응급 의료 대응: 환자 소생술 절차 및 프로토콜

### 응급 의료 대응: 중환자 치료 시나리오
* 🚑 의료진은 환자의 호흡곤란을 발견하고 즉시 **심폐소생술을 시작**하여 환자의 상태를 빠르게 평가하고 안정화시켰습니다.
* 💉 의료진은 환자의 맥박과 혈압을 포함한 활력 징후를 계속 모니터링하면서 **아미오다론 300mg**을 포함한 약물을 투여했습니다.
* 📊 몇 차례의 심폐소생술과 약물 치료 후 **환자의 심박수가 개선**되기 시작하여 **분당 약 113회까지 올라갔습니다.**
* 연구팀은 맥박과 자발 호흡을 관찰했으며, **혈압은 93 이상 173 미만**으로 기록되어 치료에 대한 긍정적인 반응을 보였습니다.
* 🔄 환자가 치료 과정 내내 안정 상태를 유지할 수 있도록 약물 복용량과 조정에 대해 논의하면서 **팀원 간의 지속적인 커뮤니케이션**이 매우 중요했습니다.
* 환자의 회복을 촉진하기 위해 **케타민과 에피네프린을 포함한 추가 약물의 투여 시기**를 신중하게 정하고 모니터링했습니다.
* 🕒 일련의 개입 끝에 환자의 상태가 안정되자 의료팀은 **모든 의료 장비를 적절히 관리**하면서 이송을 준비할 수 있었습니다.
* 📞 팀이 환자를 이송할 준비를 하면서 **다른 의료진과의 협력이 필수적**이었고, 이송하는 동안 **환자가 최상의 치료**를 받을 수 있도록 했습니다.

의료진은 환자를 성공적으로 안정시켜 맥박을 회복시키고 호흡 기능을 개선했습니다.

what's that a little bit excise. I noticed she started like gasping for air. Okay, got it. We yeah keep going on three ready one two oh my God you're good go ahead man check connector and elect no gag. How are you ready one two a minute then we'll [Music] Che you got prear all [Music] that we bagging and all that you got you do have one okay cool sorry. She still has some respiratory drive I'm her at this point yeah all right going to precharge. I got it I'll do it again I'll do it keep going keep going all right we're going to check in 5 seconds yo 3 2 one all right P got it yeah okay you say clear all right back on back you got that ready to go [Applause] [Music] that get me that vate yeah right there ventilate vate ventilate secur I the [Music] looking good vate you swapping out with me yeah all right 30 more seconds of compression.

till next p to [Music] check you can tell vate all right we're going to pre-charge vate ready swap out in 5 seconds 5 4 don't wor about that 3 2 one p check be again I got good clear back on back on CH all right am's going in 300 Amo 300 yes you got it we'll wait we'll keep doing CPR yeah thanate change am perfectly all right good um let's go ahead and get a round of EP in or two perfect stop reading she was seing she said she called start yeah y ready said as as she knows I'm feel pul too yeah your intitle jumped up too a little bit yeah about 50 seconds till next post check pouring nicely all right I got I can feel the PSE right yeah I'm not sure if it's from the compressions or if she actually has a heartbeat but I I couldn't feel it earlier I think I bet she does all right we have backboard we have

sh out 30 seconds until next po medication ventilate okay all right 15 seconds ventilate pre-charging keep going okay ventilate 5 4 3 2 1 P Che you got a pulse yeah pulse Co blood pressure set have spontaneous respiration about right respiration still go uh last po she we got Ross at 103 watch your right leg y I already have everything yeah give me let's get I actually have aadi hey we have a pee B for that thing yeah it's in the bag hey the bag that I you let's just see what this blood pressure is and uh I would rather stabilize first I know just in case have radio PS I still got one okay yeah she had a stronger one just a minute ago hey br will you grab the uh yall have a yall have an ear2 you want the backo yeah whatever y think I think the whatever's easier guys awesome that's perfect dud 173 over 93 I'm G switch this

out hey are you mixing up push okay ready like another line in the yeah this thing is I we're just stabilizing man we're going to get a good pulse off real quick and just make sure she's good to go before we move her here's here's your D what we don't want to do is move her and she codes on us and we got start all over again so come on2 hey is this Kevin Hey Kevin you here to the stretcher just pick her up and move her here with Ronda I think we just pick her up here and this thing's connected to high flow and all that [Music] I just moved it to the Cartage part to see if that's a little bit better her eares are a little bit seems like her radio got a little a little biter she's got a good femoral her heart rate's going up a little bit too yeah give me uh give me that uh you have a manual cuff yeah in the t bag in the

front here go. I don't think we got it out yet. Very faint radio. Hey, her heart rate is going up pretty. You might want to be on point with that. Uh, yeah, I would get ready to give it AC. Now she's got some great AC. I'm still not getting any good for fusion with this here. Try. I will. I will get sh. Okay, okay. Yeah, I'm not. That's all her. So when we got rash was 103. Um, she's recently shot at 150, but herba is. But I can't get a good class at [Music]. All don't have a Tre on her. I can't hear. I can't hear anything. Hey, recycle that radi. You got a good radio over there? Yeah, I don't feel one right here. Yeah, I don't feel a radial anymore over here fast now. It is very fast and very faint. Yeah, in had her drop back down a little bit. Do you want to hit her with some and justy if that will help get I'm.

I'm completely fine with that, but I want to be a group decision. You got it ready? Yep, it's right here. New info: she did not complain of anything, but she didn't notice on her watch of what happened. Yeah, the needle starting to jump around 80, but I don't hear anything. Okay, that's fine. Yeah, let hit with some push. Okay, that's fast. Okay, did he say okay? Okay, one of EP push is in. You want to start her on the drip just in case? Just get the pump out. She's dropping. Hey, what did you hook that up to backing? No cool. Hey, yes, yes, yes. One milligram a minute. Yeah, can we grab your... Where's that EP at? The patient was in 15 over says patient. Yeah, yeah. Where's the small bag at? Hey bro, do you have the ep? The holding? What was your other question about with... It's a in a and a. Yeah, yeah, it's 15050. I pulled out. We can also go another minutes. We... It someone try to get another man. I

feel very, very faint, very fast right here. We can probably hit her with another if you want to. Yeah, it's very faint. Yeah, you can repeat every 1 to 3 minutes. I push those someone. Oh, we're hanging the DP right now. Hey, do you want this EP in that IV, or you want it in the IO? Um, honestly, let's go in this IV over here. She's probably got a decent AC over there as well. We can just bu out AC 98, 78, 98 over 78, and another dose. A push dose is going in right now. Okay, that's fine. Yeah, and you're, we're also going with the amod drip, right? Yeah, starting it at 4. Let me know when you are ready to go on this. Yeah, I'm good. It's he, it's in this. Yeah. Oh, you want to go on the IO? I thought you said IV. I know it's not. Oh, okay, cool. Yeah, I'm good with it. All right, all right. You can time St it. It's going. Thank you. He know.

going yep okay my down [Music] [Music] medic 22 Inc and 3184 East State Highway 199 Redy Park cross street linee and Garn Road Mark 61 why [Music] [Music] medication that to not watch the steps is that our am yeah okay say when one second do we have do we disconnect P sick person 3184 East State Highway 199 138 street5 2 you yeah it's ready no no the am's not ready that was the eie that's not not going got it ready all right go yeah go for it hey I'm about to get this thing go around here and I got to fix your epic drip real quick okay yeah he this is Amo I'm about to get it going some freaking tubing right here I've got Amo hook in this uh AC when you're ready all right we got 100 and 100 bag of Amo it's 1: one are you serious there we go one yes just going to see does that time

sink down there um. I'd like to. You want. How are we doing on pressure? It was f a second ago. I haven't taken am's going. If you a she's taking rest on her own. We're just assisting okay. I'm going to try to get a on her. How old is she? Your other generic be what what your name? Casey. Casey okay. [Music] okay 82. Yeah probably. We're signus P. You want ask don't if anyone else. I didn't 's going again. This talking POS and sheit. No but she start to open her eyes a little bit more um. Let's just uh figure out what our blood pressure is. 100 over uh literally 100 over 80. 100 over 80. I just took a manual okay. Yes I know was clear as day. Yeah I would go I would go low do K. I'm going go up on thisy dri high. No what do you think about a keep that ey gel in. Well I mean if you can get her blood pressure up and her uh

spo2 up. I'd say I'd say tu okay with her with do we want to up her in wait. We're going to try to see if can stay a little bit more. Do we take the paddles off or's something's not both upper arms. Sorry I didn't look. No you're good. It just happened. It just happened cuz you just took the 12. We sign of time. All right you're open that EP. You doing it now. It's in. Will you event an EP please. You need another firstep Taylor. No she just up the drip to six M for a minute. I'm going to try to get another another line over here. 89% there. A Sharpie over there. Somebody the r Sharpie that a terrible. I'll make it up. So we still only given the two pups this. I turned your peep up a little bit more to like right at 5 to make sure we're good there. But we need to fix that S2. We can oh there we go 100% T. I'm going to set you up foration.

what's that is all right. I that over yeah. I'm just oh this isum Sky another you're tying my RS wheer yeah thank you. You want a seven yeah that's okay about your back she's what yeah. We'll we got vomit pull it or what no yeah don't pull it yet. Don't pull it oh we're moving our where that yeah. I just set it down right there okay. Thank you I'm working on it now. I know I know h of me yep thank you. Hey somebody toss me a watch over there real quick hand yeah all right. She's chilled out a little bit all right is good. No not my a little bit of hope that's protecting that right now. How much doing got 100 a flush right here. What are we estimating for high F I say like 52 53 all right. All right here you go. This is hey this is 10 per Mark ketamine. I would that uh what's her blood pressure. I'd go 30. I'd go 30 and if she's not enough

then just give her a little bit more, okay? Yeah, give her 50 then. Yeah, she's probably waking up. You probably, uh, do you want to do 30 or 50? It's 30 and then 50 R. All right, let's do 30. Use that. It's 10 per one. Yep, 10 per one. There's 100 in there. Hey, will you, uh, like, blood pressure is good and all that good stuff? Can you reassess? That was just the last one. Okay, can I go in the same line as the, uh, I don't know. I, I would disconnect it, push it, connect it back up. What I would do there, you got suction out, tuber. Hey, she mind sitting over there for me and just use one hand if possible. 30 taking to, hey, want to get over there? Uh, no, just give us a minute, man. We're about to write, and honestly, it's, uh, going in now, okay? Push that blood pressure again, please. She vomiting again? Yep, all right, hanging on to that. That section's right there behind us. Yeah, all

right. Did we ever secure this or no? Yeah, we okay. They C it off when they thought we were going to take it out. All right, yeah. Hey, that 14 fr after we're going to need that Y come that pky Che to I. No, I was just out [Music] loud. Okay, that's good. That's good. You got suction. We already have the BBM out. We already have intitle. She's still sat 99% 131. The last1 does have a radio start that. Yeah, yeah. She still got a good take that one down as well. Yeah, a lot more. Do we still have a down um no. So when we get to R we're get 50 more can uh probably 30 30 more. Depends on when she's ready to go. So trench right there. There's rock aronium. You got your ketamine. You please label this. Yeah, I okay never mind. No, I'll I didn't see it. Sorry. No, I will do it again. Both drugs are laying right here. I'll push them or Brook compession but I believe your

ear external Notch have a p all right there you got suction you got this out only we don't have out a c color but all this stuff is ready3 all right you uh nasel Cano foric I forgot to grab it 199 on sugar we're good you had that every you know if you said it what' you get for the sugar9 who has pushed those it's over there yeah it's back here right here cool hey you want to just in case that way you know where it's at we all know where it's at all right are you right now no no no no heart rates come down around 113 so 100% and sorry my behind here see breath here that's good right now when you go to innovate I'll loosen it up and just hold it from the back what's that sorry all right we're checking one more pressure first stat were 100% we just lost it again it's probably on that same hand is that what that is okay all right there we go we're backer

and already fine. We got 50 Ep Rock Rock 50 EP. Hey, I'm sure you're going to, but I would suck in hell out of her before I in B. Oh, I know you ready. Everybody ready. Anybody disagree with this? Okay. Somebody's Watching SP2. I'm going to push drugs. Um, you'll be cycling BP cuffs. Cool. We see a drop in the end title or the heart rate oro2, right? Obviously, we want to know about all three of those things. Got open ey on there as well. What's that open down there as well? Yeah, I would go. Hey, is there a bag going to this? Yeah, I just compressor bag off. Okay, droing. Yeah, just not DC it, but shut it, shut that it failing down. All right, you ready? Yeah, time stamp that ketamine for me. Rock's going in now. Got your timer out. Every flush through. Hey, so hang on to that iel just in case we can't get it. We'll just throw it back in. Here's the Turnal knch. Everything's

good. No changes in her bottle so far. Yeah, it looks good. Can come back down a little more hard. I like it. Her quality was good. Attack. You think she just went attack and... and hey girl, I oh my God, okay. 6 seconds. Alright, alright. Still again, everything's looking good. Where we ATS? We're good. It out that down time. St this ination. I got you got the two. Alright, pet is on or sorry pet. Where the scope at? I'm going listen real quick while you hang on to that went down. I'm might recycle this. You calling it all. I'm going to work around you, okay? What's back there? Alright, hi. We just for press 148 down on that. Is our H back up? Yeah, I just HED it back up. Do you want toadi make? Yeah, yeah. She's got good radio. We just recycled that pressure. That is... oh, I have a 40 left. You want me to back down. [Music] The we gave 50 aemy. Well, we gave what you gave 301. Yeah, yeah. And I gave like 4 or 50, so it's

seven and then four to get 30. Yeah, okay, that probably, yeah, I'd like to. All right then, let's get this V out. Yeah, yeah, it doesn't matter. I'll send you ever. I just ask. Doesn't matter. These guys right here. No, honestly, I'm good if want to went. Yeah, the one on your right is that na can. Oh, 22's on another call. Okay, I mean, do one of y'all want to ride so I can stay here in town or it does matter to me unless you want me to ride with you. No, I'll take one of the other. Okay, I'm going to. Yeah, good guys, that's awesome. Hey, Taylor, yeah, what's up? I'm going to rewrite these because it's like it's all messed up, the order and stuff. I'll reite it and I'll send you the picture of it that way. Why is her Baseline like, yeah, I. I'll go back that way. You used to have to decipher all the generics and all that. Yeah, I'll go go back and I.

don't mind like rewriting it as well. I'm going to leave it right here. Hey, are you ready for post? Yeah, please. Okay. Hey, will you shut that here? Will you pinch this off for me? Time St that y have all right. I gave 40. What was left in that syringe? This is 100 right here. You want me to write 100 on it? That's 100 right there. This is 100. Okay. Sorry for drawing up two different concentrations. So 30, 30, and 40. Yeah, she just got 40. All right. You see her Baseline on intitle? That's be it's here. Hey, do me a favor, and I want you to disconnect this. Okay, on three. Ready? You cool with me doing this? Y ready? One, two, three. It back uping. Did that just got out the extra Air volume out of her? She was just stacking. What do you think I did? Like 350, 400 title volume at 12. Yeah, you can see what it is and then make your adjustment off of uh. I think your title volume is great. No air mix.

your pip settings at 40 cmdb CMV get a CLE generic this real quick everything any camine is in there too though so going to get I've got it's I got shut that one on the left Tre that's just that bag thank you all right she thr a couple pbcs but first some El look before I D your Pips like 20 you cool if I go up to eight on the peep yeah oh this never mind the people isn't even on on this one oh no I forgot to back up I went all the way down good you're there I went to like right between 5 and and see where that's happen all right are you all set all right yeah I think so you want you want me to ride with you are you sure okay I do not mind at all can we follow you back to station St restock oh yeah you got that we get it you sure you're good good job okay okay want good

Cardiac Arrest Full-Length Body Cam Video 9/4/23

PCHD EMS Podcast

팀은 환자의 호흡을 관리하면서 심폐소생술을 시행하고 맥박을 확인하고 있습니다.

이들은 환자를 안정시키기 위해 사전 처치, 약물 투여, 인공호흡을 조정하고 있습니다.

여러 차례의 개입 끝에 환자는 맥박과 자발 호흡의 징후를 보이며 안전한 이송 및 안정화 계획으로 이어집니다.

환자의 심박수가 증가하고 있고 맥박이 잘 잡히지 않습니다.

의료팀은 안정화를 위해 약물을 투여하고 링거를 시작하기로 결정합니다.

약물을 투여하기 위한 최선의 경로에 대해 논의하고 환자의 위중한 상태를 관리하기 위해 함께 노력합니다.

한 팀이 3184 이스트 주 고속도로 199에서 응급 상황에 대응하여 조난당한 환자를 돕고 있습니다.

이들은 약물을 투여하고 혈압과 산소 수치 등 환자의 바이탈 사인을 모니터링하고 있습니다.

의료팀은 환자를 안정시키기 위해 노력하고 있으며 추가 지원과 치료를 제공하기 위한 노력을 조율하고 있습니다.

한 팀이 환자의 상태를 관리하고 케타민을 투여하고 혈압을 모니터링하기 위해 협력하고 있습니다.

이들은 환자의 상태를 재평가하면서 석션 및 정맥주사 라인 확보와 같은 작업을 조율하고 있습니다.

이 팀은 적절한 용량의 약물을 제공하고 원활한 치료 전환을 보장하는 데 집중하고 있습니다.

의료팀은 석션, 심박수 모니터링, 혈압 확인에 중점을 두고 환자의 위중한 상태를 관리하기 위해 협력하고 있습니다.

케타민을 포함한 약물을 투여하고 압박백을 사용하여 환자를 지원하고 있습니다.

팀은 효율적으로 일하면서 압력을 재활용하고 시술 내내 환자의 안정을 보장하고 있습니다.

이 대화에는 그룹 간의 승차 및 작업 조율에 관한 내용이 포함되어 있습니다.

한 사람이 엉망인 주문서를 다시 작성하여 사진을 보내겠다고 제안합니다.

약품 용량과 설정을 조정하고, 공기가 섞이지 않도록 하고, 재입고를 위해 역으로 돌아가겠다고 제안하기 전에 한 사람이 최종 준비에 대해 논의합니다.