Pulseless Electrical Activity & EMD

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步驟 1:
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步驟 2:
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Secondary ABCD。
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強調 C 部份須要排除 pseudo-EMD
(可利用 doppler,若有心跳應積極治療) 。
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步驟 3:
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排除常見之病因: 5H 5T (Hypovolemia,Hypoxia,Hydrogen
(acidosis),Hyper/hypokalemia,Hypothermia; "Tablets" (OD),Tamponade,Tension
Pneumothorax,Thrombosis of coronary, Thrombosis of pulmonary)。
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Consider fluid challenge empirically。
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Consider bicardbobate: prolonged arrest (Class 2b), high K (Class 1), bicarbonate
responsive acidosis (2a), tricyclic OD (2a), to alkinalize urine for aspirin
OD (2a);not for hypercarbic acidosis。
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Wide QRS: massive myocardium damage, high K, hypoxia,hypothermia;
Wide QRS+Slow: consider OD of tricyclic, betablocker, Ca-blocker,Digoxin。
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Narrow complex: suggest intact heart, DDx: hypovolemia,infection,PE,tamponade。
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步驟 4:
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Epinephrine 1 mg q3-5 min iv。
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步驟 5:
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If HR slow, Atropine 1 mg iv q3-5 min up to 0.04mg/kg (such as 3mg)。
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流程圖。