1. 2006 CPR?????(???) ??????????? ????? ??????????? ?????

2. 2006 CPR?????(???) ???? ?? (drowning) ???? (hypothermia) ??????????(lightning & electric injury) ????? (heat-related illness) ??? (high-altitude syndrome)

3. 2006 CPR?????(???) ????(drowning)????? 2005 AHA-Circulation guidelines ??????? (class I). ??????- Drowning ????near-drowning (immersion submersion syndrome?) ????????(rescue breathing). ?????????????? (????????)! ????????

4. 2006 CPR?????(???) ???: ?????????,??????,???????,????,?????,??????????? ?

5. 2006 CPR?????(???) ????(1): water rescue ??????? ? ?????????? ? ??????????????? ?????????(hypothermia)?? ?????? (secondary drowning)? ????????????? (2005???)

6. 2006 CPR?????(???) ????(2): ????????????8-12?? ???????: 1. ??(???????????) 2. ??????(???????) 3. ?????? 4. ??(????)???????(????)

7. 2006 CPR?????(???) ??(drowning) ????????????: ????(??) ????(??????????????). ??????(???).

8. 2006 CPR?????(???) ??(drowning) ???(??)?? (secondary drowning): - ???3-4?????????????,??????? - ????????12??,??72??? - ???????(??????????)? - ???????????????(??????)?

9. 2006 CPR?????(???) ???: ????????????(???)????,????????,????????

10. 2006 CPR?????(???) ????(1)-?????? ?????,???????BLS (CPR)? ??call 119 (?????) ???????? ???????? ??????(????)? ??(??????)

11. 2006 CPR?????(???) ????(2)-?????? ??????????!(?????????)(???????????) ????????????? ???????(?????) ????? ?????

12. 2006 CPR?????(???) ??????? ???

13. 2006 CPR?????(???) ???? ????:??????????? ????? (?????) ????????? (?????) ?? ??????(????/???????) ????????? ?????????????!

14. 2006 CPR?????(???) ?????????? ?????????? ?????? ?????(?????-??????)?

15. 2006 CPR?????(???) ???: ??40???,????,??????,??????????,??????? ?

16. 2006 CPR?????(???) ?? ??????????: ???????? : ????, ??? ?????: ??, ????, ?? ??????: ??, ??, ????? ?????: ??, ???????

17. 2006 CPR?????(???) ????(1)-?????? * ?????? (first aid): ?????????? ?????????(*early CPR!) ????????????????? ??????? -> ????? ????????

18. 2006 CPR?????(???) ????(2)- ?????? ???????,?????????????(??????????) ????????????(??????????)(???????? 5ml/kg) ?????????? ?

19. 2006 CPR?????(???) ??: water rescue ?????????(??????) ????(????) ?????(????) ?????(??) ??,??,???,??,???????????

20. 2006 CPR?????(???)

21. 2006 CPR?????(???) ???: ????????,?????,?????????????????,????????? ?

22. 2006 CPR?????(???) ????(hypothermia) ?????? ??????? ???????? ??????????? ??????????????

23. 2006 CPR?????(???) ????(hypothermia) ??????????????????35??? ( Core Temp. < 35 °C) ???????: - ????? : 34-35 °C - ????? : 30-34 °C - ????? : < 30 °C

24. 2006 CPR?????(???) ????(hypothermia) ???? ?????? ??????? ????:??????????? ( ex. Barbiturate) ????(???) ???????????????????????????????

25. 2006 CPR?????(???)

26. 2006 CPR?????(???) ????(hypothermia) ?????????: ????????????; ??????? ?32 ?? ??????????????? ?????????? ????????????->????

27. 2006 CPR?????(???) *?????????? (34°C ~ 35°C) ?????? ?? ?????? ?????? ????(hypothermia)

28. 2006 CPR?????(???) ????(hypothermia) *?????????? (30°C ~ 34°C) ?????? ???? ????(????????????) ???? ????????? ????????

29. 2006 CPR?????(???) ????(hypothermia) *?????????? (< 30°C) : ???? ??????????,?????? ???????? ????????? ???????????

30. 2006 CPR?????(???) ????(hypothermia) BLS???(2005) ???????: ?????(??????????…?)? ???????: ????: ????rescue breathing ?????????: 30-45? (???????) ?????: ??????? ??AED ??: ????????(VF)-One shock only!

31. 2006 CPR?????(???) ????(????????) * ?????????: 30-35oc:???????????????? < 30oc:??????? ??????? 43oc ????, 42-46oc ????, ??????, ????, ?????, ?????? ?????????????>30oc, ???????, ?????

32. 2006 CPR?????(???)

33. 2006 CPR?????(???) ???: ???????,??????,??????????????????????????,??????????

34. 2006 CPR?????(???) ????(lightning injury) ??”????”(reverse triage)? ???????????,??????

35. 2006 CPR?????(???) ????(lightning injury) ????????? ?30%????? ????????????? ???????????? ?????????(??????? ???????)?

36. 2006 CPR?????(???) ????(lightning injury) Myths & mistreatment ?????? ????????????? ??????????? ?????????????????????

37. 2006 CPR?????(???) ????(lightning injury)

38. 2006 CPR?????(???) ????(lightning injury)

39. 2006 CPR?????(???) ????(lightning injury) ????????: ????????????? ??????????? ????????????? (electroconvulsive psychiatric disorders)

40. 2006 CPR?????(???) ???? ?????,????????????,???????,??????

41. 2006 CPR?????(???) ???(electric injury) ???? ????? 0.5?/10??? ????l(bimodal): ??????? ?? 90%???????????? ????????????(<1000??) ??: 80%?????????????

42. 2006 CPR?????(???) ???(electric injury) ??????????? ???? ??????????? ???? ?????(?????) ?? ????????

43. 2006 CPR?????(???) ???(electric injury) ??????? <1 mA ????? 5 -30 mA ???????,?????? 40-50 mA ???? >100 mA ??????(VF) >10 A ??????

44. 2006 CPR?????(???) ???(electric injury) ???(electric burn) ???????????????? ?????????? ????????? ??????? ???, ?????, ????????

45. 2006 CPR?????(???) ???(electric injury) ?????(Secondary injuries) ??????????? ???? ?????? ????

46. 2006 CPR?????(???) ???(electric injury)????: ???? ????????????? ????????????? ?????50~100CC/?? ????Mannitol 25 g, ????????12.5 g ?? 6 ?? ???(debridement) * ????30???????,??????

47. 2006 CPR?????(???) Supplemental Data

48. 2006 CPR?????(???) ??????? ??? ??? ???

49. 2006 CPR?????(???) ????

50. 2006 CPR?????(???) ????????? ????? ????? ?? ?? ?? ??

51. 2006 CPR?????(???)

52. 2006 CPR?????(???)

53. 2006 CPR?????(???) ??? ????? ??????(????????????) ?????(???? > 40.5?)(?????) ?????

54. 2006 CPR?????(???) ??? ??????? ??:??????????????(????????) ????? ????????? ?????? ???????????????

55. 2006 CPR?????(???) ???????????

56. 2006 CPR?????(???) ???? 21????????????,???????????????????????,??????????

57. 2006 CPR?????(???) ????????? ??????? ? ????????? Thyroid hormone ? haloperidol amphetamine cocaine Tricyclic antidepressants Lysergic acid diethylamine (LSD) ??????? Antihistamines Anticholinergics Phenothiazines Benztropine mesylate

58. 2006 CPR?????(???) ?? ????,???????(ABC) ???(5-10 L/min)??? ???? - ????????????

59. 2006 CPR?????(???) ???? 22?????,????????????,?????????????????

60. 2006 CPR?????(???) ?????????????

61. 2006 CPR?????(???)

62. 2006 CPR?????(???) ??? ?????????????????? ???? ??????????????????? ?????????????????? ???????????

63. 2006 CPR?????(???) ??? ???? ????,??????????? ?????,?????,????? ??(cool down),??????????????????

64. 2006 CPR?????(???) ??????

65. 2006 CPR?????(???) ??? ??????????,???????????,???????????? ?? ???????? ????? ??????

66. 2006 CPR?????(???)

67. 2006 CPR?????(???) ???(heat edema) ??????????????,??????????????????????,?????????????? ???(heat syncope) ?????????,????????????????????????????????????????????????? ?????(?)?????

68. 2006 CPR?????(???) ??:????

69. 2006 CPR?????(???) ????(Caisson disease) ???(decompression sickness):???????????????????? ???????????: ???????: ???(???)??? ???????: ???????????? ????(??????? ???????)?

70. 2006 CPR?????(???) ????(Caisson disease) Gas principles Boyle’s law Henry’s law ~ pressure differential between the environments of air and water ~

71. 2006 CPR?????(???) ??????(1): ????(air embolism): ??????????????? ????: ???????????????????,??????????,?????????????? ??:??????????(30??)?????(HBO)

72. 2006 CPR?????(???) ????(Caisson disease) *????(HBO) re-compression HBO (hyperbaric oxygen therapy) - 60 ft depth underwater pressure - “on and off gassing”, 100% O2 by 5-min breaks

73. 2006 CPR?????(???) ????????????

74. 2006 CPR?????(???) ??????(2): ??(barotrauma): ?????????????????????-??????????????? 100%?? ??????

75. 2006 CPR?????(???) ????-?????? ?????? ????? ???? ????

76. 2006 CPR?????(???) ????: ?????????????,????;???????????

77. 2006 CPR?????(???) ??????(???)????

78. 2006 CPR?????(???) ???

79. 2006 CPR?????(???) ???(high-altitude syndrome) “going too high, too quickly“ (???????) hypobaric hypoxia(?????????) ?????????? ??????(???????) ??????(???????) ????????? ??????? ? 2,3-DPG (O2-Hb dissociation curve shift to right)

80. 2006 CPR?????(???) 154?????????????????

81. 2006 CPR?????(???) ???(high-altitude syndrome) ????? (AMS) ?? – ?????? ???????????(????) ??????,????24??? ????? ??: ?? ????,??,??,?????

82. 2006 CPR?????(???) ???(high-altitude syndrome) ????? (HAPE) ?????????????????? > 8000 feet (2500m), ????, ????2-4? ??“???????”(ARDS) ??: (??????????) ?? ? ????? ????? ? ????? ???? ? ???? ?????? ? ??????

83. 2006 CPR?????(???) High-altitude pulmonary edema(HAPE)

84. 2006 CPR?????(???)

85. 2006 CPR?????(???) ???(high-altitude syndrome) ????? (HACE) ???(cytotoxic or vasogenic edema) 12,000 ????,???? ? 1-3 ? ?? 13%???? ?? ? ??(average 15,500 feet) ???? ????(sensitive cerebellum) ????? (>20,000 ?), ???????

86. 2006 CPR?????(???) ?????-????????(MRI)

87. 2006 CPR?????(???) ???(high-altitude syndrome) ?? Early recognition – ”rapidly progression” Three strategies(???: ?????) ?????????(Descent) ?????? (O2 supply ?) ??? ?????? ???? Diamox, dexamethasone, nifedipine Ginko Biloba?

88. 2006 CPR?????(???) ???- “hyperbaric treatment”

89. 2006 CPR?????(???) Hyperbaric chamber

90. 2006 CPR?????(???) ???(high-altitude illness) ?? ????????(“staging” - gradual ascent) ??????????? ?????????????? ??????

91. 2006 CPR?????(???)

92. 2006 CPR?????(???) High Altitude Medicine Guide www.high-altitude-medicine.com www.vnh.org (virtual naval hospital) ???? ?????(????????? )-http://www.alpineclub.org.tw/read1.php?id=9ptshbbn7w5v7yWm6sc9RpjImchcDTzv