LOGO心脏电复律心脏电复律心脏电复律心脏电复律主讲人:王念主讲人:王念CompanyLogo适应症适应症2操作过程操作过程4禁忌症禁忌症335注意事注意事项项心脏电复律心脏电复律定定义义31CompanyLogo定义:定义:是在短时间内向心脏通以高压强电流,使心肌瞬间同时除极,消除异位性快速心律失常,使之转复为窦性心律的方法最早用于消除心室颤动,故亦称为心脏电除颤心脏电复律心脏电复律CompanyLogo心脏电复律心脏电复律适适应应症症绝对适应症:心室颤动、心房扑动(非同步)相对适应症:1.心房颤动和扑动(同步)2.阵发性室上速、室速、预激综合征伴快速心律失常者(同步)CompanyLogo心脏电复律心脏电复律禁禁忌忌症症心脏明显增大及心房内有新鲜血栓;近心脏明显增大及心房内有新鲜血栓;近33个月个月有栓塞史有栓塞史伴高度或完全房室传导阻滞的心房颤动或扑动伴高度或完全房室传导阻滞的心房颤动或扑动伴病态窦房结综合征的异位性快速心律失常伴病态窦房结综合征的异位性快速心律失常有洋地黄中毒、低血钾时,暂不宜电复律有洋地黄中毒、低血钾时,暂不宜电复律CompanyLogo心脏电复律的分类心脏电复律的分类非同步直流电复律同步直流电复律适应症心室颤动心室扑动除心室颤动以外的快速型心律失常特点1.病情紧急,意识丧失,立即除颤2.无心动周期,无QRS波3.争分夺秒1.一般为择期,可做好准备2.电流与R波同步房颤、室上速:100~150J房扑:50~100J室速:100~200J选择能量200~360JCompanyLogoCompanyLogo物品准备物品准备除颤仪、导电糊、生理盐水、无菌纱布、氧气地西泮抢救设备及药品CompanyLogo复律中配合平卧于绝缘的硬板床,松开衣领,取下义齿,建立静脉通道,给予氧气吸入清洁电击处皮肤,链接心电导联遵医嘱静脉推注地西泮0.3~0.5mg/kg,严密观察呼吸CompanyLogo复律中配合连接电源,打开开关,选择“同步”或“非同步”按钮能量选择电极板均匀抹导电糊电极板位置CompanyLogo电极板位置心尖部心尖部::左腋前线内第左腋前线内第55肋间肋间心底部心底部::胸骨右缘第胸骨右缘第2~32~3肋间肋间CompanyLogo复律中配合充电放电记录CompanyLogo复律后注意事项CompanyLogoDiagramThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.TitleAddyourtextThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.CompanyLogoCycleDiagramTextTextTextTextTextCyclenameAddYourTextCompanyLogoDiagramTextTextTextAddYourTitleText•Text1•Text2•Text3•Text4•Text5AddYourTitleText•Text1•Text2•Text3•Text4•Text5TextTextCompanyLogoDiagramConceptAddYourTextTextTextTextTextTextTextCompanyLogoDiagramAddYourTextAddYourTextAddYourTextAddYourTextAddYourTextAddYourTextAddYourTextAddYourTextCompanyLogoThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.DiagramTextTextTextCompanyLogoTableConceptConceptConceptConceptconceptconceptConceptConceptCompanyLogoDiagramTitleAddYourTextAddYourTextAddYourTextAddYourTextAddYourTextAddYourTextCompanyLogoDiagram1ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.2ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.3ThemeGalleryisaDesignDigitalContent&leOOOOOTitleOOOOOTitleOOOOOTitleOOOOOTitleOXOXOCompanyLogoText1Text2Text3Text4Text53-DPieChartCompanyLogoDiagramAddYourTitleAddYourTextAddYourTextAddYourTextAddYourTextAddYourTextLOGOAddyourcompanyslogan