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Emergency Cardiovascular Care Library
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Emergency Cardiovascular Care Library (American Heart Association).ISO
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Book_ACLS
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ACLS_ch15
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ta15_02.htx
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ta15_02
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1998-01-11
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<TABLE WIDTH="446" BORDER="1" CELLSPACING="2" CELLPADDING="5" HEIGHT="465">
<CAPTION ALIGN="TOP"><P ALIGN=LEFT><B><FONT COLOR="#ffff3f">Table 2. General Brain-Oriented Intensive
Care</FONT></B></CAPTION>
<TR>
<TD WIDTH="100%" HEIGHT="458"><P>Normotension throughout coma (eg, mean arterial pressure, 90-100 mm Hg
or normal systolic level for patient): titrated fluids and vasopressors
as needed</P>
<A NAME="anchor1"></A>
<P>Moderate hyperventilation (arterial P<FONT SIZE=-1>CO</FONT><SUB><FONT
SIZE=-1>2</FONT></SUB>, 30-35 mm Hg)</P>
<A NAME="anchor2"></A>
<P>Moderate hyperoxia (arterial P<FONT SIZE=-1>O</FONT><SUB><FONT SIZE=-1>2</FONT></SUB>,
> 100 mm Hg): titrated F<FONT SIZE=-1>IO</FONT><SUB><FONT SIZE=-1>2</FONT></SUB>;
least positive end-expiratory pressure (PEEP) possible</P>
<A NAME="anchor3"></A>
<P>Arterial pH 7.3-7.5</P>
<A NAME="anchor4"></A>
<P>Immobilization (neuromuscular paralysis) as needed</P>
<A NAME="anchor5"></A>
<P>Sedation (morphine or diazepam) as needed</P>
<A NAME="anchor6"></A>
<P>Anticonvulsants (eg, diazepam, phenytoin, or barbiturates) as needed</P>
<A NAME="anchor7"></A>
<P>Normalization of blood chemistry (hematocrit, electrolytes, osmolality,
and glucose)</P>
<A NAME="anchor8"></A>
<P>Osmotherapy (mannitol or glycerol) as needed for monitored intracranial
pressure elevation or secondary neurological deterioration</P>
<A NAME="anchor9"></A>
<P>Normothermia</P>
<A NAME="anchor10"></A>
<P>Nutritional support started by 48 hours</TD></TR>
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