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The new Imelda rea - concept for Out of Hospital Cardiac arrest

The new Imelda rea - concept for Out of Hospital Cardiac arrest. Marc Gillis , Carsten Steinkamm , Anouck Keirens , Jim Verbelen , Werner Muysoms Dienst Urgentiegeneeskunde Imelda Bonheiden. 1. Inleiding. Prognose na OHCA 25% bereikt het ziekenhuis

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The new Imelda rea - concept for Out of Hospital Cardiac arrest

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  1. The newImeldarea-conceptfor Out of HospitalCardiac arrest Marc Gillis, CarstenSteinkamm, AnouckKeirens, Jim Verbelen, Werner Muysoms Dienst Urgentiegeneeskunde Imelda Bonheiden

  2. 1. Inleiding • Prognose na OHCA • 25% bereikt het ziekenhuis • 7% verlaat het ZH in goede conditie • Eigen studie: LUCAS-BOUSSIGNAC bij 78 ptn; • Betere outcome • Reden • Falen initiële resuscitatie • Hypoxische cerebrale schade bij post-resus.ptn 3.3.13

  3. 3.3.13

  4. BASISREANIMATIE + AED 3.3.13

  5. 3.3.13

  6. The new I OHCA concept • EMCC (LUCAS 2) • C I oxygen (Boussignac tube) • EZ IO (Intra Osseuze toegangsweg) • I H (InducedHypothermia) • Capnografie • Medicatie (préfilledsyringes) • DONOR ? 3.3.13

  7. 1. LUCAS2 EMCC 3.3.13

  8. 2. ContinuousInsufflation of oxygen 3.3.13

  9. 3.Intra-Osseuse toegangsweg 3.3.13

  10. 4. Geïnduceerde hypothermie • Therapeutische hypothermie tijdens CPR met gebruik van “large-volume, ice-cold “ intraveneus vocht. • NaCl0.9% (4°C) • 40 ml/kg zo snel mogelijk laten inlopen • Therapeutische hypothermie rond 33°C na 25-30’. • Geen iatrogeen longoedeem 3.3.13

  11. 5. Capnografie 3.3.13

  12. 6. Medicatie • Adrenaline max 5mg…. • Cordarone 2 x 150 mg + 150 mg • Magnesiumsulfaat 2 – 4 g • …. In préfilledsyringes 3.3.13

  13. 7. DONOR ? 3.3.13

  14. 3.3.13

  15. referenties • Rapidnon-invasiveexternalcooling to induce mild therapeutichypothermia in adulthuman-sizedswine. K. Bayegan et al. ,Resuscitation (2008) 76,291-298 2. ERC guidelinesforresuscitation. JP Nolan et al.,Resuscitation 2005;67:539-86 3. Treatment of comatosesurvivors of out-of-hospitalcardiac arrest withinducedhypothermia; The hypothermiaafterCardiac Arrest StudyGroup.NEngl J Med 2002;346:549-56 4.Systematic review of earlyprediction of pooroutcome in anoxic-ischaemic coma. Zandbergen et al.,Lancet 1998 5;352(9143):1808-12 3.3.13

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