cơ chế tan bị tổn hại, chẳng hạn như trẻ sơ sinh và người già, béo phì, nghiện rượu, những người dùng một số loại thuốc (tức là, các phenothiazin, anticholinergics, thuốc kháng histamin, giao cảm) và trong một số hoạt động gắng sức nặng | 46 Vital Signs and Resuscitation Brađỵcaràite absolute Orađýca rdia - rale - a bpm 0 R Mirdy slow I rats less than expected relftlive Io underlying condilion or cause 3 Primary A BCD Survey Assess ABCs Secure atway noniHVElsiYEly Ensure monitori daiibriiiator IS available Secondary ABCD Survey Assess soconciary ABCs invasive a irvjav management needed 7 Oxygen-lV access-cnoniKH-fluds Vital signa pulse oximeler monitor BP Oblacn a d review 12-lead ECG Oblam arid review portable chosl x -ray Problem lecused hisipry probiem-iocused physical examination Consider causes Iditferenltftl diagnoses Fig. . Bradycardia Algorithm. Reprinted with permission from Guidelines for 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care American Heart Association. normal atrial depolarization the P-wave the EKG shows fibrillatory waves accompanied by irregular QRS-complexes. Treatment if the condition is recent 48 hours amiodarone Cordarone 150 mg IV over 10 min or ibutilide Corvert mg kg IV over 10 min is effective. If the condition is old and the rate normal because of the high risk for embolization anticoagulation is begun with coumadin target INR of or aspirin for 3 weeks depending on risk factors and age. This is followed by electrical or pharmacologic cardioversion Fig. . Premature supraventricular contractions are extra beats originating from either the atria premature atrial contractions PAC s or the AV node junctional premature beats . They occur in patients with and without heart dis Vital Sign 2 Heart Rate Pulse 47 ease. The EKG shows a premature P-wave in the first and no P-wave in the latter. Treatment usually none is required Fig. . Premature ventricular contractions PVC s are extra beats originating from a single focus unifocal or different foci multifocal in the ventricle. Many older citizens have occasional PVC s. The condition is aggravated by caffeine smoking stress and heart disease. Some cardiac drugs may cause PVC s. The .
