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低温的急救
原作者: Michael Bond, 肖锋译 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2013-05-02

Title: Hypothermia
题目:低温的急救
Author 作者:Michael Bond
Lidocaine is generally ineffective in preventing ventricular arrhythmias, as is cardiac pacing or atropine to increase the heart rate.
利多卡因一般在预防室性心律失常是无效的,就像心脏起搏或阿托品对心率增加没有帮助一样。
Should the patient fully arrest be prepared to perform CPR for a long time.  If your ED does not have a automatic CPR device consider calling your local fire department or ambulance service as they might have one that can be loaned to your department.
如果病人处于心脏骤停,要准备进行长时间的心肺按压。如果你科没有自动心肺复苏设备,考虑向你当地的消防队或救护车服务公司求助,因为他们可能会有一个可以租借到你科。
Warm fluids, heated blankets and heat lamps will typically increase a patients temperature about 1' C an hour.
温暖的液体,电热毯和热灯,通常会使患者温度每小时增加约1°C左右 。
Gastric lavage, peritoneal lavage and heated IV fluids can warm as much as 3' an hour.
洗胃,腹腔灌洗和加热的静脉液体可以使患者温度每小时增加约3°C左右。
To rewarm quickly as high as 18'C an hour requires cardiac bypass or thoracic lavage.
要以每小时18℃的速度复温,需要体外循环或胸腔灌洗。
Finally, remember to monitor the patient closely when you first start rewarming as this can induce cardiac arrest.  This is thought to occur as colder peripherial blood returns to the central circulation as peripherial veins and arteries dilated from the warm fluid.
最后,记得要密切监测病人,因当病人开始复温时,可诱发心脏骤停。这被认为是由于由外周静脉和动脉因温暖液体而扩张所造成的更冷的外周血返回到中央循环所致。
 

文章来源:《中华急诊医学杂志》编辑部