ʻO ke kumu ʻo Tachycardia kahi ʻoi aku ka wikiwiki o ka puʻuwai ma mua o ka maʻamau. Me ka pona sinoatrial, ʻo ia ka mea hanau i loko o ka puʻuwai, aia ka helu intrinsic ma waena o 60 a me 100 mau kani i kēlā me kēia minuke. Ke piʻi ka helu i 100 mau kuʻi i kēlā me kēia minuke, aia ka tachycardia.

Ke mālama nei i ka tachycardia, he mea nui ia e noʻonoʻo mua i kahi kumu hoʻopiʻi. ^ E Ha yM. Hoʻolā ka kino i ka hoʻohana ʻana i ka nui o ka puʻuwai naʻau e like me ka ʻoihana hoʻokoʻenehana pinepine i ka wā e ʻike ai i ka pau ʻana o ka ʻaila.

ʻO nā ʻelua maikaʻi loa kūleʻaleʻa ma ka EMT ame 'ōpiko' OXYGEN lāua ʻo NORMAL SALINE. Pono e hoʻāʻo ʻia i kēia mau ʻano ma mua o ka hoʻohana ʻana i nā lāʻau ʻē aʻe. ʻAʻole ia he pōmaikaʻi e hoʻopau i kahi tachycardia compensatory i kahi mea maʻi e pono ai e perfuse. ʻO ka loaʻa ʻana ke kumu o ka hoʻoliʻiliʻi hoʻoliʻiliʻi e maikaʻi loa.

ʻO kekahi mea e noʻonoʻo ai ke kūpaʻa hemodynamic o ka mea maʻi. Me nā rachm tachycardic i hoʻonohonoho ʻia i nā mea maʻi paʻa ʻole, hōʻike ʻia ka cardioversion synchised. Me he mea lā he makaʻu i waena o nā mea lawelawe prehospital ke hiki mai hoʻolele hauli nā kānaka.

ka 'ōpiko ʻoi aku ka maikaʻi o ka hāʻawi ʻana nā lāʻau anti-arhythmic / dysrhythmic ma mua o kā lākou hana ʻana i ka cardioversion. Ke noʻonoʻo nei i hope kēia. E noʻonoʻo i ka nānā ʻana o Kelly Grayson i nā lāʻau disrhythmic - he cardiotoxins koho lākou. ʻO ka mua, ʻaʻole i loaʻa kūlohelohe lākou i ke kino. ʻO ka lua, hoʻopili lākou i ka manawa a hiki i ka hopena ke kuhi ʻole. ʻO ke kolu, hoʻohana ʻia lākou i mea e pale aku ai i ka depolarization pūnaewele.

Oe e ʻike i ka mea e hana nei i ka haʻalele ole o ka depolarization cellular i loko o ka myocardium? Mokohena - ʻaʻole ka hopena maʻamau, akā hoʻokele ia i ka home i ka pae ʻaʻole? ʻO nā ʻōmole'ē aʻe, e like me nā papa atrioventricular kiʻekiʻe, a me ka hanana QT lōʻihi hoʻi e hele pū.

ʻO ka mea ʻē aʻe, ʻaʻohe o nā hopena i makemake ʻole ʻia e cardioversion i hoʻopili ʻia. Hana wikiwiki ia, a hele aku. ʻO ka lāʻau āu e noʻonoʻo ai, ʻo kahi ʻano sedative a benzodiazapine paha ma mua o ka cardioversion.

A laila, ma hope o ka hoʻoholo ʻana i ka hoʻokele hemodynamic maʻi, pono e noʻonoʻo pono i ka laulā o ka QRS. Inā paʻa ka hoʻomanawanui, aia lākou i kahi tachycardia paʻa, hiki ke noʻonoʻo ʻia nā lāʻau lapaʻau.

He mea nui e hoʻoholo i ka laulā o QRS, no ka mea, nā lāʻau lapaʻau e like me Cardizem (diltiazem), a me Adenocard (adenosine) i mea e lawelawe ʻia ai i nā mele puʻupuʻu paʻakikī, hiki iā ia ke hana iā KILL nā poʻe me nā moʻolelo QRS ākea.

Hoʻomaopopo ʻaʻole ʻaʻohe 'ventricular tachycardia' algorithm? Ua ʻōlelo ʻia ʻo 'Wide QRS', a papa inoa ʻia i ka 'rhythm maopopo' ma lalo. He manaʻo nui kēia. Inā ākea ia, a kānalua ʻoe i ke kumu, ʻo ia ka ventricular tachycardia a hiki i ka hōʻoiaʻana o ke kīpē.

ʻO kekahi kumu ʻē aʻe ia Kuhi WCT aʻaʻole ka ke kulekele kāriccardia aia ma muli o nā kūlana e like me WPW (wolff parkinson keʻokeʻo maʻi maʻi). Me WPW, aia paha kahi nalu delta e hiki ai ke hoʻonui i ka paʻakikī QRS.

He mea nui kēia ma muli o ka lawelawe ʻole ʻia o adenosine, a me Cardizem i nā mea maʻi me WPW. Aia kekahi hoʻopaʻapaʻa e pili ana inā palekana ʻo Amiodarone me WPW, akā i kēia manawa ua manaʻo ka American Heart Association he koho palekana ia.

Nā mea e hoʻomanaʻo:

• ʻO2 & nā wai no ka tachycardia compensatory
•  ʻO ka cardioversion pūnaeweleʻo ia ka koho SAFER
• Inā he laha nuiʻo QRS e like me V-tach