Semantic module 3. General anesthesiology and reanimation Practical employment # 13

Theme: reanimation measures for surgical patients.

I. Actuality of theme.

A reanimation and intensive therapy is basic sections of clinical reanimatology. Decision-making about a necessity reanimation, and also implementation of its methods is carried out in the conditions of extreme deficit of time, it must diagnose during seconds and immediately to proceed to the grant of reanimation help.

Taking into account this of principle circumstance, the domain of urgent diagnostics and proceeding in the faded essential functions of organism methods is obligatory for the doctors of all specialities. The terminal states must be exactly diagnosed, so as knowledges of pathogeny of different processes determine tasks and character of reanimation measures. More frequent the fate of man is decided by an interval in 10-15 minutes from the moment of catastrophe. The grant of help in this period will allow to save life many victims with the external or internal acute massive bleeding, poisoning, sinking, by a trauma, after a blow by an electric current or lightning and others like that

II. Purpose of the lesson:

1. To know classification of the terminal states (=II).

2. To know the clinical displays of preagony, agony, different types of death (=II).

3. To know principles of treatment of the terminal states (=II).

4. Method of artificial ventilation of lungs (=III).

5. Method of indirect massage of heart (=III).

III. Providing of initial level of knowledge-abilities

Literature:

1. Butursky A. “General surgery”. (Simferopol 2004)

2. S. I. Shevchenko; A. A. Tolkoglas and etc. “Surgery” (Kharkov 2004)

3. Methodological Instruction.

Tests and tasks for verification of initial level of knowledge

1.Method of reanimation at acute asphyxia?omy

1 oxygen therapy

2 indirect massage of heart

3+artificial ventilation of lungs by a method «mouth to mouth»

4+artificial ventilation of lungs by a method «mouth to nose»

5 conico or tracheotomy

6 thoracotomy

2.What symptoms can we find during the asystole ?

1 bradicardia

2 tachycardia

3 convulsive, unrhythmical breathing

4+cardiac activity is absents

5 violation of exchange processes

6+absence of pulse

3.Leadthrough of defibrillation is necessary at:

1+ acute stop of heart

2 bradicardia below 40 in 1 minute

3 fibrillation of atrium

4+fibrilation of ventricles

5 preagonal state

4.During the leadthrough of indirect massage of heart it is necessary to place in the grown man a palm:

1+on verge of middle and lower third of breastbone

2 in fifth intercostal space

3 on overhead third of breastbone

4 in fourth intercostal space

5 in the area of handle of breastbone

6+in the underbody of breastbone

5.Symptoms of efficiency of indirect massage of heart:

1 appearance of tendon reflexes

2 expansion of pupils

3+narrowing of pupils

4 absence of pulse is on carotids

5+appearance of pulse

6 cyanosys of skin covers

6.The final diagnosis of stop of heart set on the basis of?

1 absence of consciousness

2+absence of pulse on carotids

3 wide pupils

4+EKG

5 diffusive hypoxia

7.What is the correlation between artificial ventilation and indirect massage of heart during the leadthrough of reanimation?

1+1:5

2+2:15

3 1:7

4 1:3

5 1:2

8.The indirect massage of heart is conducted with force :

1+approaching of breastbone to the spine on 5 sm

2 approaching of breastbone to the spine on 2 sm

3 approaching of breastbone to the spine on 1 sm

4 approaching of breastbone to the spine on 10 sm

5+approaching of breastbone to the spine on 7 sm