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Notfall + Rettungsmedizin
Erschienen in:

01.11.2010 | ERC-Leitlinien

Elektrotherapie: automatisierte externe Defibrillatoren, Defibrillation, Kardioversion und Schrittmachertherapie

Sektion 3 der Leitlinien zur Reanimation 2010 des European Resuscitation Council

verfasst von: C.D. Deakin, J.P. Nolan, K. Sunde, R.W. Koster

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 7/2010

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Auszug

Die wichtigsten Änderungen in den Leitlinien des European Resuscitation Council (ERC) von 2010 für Elektrotherapien beinhalten:
  • Die Bedeutung früher ununterbrochener Herzdruckmassage wird durchgängig in diesen Leitlinien betont.
  • Die Verringerung der Pausendauer vor und nach der Schockabgabe wird wesentlich mehr betont. Empfohlen wird die Fortführung der Herzdruckmassage während des Ladevorgangs des Defibrillators.
  • Ebenfalls betont wird die sofortige Wiederaufnahme der Herzdruckmassage nach der Defibrillation; in Kombination mit der Fortführung der Kompressionen während des Ladevorgangs sollen die Herzdruckmassagen für den Vorgang der Defibrillation nicht länger als 5 s unterbrochen werden.
  • Die Sicherheit des Retters hat höchste Priorität. In diesen Leitlinien wird aber festgestellt, dass das Risiko, durch den Defibrillator Schaden zu erleiden, für den Anwender sehr gering ist, insbesondere, wenn der Retter Handschuhe trägt. Das Hauptaugenmerk wird jetzt auf einen schnellen Sicherheits-Check gelegt, um die Zeit vor der Schockabgabe möglichst gering zu halten.
  • Bei der Behandlung des präklinischen Kreislaufstillstands soll der Rettungsdienst hochwertige Maßnahmen der kardiopulmonalen Reanimation („cardiopulmonary resuscitation“, CPR) durchführen, während der Defibrillator geholt, eingesetzt und hochgeladen wird. Eine routinemäßig genau festgelegte Dauer der Wiederbelebung (z. B. 2 oder 3 min) vor der Herzrhythmusanalyse und einer Schockabgabe wird aber nicht mehr empfohlen. Für diejenigen Rettungsdienste, die eine genau festgelegte Zeitdauer für die Herzdruckmassage vor der Defibrillation schon vollständig eingeführt haben, ist es vernünftig, diese Praxis beizubehalten, da es keine stichhaltigen Daten für oder gegen diese Strategie gibt.
  • Die Anwendung von bis zu 3 schnell aufeinanderfolgenden Schocks kann in Betracht gezogen werden, wenn sich Kammerflimmern/Kammertachykardie („ventricular fibrillation/ventricular tachycardia“, VF/VT) während Herzkatheterisierung oder kurz nach einer Thorakotomie ereignet. Diese Dreischockstrategie kann ebenso für einen unmittelbar am Monitor beobachteten VF/VT-Kreislaufstillstand, wenn der Patient bereits an einen manuellen Defibrillator angeschlossen ist, erwogen werden.
  • Elektrodenpasten und -gels können sich zwischen den beiden „paddles“ ausbreiten, die Möglichkeit für einen Funkenschlag schaffen und sollen daher nicht verwendet werden.
…
Vorheriger Artikel Basismaßnahmen zur Wiederbelebung Erwachsener und Verwendung automatisierter externer Defibrillatoren
Nächster Artikel Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)
Fußnoten
1
Notfallsanitäter.
 
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Metadaten
Titel
Elektrotherapie: automatisierte externe Defibrillatoren, Defibrillation, Kardioversion und Schrittmachertherapie
Sektion 3 der Leitlinien zur Reanimation 2010 des European Resuscitation Council
verfasst von
C.D. Deakin
J.P. Nolan
K. Sunde
R.W. Koster
Publikationsdatum
01.11.2010
Verlag
Springer-Verlag
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 7/2010
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-010-1369-9

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