Beginning >> Reference >> Acute management >> Algorithm of stopping of fibrillation of ventricles

Algorithm of stopping of fibrillation of ventricles

Алгоритм купирования фибрилляции желудочков

* 1 B the first 10-30 with to strike precardiac blow, and then if there is no effect, in a row 3 categories of a defibrillator if they can be carried quickly out. If between categories intervals increase> 15 with owing to: a) design features of a defibrillator or b) need of confirmation that FZh proceeds, between categories carry out 2 cycles 5:1 (massage/ventilation).

* 2 At the registered ZhT of a dose of energy it is possible to reduce twice.

* 3 Adrenaline is entered in/in: 1 mg and then each 2-5 min., increasing a dose to 5 mg (to at most 0,1 mg/kg there are each 3-5 min.). At endotracheal introduction the dose is increased by 2-2,5 times and dissolve 0,9% of NaCl solution in 10 ml;

at introduction through a peripheral vein dissolve 0,9% of NaCl solution in 20 ml.

* 4 Lidocaine of 1-1,5 mg/kg each 3-5 min. to the general dose of 3 mg/kg, then it is possible to enter novokainamid on 30 mg/min. to the maximum dose 17 mg/kg (The European committee considers administration of antiarrhytmic drugs optional). For prevention of recurrence of FZh lidocaine is recommended to enter on 0,5 mg/kg to the general dose 2 mg/kg, then the supporting infusion of 2-4 mg/min. At low cordial emission, a liver failure and age 70 years of a dose of lidocaine are more senior reduce twice.

* 5 Na a hydrocarbonate are recommended to be entered after the 10th minute of reanimation or if the blood circulation stop prior to the beginning of SLR proceeded more than 3-5 min.; enter 50 mekv and then it is possible to repeat this dose in 10 min. 1-2 times. Na enter a hydrocarbonate also if to a stop of blood circulation the hyperpotassemia or a metabolic acidosis took place; after recovery of cordial activity if the stop of blood circulation was long.

* 6 Mg sulfate of 1-2 g at: a) polymorphic ZhT, b) the suspected hypomagnesiemia, c) prolonged refractory / recurrent FZh.

* 7 Potassium chloride on 10 mekv each 30 min. at an initial hypopotassemia.

* 8 Ornidum of 5 mg/kg, repeatedly in 5 min. with increase in a dose up to 10 mg/kg 2 times.

* 9 Atropine on 1 mg to 2 times if recurrence of FZh is preceded by bradycardia —> an asystolia.

* The 10th beta Adrenoblockers (anaprilin from 1 to 5 bucketed mg of 5 min.) if recurrence of FZh is preceded by tachycardia —> arrhythmia.

* 11 Drugs of calcium are used restrictedly, only according to precisely established indications — a hyperpotassemia, a hypocalcemia or intoxication antagonists of calcium.

* 12 Intravenous administration of large volume of liquid at a stop of blood circulation do not make sense without special indications.

Used dressing materials: Intensive care, Paul L. Marino.

 
"Algorithm of stopping of the anginous status   Algorithm of actions at an asystolia"