Tachycardia tsuas yog txhais tau tias lub plawv dhia ceev dua li ib txwm. Nrog cov ntshav tawm ntawm lub plawv, uas yog lub siab lub plawv dhia ceev ceev, qhov ntsuas mob siab yog nyob nruab nrab ntawm 60 txog 100 tus neeg ntaus ib feeb. Thaum tus nqi siab tshaj 100 tus neeg tauj ib feeb, tachycardia tuaj tam sim no.

Thaum kho tachycardia, nws yog ib qho tseem ceeb ua ntej xav txog a kev tsim txom cov laj thawjCov. Lub cev nyhav siv ntau lub plawv dhia nrawm raws li lub tswv yim them rov qab ntau thaum nws hnov ​​qhov tsis zoo.

Ob qhov zoo tshaj plaws dysrhythmics hauv EMT thiab paramediclub thawv ntsuas khoom siv yog OXYGEN thiab NORMAL SALINECov. Ob qho ntawm cov kev kho mob no yuav tsum tau sim ua ntej siv lwm yam tshuaj noj. Nws tsis yog qhov zoo uas yuav tau tshem tawm txoj kev kho mob tachycardia hauv tus neeg mob uas xav tau nws los ua kom zoo. Kev pom qhov ua rau ua rau muaj qis qis zoo dua yuav yog qhov zoo tshaj.

Lwm qhov yuav tau xav txog yog tus neeg mob hemodynamic ruaj ntseg. Nrog cov tachycardic rhythms hauv cov neeg mob tsis ruaj khov, synchronized cardioversion yog qhia. Muaj qhov zoo li kev txaus ntshai ntawm cov neeg muab kev pabcuam ua ntej thaum nws los txog shocking neeg.

cov paramedic zoo li ntau muab ntau tau siv tshuaj tiv thaiv / ua tsis siv tshuaj / dysrhythmic tshaj li lawv ua ua cardioversion. Qhov no yog qhov tseeb hauv kev xav rov qab. Xav txog Kelly Grayson cov kev xav txog ntawm cov tshuaj tsis ua hauj lwm - lawv tau xaiv cardiotoxins. Xub thawj, lawv tsis muaj nyob rau hauv lub cev. Thib ob, lawv metabolize rau lub sijhawm thiab qhov tshuaj tiv thaiv tuaj yeem tsis paub txog. Thirdly, lawv tau siv los tawm tsam cellular depolarization.

Koj puas paub tias ua li cas thaum tsis muaj cellular depolarization hauv myocardium? Asystole - tsis yog cov kev mob tshwm sim, tab sis nws lub tsev coj tus taw tes tsis yog nws? Lwm qhov kev cuam tshuam, zoo li cov qib high-qib atrioventricular, thiab QT syndrome ntev kuj tseem yuav tshwm sim.

Hloov siab, synchronized cardioversion tsis muaj ze li ntau qhov tsis xav. Nws ua haujlwm sai, thiab ploj mus. Cov tshuaj uas koj yuav tsum tau xav txog, yog qee yam ntawm sedative lossis benzodiazapine ua ntej cardioversion.

Tom ntej no, tom qab txiav txim siab ntawm tus neeg mob hemodynamic ruaj ntseg, qhov dav ntawm QRS yuav tsum tau txiav txim siab. Yog tias tus neeg mob ruaj khov, thiab lawv tau nyob hauv a txhawb nqa tachycardia, tshuaj mob plab tsis tuaj yeem txiav txim siab.

Nws yog ib qho tseem ceeb los txiav txim siab qhov dav ntawm QRS, vim hais tias cov tshuaj zoo li Cardizem (diltiazem), lossis Adenocard (adenosine) uas yuav raug tswj hwm kom nqaim ua rau muaj kev cuam tshuam, muaj peev xwm tua tau cov neeg uas muaj QRS rhythms zoo.

Daim ntawv ceeb toom tias tsis muaj 'ventricular tachycardia' algorithm? Nws hais tias 'Dav QRS', thiab teev npe 'tsis meej txog kev sib dhos' hauv qab no. Nov yog lub tswvyim tseem ceeb. Yog tias nws dav, thiab koj tsis paub tseeb ntawm lub hauv paus chiv keeb, nws yog cov hlab ntses qis dua kom txog thaum xaus.

Lwm qhov laj thawj uas nws yog a WCT cov lus qhia thiab tsis a cov lus qhia ntawm cov cuab yeej yau yog vim muaj cov xwm txheej zoo li WPW (wolff parkinson white syndrome). Nrog WPW, delta yoj tuaj yeem tam sim no ua rau muaj qhov dav dav QRS.

Qhov no yog qhov tseem ceeb vim tias adenosine, thiab Cardizem yuav tsum tsis txhob muab rau cov neeg mob nrog WPW. Muaj kev sib cav txog seb Amiodarone puas muaj kev ruaj ntseg nrog WPW, tab sis tam sim no lub koom haum American Heart Association xav tias nws yog qhov kev xaiv nyab xeeb.

Cov ntsiab lus kom nco ntsoov:

• O2 & kua dej rau kev tiv thaiv tachycardia
•  Synchronized cardioversion yog qhov kev xaiv SAFER
• Yog tias QRS muaj kev kho dav dav li V-tach