BASIC REANIMATION

BASIC REANIMATION

1. The cardiocirculatory stop is defined as the sudden interruption of circulation and ventilation, constitutes an absolute urgency. Although it occurs regularly in hospitals, most cardio-circulatory stops are extrahospital.

   • +Steps : immediate call of the emergency service (15) or collaborators, - Rapid initiation of basic cardiopulmonary resuscitation, - evaluation of heart rate and early defibrillation, - effective ventilation and administration of emergency medications by route intravenously as soon as possible

2. The causes of cardiorespiratory arrest are multiple. We usually distinguish mechanism of circulatory arrest and underlying pathology.

3. The electrocardiogram (ECG) is therefore the essential test for the diagnosis of the disorder

   • Ventricular fibrillation : defined as anarchic, non-synchronous contractions, myocardial ventricular fibers unable to provide ventricular ejection
   • Untreated ventricular tachycardia progresses rapidly to the ventricular fibrillation approach for prognosis and treatment.

4. Diagnosis : The diagnosis of cardio-circulatory arrest is easy to take before: - a state of apparent death with sudden unconscious loss of consciousness   Tremors, - Disappearance of the carotid or femoral pulse

5. The objective of resuscitation is to provide oxygenation and myocardial perfusion and brain

   • Basic cardiopulmonary resuscitation involving first aid procedures elements that can be practiced by witnesses of cardio-circulatory arrest that followed basic training - Specialized cardiopulmonary resuscitation that complements basic resuscitation and that must be practiced by a person with medical experience
     • Allows survival by maintaining freedom of the respiratory tract
       • Free open mouth- Hyperextension of the head

6. Breathing: ventilation Several techniques can be used: mouth to mouth, mouth to nose

   • Ventilation mask Before endotracheal intubation, ventilation should be interspersed with chest compressions at a rate of 10 to 12 breaths per minute. Each insufflation is done in two seconds
   • The principle is to ensure a blood circulation by rhythmically compressing the Cardiac muscle externally between the rib cage and the spine
     • External cardiac massage should be performed according to strict rules to obtain optimal efficiency and a minimum of harmful effects
     • The patient supine in a hard plane, the heel of the hand in the support of the lower third of the sternum in the midline, placing the other hand perpendicular to the upper part. The sternum should be depressed frankly but not brutally
     • The compression rate should be 80 to 100 / min. The compression time must be equal to relaxation time.
   • Stop truck
     • Defibrillation Ventricular fibrillation is the most common cause of cardio-circulatory arrest and External electrical discharge is your only treatment. The forecast depends on the speed of the realization of the electric shock
       • The purpose of electric shock is to depolarize a critical mass of myocardium to restore normal electrical activity generated by a unique autofocus
         • Electrodes strongly coated with conductive gel are placed under the right clavicular and under the left axillary, to take the heart in its main axis The operator and the patient must be perfectly isolated from each other

7. First line and infusion fluids The choice of approach is based on the speed and safety of its venous, peripheral or central implementation (internal jugular, subclavian, femoral), it is used more frequently. The first has the advantage of being faster, easier to start up with a low complication rate

   • Pharmacotherapy
     • Adrenalin Due to these stimulating properties of alpha and beta adrenergic receptors, adrenaline is a drug widely used in the resuscitation of cardiocirculatory arrest
     • Internationals must inject 1 mg bolus, to repeat every 3 to 5 minutes
     • Atropine With parasympatholytic properties, it is used in case of asystole or significant Bradycardia related to atrioventricular conduction disorders.
       • The recommended dose is 1 mg to be renewed if necessary every 5 minutes
     • Lidocaine is used in cases of recurrent ventricular fibrillation or in case of failure of defibrillation. During acute myocardial infarction, decreases The incidence of ventricular fibrillation but does not improve mortality
       • The recommended dose is 1 mg / kg in unit injection using a 2% solution that can be repeated at a dose of 0.5 mg / kg every 10 minutes without exceeding 3 mg / kg in total or 200 to 300 mg hour.
     • Amiodarone is indicated for tachycardia or ventricular fibrillation. ventricular refractory to defibrillation
       • Your dose is 150 mg in 10 minutes (possibly renewable) followed by an infusion of 1 mg / min for 6 hours followed by an infusion of 0.5
     • Calcium Chloride is currently indicated only in hypercalcemia, hypocalcemia and poisoning with calcium channel blockers. The recommended dose is 1 mg (10 ml) in slow injection.