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Urgent measures in AMI
1. An immediate start of monitoring of cardiac rhythm to reveal life threatening arrhythmias. 2. 02 inhalation through nasal catheters. 3. Transcutaneous puncture and catheterization of veins. 4. Nitroglycerin sublingually (in absence of hypotonia and pronounced brady- or tachycardia). 5. The intake of the first dose of aspirin as soon as possible. To transport patients with high risk to medical institutions where there is a possibility to perform immediately coronaroangiography and myocardial revascularization. 6. Anesthesia: the drug of choice is morphine intravenously 1% solution 1 ml. The administration of morphine hydrochloride is permissible only in intense pain not controlled with non-narcotic analgetics. This is conditioned by side effects of the preparation: aggravation of functional state of the myocardium and peripheral resistance, respiratory depression with elevation of PC02 and decrease of blood pH, excitation of vomiting center and further aggravation of bradycardia, quite often accompanying AMI. Arising, here, hypotonia and bradycardia may be eliminated by infusion of dofamin and atropine, respiratory depression — with naloxon. In case of insufficient effectiveness of opiates /^-blockers and (or) nitrates are used. In order to diminish anxiety some tranquilizers are prescribed. In cardiac arrest a standard complex of CPCR is applied. Дата добавления: 2015-02-05 | Просмотры: 600 | Нарушение авторских прав |