected heart with a device called a defibrillator. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal sinus rhythm to be

reestablished by the body's natural pacemaker, in the sinoatrial node of the heart.

Defibrillators can be external, transvenous, or implanted, depending on the type of device used or needed. Some external units, known as automated external defibrillators (AEDs), automate the

diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little, or in some cases no training at all.

Types

2.1 Manual external defibrillator

2.2 Manual internal defibrillator

2.3 Automated external defibrillator (AED)

2.4 Semi-automated external defibrillators

2.5 Implantable Cardioverter-defibrillator (ICD)

2.6 Wearable Cardiac Defibrillator

Placement

Resuscitation electrodes are placed according to one of two schemes. The anterior-posterior scheme (conf. image) is the preferred scheme for long-term electrode placement. One electrode is placed

over the left precordium (the lower part of the chest, in front of the heart). The other electrode is placed on the back, behind the heart in the region between the scapula. This placement is preferred

because it is best for non-invasive pacing.

The anterior-apex scheme can be used when the anterior-posterior scheme is inconvenient or unnecessary. In this scheme, the anterior electrode is placed on the right, below the clavicle. The apex

electrode is applied to the left side of the patient, just below and to the left of the pectoral muscle. This scheme works well for defibrillation and cardioversion, as well as for monitoring an ECG.

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In medicine, a wound is a type of injury in which skin is torn, cut or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound). In pathology, it specifically refers

to a sharp injury which damages the dermis of the skin.

Types of wounds

1.) Open

Open wounds can be classified according to the object that caused the wound. The types of open wound are:

Incisions or incised wounds, caused by a clean, sharp-edged object such as a knife, a razoror a glass splinter.

Lacerations, irregular tear-like wounds caused by some blunt trauma. The term laceration is commonly misused in reference to incisions.
http://en.wikipedia.org/wiki/Knifehttp://en.wikipedia.org/wiki/Razorhttp://en.wikipedia.org/wiki/Knifehttp://en.wikipedia.org/wiki/Razor


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Abrasions (grazes), superficial wounds in which the topmost layer of the skin (the epidermis) is scraped off. Abrasions are often caused by a sliding fall onto a rough surface.

Puncture wounds, caused by an object puncturing the skin, such as a nail orneedle.

Penetration wounds, caused by an object such as a knife entering the body.

Gunshot wounds, caused by abullet or similar projectile driving into or through the body. There may be two wounds, one at the site of entry and one at the site of exit, such is generally

known as a through-and-through.

2.) Closed

Closed wounds have fewer categories, but are just as dangerous as open wounds. The types of closed wounds are:

Contusions, more commonly known asbruises, caused by blunt force trauma that damages tissue under the skin.

Hematomas, also called blood tumors, caused by damage to a blood vessel that in turn causesblood to collect under the skin.

Crushing injuries, caused by a great or extreme amount of force applied over a long period of time.

Treatment

Treatment of recent lacerations involves examination, cleaning, and closing the wound. If the laceration occurred some time ago it may be allowed to heal by secondary intention due to the high rate

of infection with primary closure.

1.) Cleaning

For simple lacerations cleaning can be accomplished using a number of different solution including: tap water, sterile normal saline, or an antiseptic solution. Tap water has been found to be as good

as, or better than, sterile saline. Tap water is less expensive, can be done by the patient themselves, and leads to equally low rates of infection.

2.) Closure

If closure of a wound is decided upon a number of techniques can be used. These include Steri strips, a Cyanoacrylate glue, staples, and sutures.Absorbable sutures have the benefit over non

absorable sutures of not requiring removal. They are often preferred in children.

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An endotracheal tube (also called an ET tube or ETT) is used in general anaesthesia, intensive care and emergency medicine for airway management and mechanical ventilation. The tube is insertedinto a patient's trachea in order to ensure that the airway is not closed off and that air is able to reach the lungs. The endotracheal tube is regarded as the most reliable available method for protecting

a patient's airway.
http://en.wikipedia.org/wiki/Abrasion_(medical)http://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Hypodermic_needlehttp://en.wikipedia.org/wiki/Penetrating_traumahttp://en.wikipedia.org/wiki/Ballistic_traumahttp://en.wikipedia.org/wiki/Ballistic_traumahttp://en.wikipedia.org/wiki/Bullethttp://en.wikipedia.org/wiki/Bruisehttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Hematomahttp://en.wikipedia.org/wiki/Blood_vesselhttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/w/index.php?title=Crush_injury&action=edit&redlink=1http://en.wikipedia.org/wiki/Abrasion_(medical)http://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Hypodermic_needlehttp://en.wikipedia.org/wiki/Penetrating_traumahttp://en.wikipedia.org/wiki/Ballistic_traumahttp://en.wikipedia.org/wiki/Bullethttp://en.wikipedia.org/wiki/Bruisehttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Hematomahttp://en.wikipedia.org/wiki/Blood_vesselhttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/w/index.php?title=Crush_injury&action=edit&redlink=1


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atropine sulfate

(Medazolam)

Class:Anticholinergic

IM,ampule MOA-anesthetic form

(salivation), HR

Decreases action of the

parasympathetic nervous

system increasing

conduction velocity and

heart rate

I- HR,

Symptomatic

bradycardia

CI-Tachycardia AR-drowsiness, HPN,

edema

NR- HR, MIO, void

before giving

Clonidine (Catapress)

-Anti-HPN

sublingual HR,BP Renal HPN Use cautiously in

patients with recent MI

Wt. gain, dizziness,

fatigue, constipation

BP,PR

Epinephrine (Adrenaline)

-Adrenergic

Ampule, ET tube Relaxes bronchial smooth

muscle

Anaphylaxis , asthma In labor , shock,

arrhythmias

Nervousness, tremor, n/v PR. weigh , caustion:w/

emphysema

Diazepam (Valium)

-anticonvulsant, sedative

Capsules, Injection, OS,

Rectal gel twin packs,

Tablets

depresses the CNS Anxiety pregnant women Drowsiness, apnea avoid activities that

require alertness

Paracetamol

(acetaminophen)

Analgesic, antipyretic

IV (>40), suppository

(250m infant, 500 adult)

30 sec to melt, ampule

reduces fever and pain Pain , fever, temp, chi ll severe liver di seases Anemia, rash, n/v Dont use > 3 days

Lidocaine hcl (xylocaine

2%)

Anti arrhythmia

IM, ET tube, IV,

lidocaine drip + D5 h2O

(slowly)

2-5 mg/dl

Prior to surgery, VF, MI temporary fix for tinnitus Caution: 2nd block Restlessness, seizure,

vomiting, nervousness

Deltoid muscle ONLY,

isoenzyme (Ck level),

BP

Mannitol (Osmitrol)

Osmotic diuretic

IV (5,10,15,20,25%)

X electrolyte

osmotic pressure,

water flow,

extracellular

Oliguria, ARF, ICF Anuria, severe

pulmonary

Blurred vision, n/v,

diarrhea

VS, use urinary cath,

freq mouth care, use in

chemo,MIO

NaCO3 (baking soda)

Antacid/alkalinizer

Oral,IV (too slow coz of

irritation) withdraw

NSS10cc 2x.

DONT give plain (dilute

in h2O)

neutralizes excess acid. Metabolic acidosis,

cardiac arrest

Metabolic alkalosis Gastr ic distention,

flatulence, irritation

Give w/o milk

Furosemide (Lasix) IM,IV,oral Inhibit reabsorbtion of

Na

Edema, nephrotic

syndrome, HPN

hepatic cirrhosis, severe

renal ds.

Restlessness,

thrombophlebitis

BP, ,DHN, MIO elevate

position, limit fld. intake


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diuretic

Albuterol sulfate

/Salbutamol (ventoiln)

adrenergic

Capsules/sol for

inhalation , Syrup,

Tablets, nebulize (15 min

interval) ampule 1 ml =

RR

Improve ventilation, relax

bronchial & uterine

smooth muscle

Acute bronchospasm HPN, DM, GI narrowing Insomnia, tremor, HPN,

dizziness

>1x= (2 min interval),

place mouthpiece, RR

Dipenhydramine(benadryl)

Anti-histamine, sedative-

hypnotic, cough

supressants, anti motion

sickness

Block effect of his tamine Seasonal allergic rhinit is Peptic ulcer , preg Sedation, dizziness w/ meal, repor t i rreg HR

Tranexamic (Hemostan)

Anti-fibronulitic

Inhibit plasmin activity Mngt. hemophilic pt. ,tx

hereditary edema

epistaxis, hemorrhage Diarrhea, n/v, DPT, color

vision,

Check vision after

admn., report DOB

s/s:bleeding: pain, BP,

poor cap refill

defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias,

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