【精品】PPT课件 AHA Evidence Based Guidelines.ppt

AHA Evidence Based Guidelines
How to proceed with scant evidence
Levels of Evidence 1
Levels of mendation
AHA Guidelines
Cocaine-Induced Ventricular Dysrhythmias
mended Therapies, Ordered By Preference:
Sodium Bicarbonate (IIB), Lidocaine (IIB), Alpha Adrenergic Blockers (IIB)
Inappropriate Therapies:
Non-Selective Beta Blockers, Epinephrine (Both III)
Cocaine-Induced Acute Coronary Syndrome (ACS)
mended Therapies, Ordered by Preference:
Benzodiazepines (IIB), Nitrates (IIB), Alpha-Adrenergic Antagonists (IIB)
Inappropriate Therapies:
Non-Selective Beta-Blockers (III)
AHA Guidelines
Calcium Channel Blocker Poisoning or Overdose
mended Therapies, Ordered By Preference:
Pacemaker, Vasopressors, High-Dose If Necessary(IIB), Calcium (IIB)
Beta-Blocker Poisoning or Overdose
mended Therapies, Ordered By Preference:
Pacemaker, Vasopressors, High-Dose If Necessary (IIB), Glucagon (IIB)
AHA Guidelines
Tricyclic Antidepressant Poisonings
mended Therapies, Ordered By Preference:
Sodium Bicarbonate (IIB), Lidocaine
Inappropriate Therapies:
Procainamide (III)
Refractory Drug-Induced Shock
High-Dose Vasopressors (IIB), Circulatory Assist Devices (IIB), Vasopressin (Indeterminate)
Opiate Poisoning: Ventilation before Naloxone?
Dr Andrew Dawson
Director Hunter Area Toxicology Service
Newcastle, Australia
Opiate Poisoning: Ventilation before Naloxone?
“Evidence supports the correction of respiratory failure with bag valve mask techniques followed by administration of naloxone in any patient suspected of opioid induced respiratory failure.”
Are all clinical situations the same?
24 year male recreational heroin OD
75 year male IHD post operative narcosis
24 year old post heroin OD respiratory arrest being ventilated
Naloxone & Ventilation Grid