Author/Editor		Antolič, Gorazd; Gričar, Marko; Šinkovec, Matjaž
Title		Obravnava neletalnih motenj srčnega ritma
Translated title		Management of non-cardiac arrest arrhythmias
Type		članek
Source		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 4. Zbornik 5. mednarodni simpozij o urgentni medicini; 1998 jun 17-20; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		1998
Volume		str. 31-43
Language		slo
Abstract		According to European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines for emergency arrhythmia management, arrhythmias can by grouped into two large categories. The first category consists of cardiac arrest (lethali rhythms: pulseless ventricular tachycardia, ventricular fibrillation, asystole, andl pulseless electrical activity; they are, despite their importance, not subject to turther detailed discussion in this article. The second category of arrhythmias is deealt with in more detail. It consists of non-cardiac arrest (non-lethal) rhythms, whic if leftt untreated, can lead to a cardiac arrest in less than one hour. Importantly, we discuss relevant drugs which are used in such circumstances. First, universal algorithm for emergency cardiac care of adults is presented. Bradycardia treatment algorithm used for patients with bradycardia and palpable peripheral pulses is presentd afterwards. It is shown that in most cases of bradycardia drug treatment is less effective compared to non-pharmacological measures (i.e. pacing) which usually present the therapeutic end-point. However, pharmacotherapy represents an indispensable therapeutical bridge to final stabilisation of patients by non-pharmacological measures requiring more equipment, skill and time. Finally, tachycardia treatment algorithm is given: narrow and broad QRS complex tachycardias are discussed. If a patient with tachycardia presents without serious signs or symptoms, then the first drugs ot choice are adenosine for narrow QRS complex tachycardia and lidocaine for broacl QRS complex tachycardia. However, if for some reason the patient with tachycardia is hemodynamically unstable or deteriorating at any point, emergency synchronizerl electrical cardioversion is usualy mandatory and pharmacotherapy can be a seconrl step.
Descriptors		ARRHYTHMIA BRADYCARDIA TACHYCARDIA ALGORITHMS