º»¹®/³»¿ë
_SLIDE_1_
½É¸Æ°ü°è complete AV block
<¾à¸®>
_SLIDE_2_
¸ñÂ÷
´ë»óÀÚ Á¤º¸
º´Å»ý¸® ? ¿ÏÀü¹æ½ÇÂ÷´Ü
¾à¹° Åõ¿©±â·Ï
¾à¹°
Heparin (Ç×ÀÀ°íÁ¦)
Lasix (Ç×°íÇ÷¾ÐÁ¦)
Amaryl (´ç´¢º´¿ëÁ¦)
Tylenol (ÇØ¿ ÁøÅëÁ¦)
_SLIDE_3_
¥°. ´ë»óÀÚ Á¤º¸- °³ÀηÂ
³ªÀÌ: 61¼¼
¼ºº°: ¿©ÀÚ
°áÈ¥»óÅÂ: ±âÈ¥
ÀÔ¿øÀÏ: 2xxx- xxxxxx- 2
Ű: 159.8cm
üÁß: 63kg
Áø´Ü¸í: complete AV block
R/O(ÃßÁ¤ Áø´Ü)
- cardiomyopathy ½É±ÙÁõ
- myocardial ischemia ½É±Ù ÇãÇ÷
_SLIDE_xxxxxx_
´ë»óÀÚ Á¤º¸- °Ç°·Â
(1)Çöº´·Â
ÀÔ¿ø½Ã V/S
Ç÷¾Ð
119/xxxxxx6 mmHg
Á¤»ó¹üÀ§ 120/80 mmHg
¸Æ¹Ú
36 ȸ/ºÐ
Á¤»ó¹üÀ§ 60-100 ȸ/ºÐ
È£Èí
16 ȸ/ºÐ
Á¤»ó¹üÀ§ 15-20 ȸ/ºÐ
ü¿Â
36.8 ¡É
Á¤»ó¹üÀ§ 35.9¡É~37.xxxxxx¡É
_SLIDE_5_
´ë»óÀÚ Á¤º¸- °Ç°·Â
(2)°ú°Å·Â
´ç´¢º´
(3)°¡Á··Â
¾î¡¦(»ý·«)
¥± .¹æ½Ç Â÷´Ü(atrio-ventricular block, AVB)
¥². ¾à¹°Åõ¿©±â·Ï
¥³. ¾à¹°
1)Antithrombin ¥² ¿Í °áÇÕÇÏ¿© throimbinÀÇ ÀÛ¿ëÀ» ¾ïÁ¦ÇÑ´Ù
2)»õ·Î¿î clot Çü¼ºÀ» ¾ïÁ¦
ÀϽÃ
Áø¼ú¹®
¼Ó¼º/»ó¼¼³»¿ª
2-xxxx-02 00:xxxxxx0
Temporary pace maker keep state (¿À¸¥ÂÊ femoral)
Mode: VVI, rate: 60ȸ/ ºÐ
-> Temporary pace maker »ðÀÔÀ¸·Î ÀÎÇÑ
Ç÷¾×ÀÀ°í (Ç÷ÀüÁõ)¸¦ ¹æÁö
°£È£±â·Ï
½Ç½ÃÀϽÃ
Áø¼ú¹®
¼Ó¼º/»ó¼¼³»¿ª
2-xxxx-03 15:00
½ÉÀüµµ ¸ð´ÏÅÍ ÁßÀÓ
Pacing c Self rhythm
2-xxxx-03 15:00
»ðÀÔ°ü ¹× ºÎÂø¹° ÀÖÀ½
Àß °íÁ¤µÇ¾î ÀÖÀ½
2-xxxx-03 15:00
¼ö¾× ÁÖÀÔÁßÀÓ
Heparin xxxxxx1cc/hr,
NS xxxxxx0cc/hr
_SLIDE_16_
¾à¹° °£È£ - Heparin
*aPTT: Ȱ¼ºÈ ºÎºÐ Æ®·Òº¸ÇÃ¶ó½ºÆ¾ ½Ã°£
È¿´É, È¿°ú
Ç÷ÀüÁõÀÇ ÀÀ°í ¿¹¹æ
¼ö¼ú ÈÄ Ç÷ÀüÁõ ¹× Æó»öÀüÁõÀÇ ¿¹¹æ ¹× Ä¡·á
³úÀÏÇ÷·Î ÀÎÇÑ ³úÇ÷ÀüÁõÀÇ ¿¹¹æ
°ü»óµ¿¸Æ, Æó»öÁõ, ¸»ÃÊÇ÷°ü »öÀüÁõ
ÁÖÀÇ»çÇ×
ÃâÇ÷ȯÀÚ, ¿ù°æ±â°£ Áß, ¼ö¼ú½Ã, ÃâÇ÷°¡´É¼º ÀÖ´Â ÀÚ
¸ÛÀ̳ª ÃâÇ÷ÀÌ ½±°Ô »ý±æ ¼ö ÀÖÀ½
¾à¹°°£È£
°³ºÀ Àü £Àº °¥»ö Àü¿ë¿ë±â¿¡ º¸°ü, °³ºÀ ÈÄ ³ÃÀ庸°ü (ÀÏÁÖÀÏ À¯È¿)
óÀ½ Åõ¾à Àü Ȱ·Â¡ÈÄ ÃøÁ¤
aPTT·Î monitoring : controlÀÇ 1.5~2¹è À¯Áö
? ¸ÅÀÏ aPTT Ä¡¿¡ µû¶ó Åõ¿©¿ë·® °áÁ¤
ÃâÇ÷¿©ºÎ °üÂû
_SLIDE_17_
2. Ç×°íÇ÷¾ÐÁ¦ (ÀÌ´¢Á¦) - Lasix
_SLIDE_18_
¾à¸® ±âÀü - Lasix
_SLIDE_19_
¾à¸® ±âÀü - Lasix
*Loop acting diuretics
Çî·¹°í¸®¿¡¼ÀÇ Na+/K+/2Cl- °øµ¿¼ö¼ÛÀ» ¾ïÁ¦ÇÏ¿© ÀçÈí¼ö¸¦ °¨¼Ò½ÃÅ´
_SLIDE_20_
Åõ¾à ÀÌÀ¯ - Lasix
°£È£±â·Ï
½Ç½ÃÀϽÃ
Áø¼ú¹®
¼Ó¼º/ »ó¼¼³»¿ª
2-xxxx-03 21:55
½Ã°£´ç ¼Òº¯·® °¨¼ÒÇÔ
50cc
2-xxxx-03 21:55
¼·Ãë·®/¹è¼³·® ÃøÁ¤ÇÔ
I/O : + 220
2-xxxx-03 23:xxxxxx1
ABGA°á°ú & I/O & ½Ã°£´ç ¼Òº¯·®
-> ÀÇ»ç Áø¿ì¶÷¿¡