4 курс / Медицина катастроф / Алгоритмы_оказания_скорой_и_неотложной_медицинской_помощи
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,9 ɫɬɟɩɟɧɢ |
Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
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- ɇɚɬɪɢɹ ɯɥɨɪɢɞ - 10 - ɦɥ ɤɝ ɜ ɜɟɧɧɨ ɤɚɩɟɥɶɧɨ |
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- ɉɪɟɞɧɢɡɨɥɨɧ - 10 ɦɝ ɤɝ ɢɥɢ Ⱦɟɤɫɚɦɟɬɚɡɨɧ - 1,2 |
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ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɉɟɪɟɞ ɢɧɬɭɛɚɰɢɟɣ |
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- Ⱥɬɪɨɩɢɧ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɩɨ ɩɨɤɚɡɚɧɢɹɦ |
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ȼɜɨɞɧɚɹ ɚɧɟɫɬɟɡɢɹ ɤɨɦɛɢɧɚɰɢɟɣ ɩɪɟɩɚɪɚɬɨɜ |
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ɩɪɨɢɡɜɨɞɢɬɫɹ ɩɪɢ ɭɪɨɜɧɟ ɫɨɡɧɚɧɢɹ ! ɛɚɥɥɨɜ ɩɨ |
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ɲɤɚɥɟ ɤɨɦɵ ȽɅȺɁȽɈ |
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- Ɇɢɞɚɡɨɥɚɦ ɦɝ ɤɝ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ ɢ Ʉɟɬɚɦɢɧ |
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1 - ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɢɥɢ - Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢ Ʉɟɬɚɦɢɧ 1 - 2 |
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ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɢɥɢ - ɉɪɨɩɨɮɨɥ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ |
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ɂɧɬɭɛɚɰɢɹ ɬɪɚɯɟɢ ɬɪɭɛɤɚ ɞɢɚɦɟɬɪɨɦ ɧɚ ɨɞɢɧ |
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ɪɚɡɦɟɪ ɦɟɧɶɲɟ ɜɨɡɪɚɫɬɧɨɣ ɧɨɪɦɵ ɢɥɢ |
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ɤɨɧɢɤɨɬɨɦɢɹ |
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ɂȼɅ ȼȼɅ ɫ FiO2 1.0 |
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ɉɨɩɵɬɤɚ ɢɧɬɭɛɚɰɢɢ ɞɨɥɠɧɚ ɛɵɬɶ ɨɞɧɨɤɪɚɬɧɨɣ |
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ɉɪɢɦɟɧɟɧɢɟ ɥɚɪɢɧɝɟɚɥɶɧɨɣ ɬɪɭɛɤɢ |
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ɩɪɨɬɢɜɨɩɨɤɚɡɚɧɨ |
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- ɩɪɢ ɬɪɚɜɦɟ ɝɨɪɬɚɧɢ |
ɫɦ ɪɚɡɞɟɥ «Ɉɬɨɪɢɧɨɥɚɪɢɧɝɨɥɨɝɢɹ» ɫɬɪ 187) |
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- ɩɪɢ ɨɠɨɝɟ ɜɟɪɯɧɢɯ |
ɫɦ ɩɨɞɪɚɡɞɟɥ ɞɚɧɧɨɝɨ ɪɚɡɞɟɥɚ ɫɬɪ 237) |
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ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ |
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Ɍ |
ɂɧɨɪɨɞɧɨɟ ɬɟɥɨ |
ɉɭɥɶɫɨɤɫɢɦɟɬɪɢɹ |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ |
ɗɄȽ - ɦɨɧɢɬɨɪɢɧɝ |
ɛɨɥɶɧɢɰɭ |
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- ɥɨɤɚɥɢɡɨɜɚɧɨ ɜ ɧɨɫɨɜɵɯ |
ɂɧɨɪɨɞɧɨɟ ɬɟɥɨ ɢɡ ɧɨɫɨɜɨɝɨ ɯɨɞɚ ɢ ɫɥɭɯɨɜɨɝɨ |
2. ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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ɯɨɞɚɯ ɢ ɫɥɭɯɨɜɵɯ |
ɩɪɨɯɨɞɚ ɧɟ ɢɡɜɥɟɤɚɟɬɫɹ |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɩɪɨɯɨɞɚɯ |
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ɚɤɬɢɜ ɜ ɩɨɥɢɤɥɢɧɢɤɭ |
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220 |
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- ɥɨɤɚɥɢɡɨɜɚɧɨ ɜ |
ɋɚɧɚɰɢɹ ɜɟɪɯɧɢɯ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ ɭɞɚɥɟɧɢɟ |
Ɋɟɤɨɦɟɧɞɨɜɚɬɶ |
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ɪɨɬɨɝɥɨɬɤɟ ɢ ɜɵɲɟ |
ɢɧɨɪɨɞɧɨɝɨ ɬɟɥɚ ɜ ɬ ɱ ɫ ɩɨɦɨɳɶɸ ɩɪɹɦɨɣ |
ɨɛɪɚɬɢɬɶɫɹ ɜ ɩɨɥɢɤɥɢɧɢɤɭ |
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ɝɨɥɨɫɨɜɵɯ ɫɜɹɡɨɤ ɛɟɡ |
ɥɚɪɢɧɝɨɫɤɨɩɢɢ |
ɩɨɫɥɟ ɢɡɜɥɟɱɟɧɢɹ |
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ɚɫɮɢɤɫɢɢ ɢɥɢ ɟɟ ɭɝɪɨɡɵ |
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ɢɧɨɪɨɞɧɨɝɨ ɬɟɥɚ |
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2. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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ɛɨɥɶɧɢɰɭ ɩɪɢ |
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ɧɟɜɨɡɦɨɠɧɨɫɬɢ ɢɡɜɥɟɱɟɧɢɹ |
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ɢɧɨɪɨɞɧɨɝɨ ɬɟɥɚ |
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3. ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɚɤɬɢɜ ɜ ɩɨɥɢɤɥɢɧɢɤɭ |
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- ɥɨɤɚɥɢɡɨɜɚɧɨ ɧɢɠɟ |
ɉɨɩɵɬɤɢ ɢɡɜɥɟɱɟɧɢɹ ɢɧɨɪɨɞɧɨɝɨ ɬɟɥɚ ɧɚ |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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ɝɨɥɨɫɨɜɵɯ ɫɜɹɡɨɤ ɛɟɡ |
ɞɨɝɨɫɩɢɬɚɥɶɧɨɦ ɷɬɚɩɟ ɧɟ ɜɵɩɨɥɧɹɸɬɫɹ ɩɨɤɚɡɚɧɚ |
ɛɨɥɶɧɢɰɭ |
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ɚɫɮɢɤɫɢɢ ɢɥɢ ɟɟ ɭɝɪɨɡɵ |
ɷɤɫɬɪɟɧɧɚɹ ɦɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ |
2. ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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• Ɉɤɫɢɝɟɧɨɬɟɪɚɩɢɹ ɩɪɢ SpO2 - FiO2 0.5 - 1.0 |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɚɤɬɢɜ ɧɚ «103» ɱɟɪɟɡ ɱɚɫɚ |
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ɉɪɢ ɩɨɜɬɨɪɧɨɦ ɨɬɤɚɡɟ – |
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- ɥɨɤɚɥɢɡɨɜɚɧɨ ɧɢɠɟ |
ɉɪɢɞɚɬɶ ɩɨɥɨɠɟɧɢɟ ɬɭɥɨɜɢɳɚ ɫ ɧɚɤɥɨɧɨɦ ɜɩɟɪɟɞ ɢ |
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ɝɨɥɨɫɨɜɵɯ ɫɜɹɡɨɤ ɫ |
ɧɚɧɟɫɬɢ ɭɞɚɪɨɜ ɥɚɞɨɧɶɸ ɜ ɦɟɠɥɨɩɚɬɨɱɧɭɸ ɨɛɥɚɫɬɶ |
ɚɤɬɢɜ ɜ ɈɇɆɉȼɢȾɇ |
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ɚɫɮɢɤɫɢɟɣ ɢɥɢ ɟɟ ɭɝɪɨɡɨɣ |
ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
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ɭ ɞɟɬɟɣ ɞɨ ɝɨɞɚ |
- ɩɟɪɟɜɟɪɧɭɬɶ ɪɟɛɟɧɤɚ ɩɨɞɞɟɪɠɢɜɚɹ ɟɝɨ ɜ ɩɨɥɨɠɟɧɢɢ |
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ɧɚ ɫɩɢɧɟ ɝɨɥɨɜɚ ɪɟɛɟɧɤɚ ɞɨɥɠɧɚ ɧɚɯɨɞɢɬɫɹ ɧɢɠɟ |
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ɬɭɥɨɜɢɳɚ ɢ ɩɪɨɢɡɜɟɫɬɢ ɬɨɥɱɤɨɜ ɨɞɧɨɣ ɪɭɤɨɣ ɧɚ |
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ɭɪɨɜɧɟ ɧɢɠɧɟɣ ɬɪɟɬɢ ɝɪɭɞɢɧɵ ɧɚ ɨɞɢɧ ɩɚɥɟɰ ɧɢɠɟ |
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ɫɨɫɤɨɜ ɩɨɞ ɭɝɥɨɦ ɜ ɧɚɩɪɚɜɥɟɧɢɢ ɤ ɝɪɭɞɧɨɣ ɤɥɟɬɤɟ |
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ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
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ɂȼɅ ɞɵɯɚɬɟɥɶɧɵɦ ɦɟɲɤɨɦ (ɟɫɥɢ ɨɬɦɟɱɚɟɬɫɹ |
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ɜɢɞɢɦɚɹ ɷɤɫɤɭɪɫɢɹ ɝɪɭɞɧɨɣ ɤɥɟɬɤɢ - ɩɨɤɚɡɚɧɚ |
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ɢɧɬɭɛɚɰɢɹ ɬɪɚɯɟɢ ɩɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɤɫɤɭɪɫɢɢ ɝɪɭɞɧɨɣ |
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ɤɥɟɬɤɢ - ɤɨɧɢɤɨɬɨɦɢɹ |
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• Ɉɤɫɢɝɟɧɨɬɟɪɚɩɢɹ ɩɪɢ SpO2 - FiO2 1.0 |
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221 |
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- ɥɨɤɚɥɢɡɨɜɚɧɨ ɧɢɠɟ |
ɉɪɢɦɟɧɢɬɶ ɩɪɢɺɦ Ƚɟɣɦɥɢɯɚ |
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ɝɨɥɨɫɨɜɵɯ ɫɜɹɡɨɤ ɫ |
- ɩɪɢɞɚɬɶ ɩɨɥɨɠɟɧɢɟ ɬɭɥɨɜɢɳɚ ɫ ɧɚɤɥɨɧɨɦ ɜɩɟɪɟɞ ɢ |
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ɚɫɮɢɤɫɢɟɣ ɢɥɢ ɟɟ ɭɝɪɨɡɨɣ |
ɩɪɨɢɡɜɟɫɬɢ ɞɨ ɬɨɥɱɤɨɜ ɞɜɭɦɹ ɪɭɤɚɦɢ ɜ |
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ɭ ɞɟɬɟɣ ɫɬɚɪɲɟ ɝɨɞɚ |
ɦɟɡɨɝɚɫɬɪɚɥɶɧɭɸ ɨɛɥɚɫɬɶ ɩɨɞ ɭɝɥɨɦ ɜ ɧɚɩɪɚɜɥɟɧɢɢ ɤ |
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ɝɪɭɞɧɨɣ ɤɥɟɬɤɟ ɧɚɯɨɞɹɫɶ ɫɡɚɞɢ ɫɢɞɹɳɟɝɨ ɢɥɢ ɫɬɨɹɳɟɝɨ |
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ɪɟɛɟɧɤɚ |
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ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
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ɂȼɅ ɞɵɯɚɬɟɥɶɧɵɦ ɦɟɲɤɨɦ (ɟɫɥɢ ɨɬɦɟɱɚɟɬɫɹ |
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ɜɢɞɢɦɚɹ ɷɤɫɤɭɪɫɢɹ ɝɪɭɞɧɨɣ ɤɥɟɬɤɢ - ɩɨɤɚɡɚɧɚ |
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ɢɧɬɭɛɚɰɢɹ ɬɪɚɯɟɢ ɩɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɤɫɤɭɪɫɢɢ ɝɪɭɞɧɨɣ |
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ɤɥɟɬɤɢ - ɤɨɧɢɤɨɬɨɦɢɹ |
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• Ɉɤɫɢɝɟɧɨɬɟɪɚɩɢɹ ɩɪɢ SpO2 - FiO2 0.5 - 1.0 |
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- ɩɪɢ ɝɢɩɨɤɫɢɱɟɫɤɨɣ ɤɨɦɟ |
Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
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ɩɨɫɥɟ ɭɞɚɥɟɧɢɹ |
ɉɟɪɟɞ ɢɧɬɭɛɚɰɢɟɣ |
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ɢɧɨɪɨɞɧɨɝɨ ɬɟɥɚ |
- Ⱥɬɪɨɩɢɧ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɩɨ ɩɨɤɚɡɚɧɢɹɦ |
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ȼɜɨɞɧɚɹ ɚɧɟɫɬɟɡɢɹ ɤɨɦɛɢɧɚɰɢɟɣ ɩɪɟɩɚɪɚɬɨɜ |
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ɩɪɨɢɡɜɨɞɢɬɫɹ ɩɪɢ ɭɪɨɜɧɟ ɫɨɡɧɚɧɢɹ ! ɛɚɥɥɨɜ ɩɨ |
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ɲɤɚɥɟ ɤɨɦɵ ȽɅȺɁȽɈ |
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- Ɇɢɞɚɡɨɥɚɦ ɦɝ ɤɝ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ ɢ Ʉɟɬɚɦɢɧ |
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1 - ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɢɥɢ - Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢ Ʉɟɬɚɦɢɧ - 2 |
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ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɢɥɢ - ɉɪɨɩɨɮɨɥ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ |
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ɋɚɧɚɰɢɹ ɜɟɪɯɧɢɯ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ |
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ɂɧɬɭɛɚɰɢɹ ɬɪɚɯɟɢ ɢɥɢ ɩɪɢɦɟɧɟɧɢɟ ɥɚɪɢɧɝɟɚɥɶɧɨɣ |
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ɬɪɭɛɤɢ |
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ɂȼɅ ȼȼɅ ɫ FiO2 0.5 - 1.0 |
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- ɩɪɢ ɫɭɞɨɪɨɝɚɯ |
- Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɋɦ ɪɚɡɞɟɥ ©ɇɟɜɪɨɥɨɝɢɹª ɗɩɢɥɟɩɫɢɹ - ɫɬɪ 62 |
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222 |
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L51.2 |
Ɍɨɤɫɢɱɟɫɤɢɣ |
ɉɭɥɶɫɨɤɫɢɦɟɬɪɢɹ |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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ɷɩɢɞɟɪɦɚɥɶɧɵɣ ɧɟɤɪɨɥɢɡ |
• Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
ɛɨɥɶɧɢɰɭ |
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Ʌɚɣɟɥɥɚ |
- ɉɪɟɞɧɢɡɨɥɨɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
2. ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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- ɏɥɨɪɨɩɢɪɚɦɢɧ ɦɥ ɝɨɞ ɠɢɡɧɢ ɜ ɜɟɧɧɨ |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɉɪɢ ɩɨɜɵɲɟɧɢɢ ɬɟɦɩɟɪɚɬɭɪɵ ɬɟɥɚ |
ɚɤɬɢɜ ɧɚ «103» ɱɟɪɟɡ ɱɚɫɚ |
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ɠɚɪɨɩɨɧɢɠɚɸɳɢɟ ɩɪɟɩɚɪɚɬɵ ɧɟ ɜɜɨɞɢɬɶ |
ɉɪɢ ɩɨɜɬɨɪɧɨɦ ɨɬɤɚɡɟ – |
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• Ⱥɫɟɩɬɢɱɟɫɤɚɹ ɩɨɜɹɡɤɚ ɧɚ ɩɨɪɚɠɟɧɧɵɟ ɭɱɚɫɬɤɢ ɤɨɠɢ |
ɚɤɬɢɜ ɜ ɈɇɆɉȼɢȾɇ |
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- ɩɪɢ ɛɨɥɢ |
- Ɍɪɚɦɚɞɨɥ - ɦɝ ɤɝ ɢɥɢ Ɏɟɧɬɚɧɢɥ 1 - ɦɤɝ ɤɝ |
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ɜ ɜɟɧɧɨ ɢɥɢ ɜ ɦɵɲɟɱɧɨ |
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ɇɟ ɩɪɢɦɟɧɹɬɶ ɧɟɫɬɟɪɨɢɞɧɵɟ ɩɪɨɬɢɜɨɫɩɚɥɢɬɟɥɶɧɵɟ |
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ɩɪɟɩɚɪɚɬɵ |
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- ɩɪɢ ɝɢɩɨɜɨɥɟɦɢɱɟɫɤɨɦ |
ɋɦ ɩɨɞɪɚɡɞɟɥ ɞɚɧɧɨɝɨ ɪɚɡɞɟɥɚ «Ƚɢɩɨɜɨɥɟɦɢɱɟɫɤɢɣ |
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ɲɨɤɟ |
ɲɨɤ» ɫɬɪ 214 |
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Ɂɚɛɨɥɟɜɚɧɢɹ ɜɧɭɬɪɟɧɧɢɯ ɨɪɝɚɧɨɜ ɢ ɷɧɞɨɤɪɢɧɧɨɣ |
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ɫɢɫɬɟɦɵ ɭ ɞɟɬɟɣ |
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J18 |
ɉɧɟɜɦɨɧɢɹ |
ɉɭɥɶɫɨɤɫɢɦɟɬɪɢɹ |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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• Ɉɤɫɢɝɟɧɨɬɟɪɚɩɢɹ ɩɪɢ SpO2 - FiO2 0.5 - 1.0 |
ɛɨɥɶɧɢɰɭ |
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2. ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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- ɩɪɢ ɩɨɜɵɲɟɧɢɢ |
- Ɇɟɬɚɦɢɡɨɥ ɧɚɬɪɢɹ ɦɝ ɤɝ ɜ ɦɵɲɟɱɧɨ |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɬɟɦɩɟɪɚɬɭɪɵ ɬɟɥɚ |
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ɚɤɬɢɜ ɜ ɈɇɆɉȼɢȾɇ |
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! ɋ |
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- ɩɪɢ ɧɟɤɚɪɞɢɨɝɟɧɧɨɦ |
ɉɨɥɨɠɟɧɢɟ ɫ ɩɪɢɩɨɞɧɹɬɵɦ ɝɨɥɨɜɧɵɦ ɤɨɧɰɨɦ ɢɥɢ |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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ɨɬɟɤɟ ɥɟɝɤɢɯ |
ɩɨɥɭɫɢɞɹ |
ɛɨɥɶɧɢɰɭ Ɍɪɚɧɫɩɨɪɬɢɪɨɜɤɚ |
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Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
ɧɚ ɧɨɫɢɥɤɚɯ ɩɨɥɭɫɢɞɹ |
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- ɉɪɟɞɧɢɡɨɥɨɧ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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- ɇɚɬɪɢɹ ɯɥɨɪɢɞɚ - 5 - ɦɥ ɤɝ ɱɚɫ ɜ ɜɟɧɧɨ |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ |
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ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ: |
ɚɤɬɢɜ ɧɚ «103» ɱɟɪɟɡ ɱɚɫɚ |
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- ɩɟɪɟɜɨɞ ɧɚ ɂȼɅ PEEP ɫɦ ɜɨɞ ɫɬ |
ɉɪɢ ɩɨɜɬɨɪɧɨɦ ɨɬɤɚɡɟ – |
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ɉɨɥɨɠɟɧɢɟ ɫ ɩɪɢɩɨɞɧɹɬɵɦ ɝɨɥɨɜɧɵɦ ɤɨɧɰɨɦ ɢɥɢ |
ɚɤɬɢɜ ɜ ɈɇɆɉȼɢȾɇ |
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ɩɨɥɭɫɢɞɹ |
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223 |
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Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ
-ɉɪɟɞɧɢɡɨɥɨɧ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ
-ɇɚɬɪɢɹ ɯɥɨɪɢɞɚ - 5 - ɦɥ ɤɝ ɜ ɜɟɧɧɨ ɛɨɥɸɫɧɨ ɜ ɬɟɱɟɧɢɟ 5 - ɦɢɧ ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ:
-ɩɟɪɟɜɨɞ ɧɚ ɂȼɅ PEEP ɫɦ ɜɨɞ ɫɬ
-ɩɪɢ ɫɧɢɠɟɧɢɢ ɋȺȾ - ɇɚɬɪɢɹ ɯɥɨɪɢɞɚ - ɦɥ ɤɝ ɜ ɜɟɧɧɨ ɛɨɥɸɫɧɨ ɜ
ɨɬ ɜɨɡɪɚɫɬɧɨɣ |
ɬɟɱɟɧɢɟ 10 - ɦɢɧ |
ɧɨɪɦɵ |
- ɇɨɪɷɩɢɧɟɮɪɢɧ - ɦɤɝ ɤɝ ɦɢɧ ɜ ɜɟɧɧɨ ɢɥɢ |
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Ⱦɨɩɚɦɢɧ - ɦɤɝ ɤɝ ɦɢɧ |
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ɫɦ ©ɉɪɢɥɨɠɟɧɢɹ 5 - 37, 29 - 31ª ɫɬɪ 86 - 288, 280 - |
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282) |
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- ɩɪɢ ɧɚɪɚɫɬɚɧɢɢ ɬɹɠɟɫɬɢ ɉɟɪɟɞ ɢɧɬɭɛɚɰɢɟɣ |
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Ⱦɇ ɢ ɪɚɡɜɢɬɢɢ |
- Ⱥɬɪɨɩɢɧ - 0,02 ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɩɨ ɩɨɤɚɡɚɧɢɹɦ |
ɝɢɩɨɤɫɢɱɟɫɤɨɣ ɤɨɦɵ |
ȼɜɨɞɧɚɹ ɚɧɟɫɬɟɡɢɹ ɤɨɦɛɢɧɚɰɢɟɣ ɩɪɟɩɚɪɚɬɨɜ |
(ɩɪɢ SpO2 < 90%) |
ɩɪɨɢɡɜɨɞɢɬɫɹ ɩɪɢ ɭɪɨɜɧɟ ɫɨɡɧɚɧɢɹ ! ɛɚɥɥɨɜ ɩɨ |
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ɲɤɚɥɟ ɤɨɦɵ ȽɅȺɁȽɈ |
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- Ɇɢɞɚɡɨɥɚɦ ɦɝ ɤɝ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ ɢ Ʉɟɬɚɦɢɧ |
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1 - ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɢɥɢ - Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢ Ʉɟɬɚɦɢɧ |
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1 - ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɢɥɢ - ɉɪɨɩɨɮɨɥ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ |
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ɋɚɧɚɰɢɹ ɜɟɪɯɧɢɯ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ |
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ɂɧɬɭɛɚɰɢɹ ɬɪɚɯɟɢ ɢɥɢ ɩɪɢɦɟɧɟɧɢɟ ɥɚɪɢɧɝɟɚɥɶɧɨɣ |
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ɬɪɭɛɤɢ |
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ɂȼɅ ȼȼɅ ɫ FiO2 0.5 - 1.0 |
224
E10ɋɚɯɚɪɧɵɣ ɞɢɚɛɟɬ |
• Ƚɥɸɤɨɦɟɬɪɢɹ |
Ⱥɤɬɢɜ ɜ ɩɨɥɢɤɥɢɧɢɤɭ |
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E16 |
ɉɭɥɶɫɨɤɫɢɦɟɬɪɢɹ |
2. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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• Ɉɤɫɢɝɟɧɨɬɟɪɚɩɢɹ ɩɪɢ SpO2 - FiO2 0.5 - 1.0 |
ɛɨɥɶɧɢɰɭ ɩɪɢ ɧɚɪɭɲɟɧɢɢ |
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ɫɨɡɧɚɧɢɹ ɢ ɜɩɟɪɜɵɟ |
Ɋ |
- ɝɢɩɨɝɥɢɤɟɦɢɱɟɫɤɨɟ |
Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
ɜɵɹɜɥɟɧɧɨɦ ɫɚɯɚɪɧɨɦ |
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ɫɨɫɬɨɹɧɢɟ ɝɥɸɤɨɡɚ ɤɪɨɜɢ |
- Ⱦɟɤɫɬɪɨɡɚ ɜ ɜɟɧɧɨ ɫɬɪɭɣɧɨ ɦɟɞɥɟɧɧɨ |
ɞɢɚɛɟɬɟ |
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ɦɦɨɥɶ ɥ |
ɞɨ ɝɨɞɚ - 10% - ɦɥ ɤɝ |
ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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1 - ɥɟɬ - 20% - 2 ɦɥ ɤɝ ɦɝ ɦɥ ɜ ɪɚɡɜɟɞɟɧɢɢ ɜɨɞɵ |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɞɥɹ ɢɧɴɟɤɰɢɢ |
ɚɤɬɢɜ ɧɚ «103» ɱɟɪɟɡ ɱɚɫɚ |
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ɫɬɚɪɲɟ ɥɟɬ - 30% - ɦɥ ɤɝ ɦɝ ɦɥ ɜ ɪɚɡɜɟɞɟɧɢɢ ɉɪɢ ɩɨɜɬɨɪɧɨɦ ɨɬɤɚɡɟ |
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ɜɨɞɵ ɞɥɹ ɢɧɴɟɤɰɢɢ ɧɨ ɧɟ ɛɨɥɟɟ ɦɥ |
ɚɤɬɢɜ ɜ ɩɨɥɢɤɥɢɧɢɤɭ |
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ɉɨɜɬɨɪɧɚɹ ɝɥɸɤɨɦɟɬɪɢɹ |
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- ɝɢɩɨɝɥɢɤɟɦɢɱɟɫɤɚɹ ɤɨɦɚ |
Ⱦɟɤɫɬɪɨɡɚ ɜ ɜɟɧɧɨ ɫɬɪɭɣɧɨ ɦɟɞɥɟɧɧɨ |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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ɞɨ ɝɨɞɚ - 10% - ɦɥ ɤɝ |
ɛɨɥɶɧɢɰɭ |
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1 - ɥɟɬ - 20% - ɦɥ ɤɝ ɦɝ ɦɥ ɜ ɪɚɡɜɟɞɟɧɢɢ ɜɨɞɵ ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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ɞɥɹ ɢɧɴɟɤɰɢɢ |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɫɬɚɪɲɟ ɥɟɬ - 30% - ɦɥ ɤɝ ɦɝ ɦɥ ɜ ɪɚɡɜɟɞɟɧɢɢ |
ɚɤɬɢɜ ɧɚ «103» ɱɟɪɟɡ ɱɚɫɚ |
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ɜɨɞɵ ɞɥɹ ɢɧɴɟɤɰɢɢ ɧɨ ɧɟ ɛɨɥɟɟ ɦɥ |
ɉɪɢ ɩɨɜɬɨɪɧɨɦ ɨɬɤɚɡɟ – |
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ɉɨɜɬɨɪɧɚɹ ɝɥɸɤɨɦɟɬɪɢɹ |
ɚɤɬɢɜ ɜ ɩɨɥɢɤɥɢɧɢɤɭ |
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ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
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- Ⱦɟɤɫɬɪɨɡɚ - 10 - ɦɥ ɤɝ ɜ ɜɟɧɧɨ ɤɚɩɟɥɶɧɨ - |
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ɤɚɩɟɥɶ ɜ ɦɢɧɭɬɭ |
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- Ⱦɟɤɫɚɦɟɬɚɡɨɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɫɬɪɭɣɧɨ |
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ɉɨɜɬɨɪɧɚɹ ɝɥɸɤɨɦɟɬɪɢɹ |
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- ɩɪɢ ɧɚɪɭɲɟɧɢɢ ɞɵɯɚɧɢɹ ɉɟɪɟɞ ɢɧɬɭɛɚɰɢɟɣȾɇ ,,,-,9 ɫɬ - Ⱥɬɪɨɩɢɧ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɩɨ ɩɨɤɚɡɚɧɢɹɦ
ȼɜɨɞɧɚɹ ɚɧɟɫɬɟɡɢɹ ɤɨɦɛɢɧɚɰɢɟɣ ɩɪɟɩɚɪɚɬɨɜɩɪɨɢɡɜɨɞɢɬɫɹ ɩɪɢ ɭɪɨɜɧɟ ɫɨɡɧɚɧɢɹ ! ɛɚɥɥɨɜ ɩɨ ɲɤɚɥɟ ɤɨɦɵ ȽɅȺɁȽɈ
225
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- Ɇɢɞɚɡɨɥɚɦ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ ɢ |
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Ʉɟɬɚɦɢɧ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɢɥɢ - Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢ Ʉɟɬɚɦɢɧ - 2 |
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ɦɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɢɥɢ - ɉɪɨɩɨɮɨɥ 2 - 4 ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ |
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ɋɚɧɚɰɢɹ ɜɟɪɯɧɢɯ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣ |
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ɂɧɬɭɛɚɰɢɹ ɬɪɚɯɟɢ ɢɥɢ ɩɪɢɦɟɧɟɧɢɟ ɥɚɪɢɧɝɟɚɥɶɧɨɣ |
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ɬɪɭɛɤɢ |
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ɂȼɅ ȼȼɅ ɫ FiO2 0.5 |
|
- ɞɢɚɛɟɬɢɱɟɫɤɢɣ |
• Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
ɤɟɬɨɚɰɢɞɨɡ |
- ɇɚɬɪɢɹ ɯɥɨɪɢɞ - ɦɥ ɤɝ*ɱɚɫ ɜ ɜɟɧɧɨ ɤɚɩɟɥɶɧɨ |
ɛɨɥɶɧɢɰɭ |
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ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
- ɞɢɚɛɟɬɢɱɟɫɤɢɟ |
• Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
ɝɢɩɟɪɝɥɢɤɟɦɢɱɟɫɤɢɟ ɤɨɦɵ - ɇɚɬɪɢɹ ɯɥɨɪɢɞ 0,9 % - ɦɥ ɤɝ*ɱɚɫ ɜ ɜɟɧɧɨ ɤɚɩɟɥɶɧɨ ɚɤɬɢɜ ɧɚ «103» ɱɟɪɟɡ ɱɚɫɚ |
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• Ɉɤɫɢɝɟɧɨɬɟɪɚɩɢɹ ɩɪɢ SpO2 - FiO2 0.5 - 1.0 |
ɉɪɢ ɩɨɜɬɨɪɧɨɦ ɨɬɤɚɡɟ – |
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ɚɤɬɢɜ ɜ ɩɨɥɢɤɥɢɧɢɤɭ |
- ɩɪɢ ɧɚɪɭɲɟɧɢɢ ɞɵɯɚɧɢɹ ɉɟɪɟɞ ɢɧɬɭɛɚɰɢɟɣȾɇ ,,,-,9 ɫɬ - Ⱥɬɪɨɩɢɧ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɩɨ ɩɨɤɚɡɚɧɢɹɦ
ȼɜɨɞɧɚɹ ɚɧɟɫɬɟɡɢɹ ɤɨɦɛɢɧɚɰɢɟɣ ɩɪɟɩɚɪɚɬɨɜɩɪɨɢɡɜɨɞɢɬɫɹ ɩɪɢ ɭɪɨɜɧɟ ɫɨɡɧɚɧɢɹ ! ɛɚɥɥɨɜ ɩɨ ɲɤɚɥɟ ɤɨɦɵ ȽɅȺɁȽɈ - Ɇɢɞɚɡɨɥɚɦ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ ɢ
Ʉɟɬɚɦɢɧ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢɥɢ - Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢ Ʉɟɬɚɦɢɧ - 2 ɦɝ ɤɝ ɜ ɜɟɧɧɨ
ɢɥɢ - ɉɪɨɩɨɮɨɥ 2 - 4 ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊɋɚɧɚɰɢɹ ɜɟɪɯɧɢɯ ɞɵɯɚɬɟɥɶɧɵɯ ɩɭɬɟɣɂɧɬɭɛɚɰɢɹ ɬɪɚɯɟɢ ɢɥɢ ɩɪɢɦɟɧɟɧɢɟ ɥɚɪɢɧɝɟɚɥɶɧɨɣ
ɬɪɭɛɤɢ
ɂȼɅ ȼȼɅ ɫ FiO2 0.5
226
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- ɩɪɢ ɝɢɩɨɜɨɥɟɦɢɱɟɫɤɨɦ |
ɋɦ ɩɨɞɪɚɡɞɟɥ ɞɚɧɧɨɝɨ ɪɚɡɞɟɥɚ «Ƚɢɩɨɜɨɥɟɦɢɱɟɫɤɢɣ |
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ɲɨɤɟ |
ɲɨɤ» ɫɬɪ 214 |
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Ʉɚɪɞɢɨɥɨɝɢɱɟɫɤɢɟ ɡɚɛɨɥɟɜɚɧɢɹ ɭ ɞɟɬɟɣ |
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I47 |
Ɍɚɯɢɫɢɫɬɨɥɢɱɟɫɤɢɟ |
ɗɄȽ |
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ɧɚɪɭɲɟɧɢɹ ɫɟɪɞɟɱɧɨɝɨ |
ɉɭɥɶɫɨɤɫɢɦɟɬɪɢɹ |
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ɪɢɬɦɚ |
• Ɉɤɫɢɝɟɧɨɬɟɪɚɩɢɹ ɩɪɢ SpO2 - FiO2 0.5 |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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ɉɚɪɨɤɫɢɡɦɚɥɶɧɚɹ |
ȼɚɝɭɫɧɵɟ ɩɪɨɛɵ (ɩɪɨɬɢɜɨɩɨɤɚɡɚɧɚ ɩɪɨɛɚ Ⱥɲɧɟɪɚ) |
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ɬɚɯɢɤɚɪɞɢɹ ɫ ɭɡɤɢɦ |
- Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢɥɢ ɜ ɦɵɲɟɱɧɨ |
ɛɨɥɶɧɢɰɭ. Ɍɪɚɧɫɩɨɪɬɢɪɨɜɤɚ |
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ɤɨɦɩɥɟɤɫɨɦ QRS |
ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ ɱɟɪɟɡ ɦɢɧɭɬ |
ɧɚ ɧɨɫɢɥɤɚɯ |
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ɋɨɫɬɨɹɧɢɟ ɫɪɟɞɧɟɣ |
• Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
2 ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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ɬɹɠɟɫɬɢ ɝɟɦɨɞɢɧɚɦɢɤɚ |
- Ɍɪɢɮɨɫɚɞɟɧɢɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɛɨɥɸɫɨɦ |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɫɬɚɛɢɥɶɧɚɹ |
ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
ɚɤɬɢɜ ɧɚ «103» ɱɟɪɟɡ ɱɚɫɚ |
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- Ɍɪɢɮɨɫɚɞɟɧɢɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɛɨɥɸɫɨɦ |
3 ɉɪɢ ɩɨɜɬɨɪɧɨɦ ɨɬɤɚɡɟ – |
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ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ ɱɟɪɟɡ ɦɢɧɭɬ ɢɥɢ ɩɪɢ |
ɚɤɬɢɜ ɜ ɈɇɆɉȼɢȾɇ |
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ɧɚɥɢɱɢɢ ɭ ɛɨɥɶɧɨɝɨ ɦɚɧɢɮɟɫɬɧɨɝɨ ɫɢɧɞɪɨɦɚ WPW: |
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- Ⱥɦɢɨɞɚɪɨɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɤɚɩɟɥɶɧɨ ɜ ɬɟɱɟɧɢɟ ɧɟ |
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ɦɟɧɟɟ ɦɢɧɭɬ ɜɨ ɜɪɟɦɹ ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ |
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ɫɦ «ɉɪɢɥɨɠɟɧɢɟ 40» ɫɬɪ 291) |
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ɋɨɫɬɨɹɧɢɟ ɬɹɠɟɥɨɟ |
• Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
1. Ɇɟɞɢɰɢɧɫɤɚɹ ɷɜɚɤɭɚɰɢɹ ɜ |
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ɝɟɦɨɞɢɧɚɦɢɤɚ |
ȼɜɨɞɧɚɹ ɚɧɟɫɬɟɡɢɹ ɤɨɦɛɢɧɚɰɢɟɣ ɩɪɟɩɚɪɚɬɨɜ |
ɛɨɥɶɧɢɰɭ Ɍɪɚɧɫɩɨɪɬɢɪɨɜɤɚ |
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ɧɟɫɬɚɛɢɥɶɧɚɹ - ɩɪɢ |
- Ɇɢɞɚɡɨɥɚɦ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ ɢ |
ɧɚ ɧɨɫɢɥɤɚɯ |
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ɫɧɢɠɟɧɢɢ ɋȺȾ |
Ɏɟɧɬɚɧɢɥ - ɦɤɝ ɤɝ ɜ ɜɟɧɧɨ |
ɉɪɢ ɨɬɤɚɡɟ ɨɬ |
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ɨɬ ɜɨɡɪɚɫɬɧɨɣ |
ɢɥɢ - Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢ Ɏɟɧɬɚɧɢɥ - 4 |
ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ – |
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ɧɨɪɦɵ |
ɦɤɝ ɤɝ ɜ ɜɟɧɧɨ |
ɚɤɬɢɜ ɧɚ «103» ɱɟɪɟɡ ɱɚɫɚ |
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ɢɥɢ - ɉɪɨɩɨɮɨɥ - ɦɝ ɤɝ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ |
ɉɪɢ ɩɨɜɬɨɪɧɨɦ ɨɬɤɚɡɟ – |
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ɋɢɧɯɪɨɧɢɡɢɪɨɜɚɧɧɚɹ ɷɥɟɤɬɪɨɤɚɪɞɢɨɜɟɪɫɢɹ - 2 |
ɚɤɬɢɜ ɜ ɈɇɆɉȼɢȾɇ |
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Ⱦɠ ɤɝ |
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ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
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ɋɢɧɯɪɨɧɢɡɢɪɨɜɚɧɧɚɹ ɷɥɟɤɬɪɨɤɚɪɞɢɨɜɟɪɫɢɹ Ⱦɠ ɤɝ |
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227 |
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ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
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- Ⱥɦɢɨɞɚɪɨɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɤɚɩɟɥɶɧɨ ɜ ɬɟɱɟɧɢɟ ɧɟ |
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ɦɟɧɟɟ ɦɢɧɭɬ ɜɨ ɜɪɟɦɹ ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ |
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ɫɦ «ɉɪɢɥɨɠɟɧɢɟ 40» ɫɬɪ 91) |
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• ɋɢɧɯɪɨɧɢɡɢɪɨɜɚɧɧɚɹ ɷɥɟɤɬɪɨɤɚɪɞɢɨɜɟɪɫɢɹ Ⱦɠ ɤɝ |
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ɧɚ ɮɨɧɟ ɢɧɮɭɡɢɢ Ⱥɦɢɨɞɚɪɨɧɚ |
Ɏɢɛɪɢɥɥɹɰɢɹ-ɬɪɟɩɟɬɚɧɢɟ |
• Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
ɩɪɟɞɫɟɪɞɢɣ |
- Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢɥɢ ɜ ɦɵɲɟɱɧɨ |
ɩɚɪɨɤɫɢɡɦɚɥɶɧɚɹ ɮɨɪɦɚ |
- ɉɪɨɤɚɢɧɚɦɢɞ ɦɝ ɤɝ ɢ Ɏɟɧɢɥɷɮɪɢɧ ɦɥ ɜ ɨɞɧɨɦ |
ɩɪɢɫɬɭɩ |
ɲɩɪɢɰɟ ɜɧɟ ɡɚɜɢɫɢɦɨɫɬɢ ɨɬ ɜɨɡɪɚɫɬɚ ɜ ɜɟɧɧɨ |
ɩɪɨɞɨɥɠɢɬɟɥɶɧɨɫɬɶɸ ɞɨ |
ɦɟɞɥɟɧɧɨ |
ɱɚɫɨɜ |
ɉɪɢ QRS ! ɫɟɤ ɉɪɨɤɚɢɧɚɦɢɞ ɩɪɨɬɢɜɨɩɨɤɚɡɚɧ |
ɋɨɫɬɨɹɧɢɟ ɫɪɟɞɧɟɣ |
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ɬɹɠɟɫɬɢ ɝɟɦɨɞɢɧɚɦɢɤɚ |
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ɫɬɚɛɢɥɶɧɚɹ |
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Ɏɢɛɪɢɥɥɹɰɢɹ-ɬɪɟɩɟɬɚɧɢɟ |
ɇɟ ɬɪɟɛɭɟɬ ɥɟɱɟɧɢɹ ɧɚ ɷɬɚɩɟ ɨɤɚɡɚɧɢɹ ɫɤɨɪɨɣ |
ɩɪɟɞɫɟɪɞɢɣ |
ɦɟɞɢɰɢɧɫɤɨɣ ɩɨɦɨɳɢ |
-ɩɚɪɨɤɫɢɡɦɚɥɶɧɚɹ ɮɨɪɦɚ ɩɪɢɫɬɭɩ ɩɪɨɞɨɥɠɢɬɟɥɶɧɨɫɬɶɸ ɛɨɥɟɟ ɱɚɫɨɜ ɢɥɢ ɩɪɨɞɨɥɠɢɬɟɥɶɧɨɫɬɶ ɩɪɢɫɬɭɩɚ ɧɟɢɡɜɟɫɬɧɚ
-ɬɚɯɢɫɢɫɬɨɥɢɱɟɫɤɚɹ
ɩɟɪɫɢɫɬɢɪɭɸɳɚɹ ɩɨɫɬɨɹɧɧɚɹ ɮɨɪɦɚ ɋɨɫɬɨɹɧɢɟ ɫɪɟɞɧɟɣ ɬɹɠɟɫɬɢ ɝɟɦɨɞɢɧɚɦɢɤɚ ɫɬɚɛɢɥɶɧɚɹ
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Ɏɢɛɪɢɥɥɹɰɢɹ - |
• Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
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ɬɪɟɩɟɬɚɧɢɟ ɩɪɟɞɫɟɪɞɢɣ |
ȼɜɨɞɧɚɹ ɚɧɟɫɬɟɡɢɹ ɤɨɦɛɢɧɚɰɢɟɣ ɩɪɟɩɚɪɚɬɨɜ |
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ɩɚɪɨɤɫɢɡɦɚɥɶɧɚɹ ɮɨɪɦɚ ɫ |
- Ɇɢɞɚɡɨɥɚɦ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ ɢ |
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ɩɪɨɜɟɞɟɧɢɟɦ ɩɨ |
Ɏɟɧɬɚɧɢɥ - ɦɤɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɞɨɩɨɥɧɢɬɟɥɶɧɨɦɭ |
ɢɥɢ - Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢ Ɏɟɧɬɚɧɢɥ - 4 |
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ɩɪɟɞɫɟɪɞɧɨ- |
ɦɤɝ ɤɝ ɜ ɜɟɧɧɨ |
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ɠɟɥɭɞɨɱɤɨɜɨɦɭ |
ɢɥɢ - ɉɪɨɩɨɮɨɥ - ɦɝ ɤɝ ɞɥɹ ɛɪɢɝɚɞ ȺɢɊ |
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ɫɨɟɞɢɧɟɧɢɸ |
ɋɢɧɯɪɨɧɢɡɢɪɨɜɚɧɧɚɹ ɷɥɟɤɬɪɨɤɚɪɞɢɨɜɟɪɫɢɹ - 2 |
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ɋɨɫɬɨɹɧɢɟ ɬɹɠɟɥɨɟ |
Ⱦɠ ɤɝ |
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ɝɟɦɨɞɢɧɚɦɢɤɚ |
ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ ɧɟ ɪɚɧɟɟ ɱɟɦ ɱɟɪɟɡ - 3 |
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ɧɟɫɬɚɛɢɥɶɧɚɹ - ɩɪɢ |
ɦɢɧɭɬɵ |
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ɫɧɢɠɟɧɢɢ ɋȺȾ |
ɋɢɧɯɪɨɧɢɡɢɪɨɜɚɧɧɚɹ ɷɥɟɤɬɪɨɤɚɪɞɢɨɜɟɪɫɢɹ Ⱦɠ ɤɝ |
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ɨɬ ɜɨɡɪɚɫɬɧɨɣ |
ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
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ɧɨɪɦɵ |
- Ⱥɦɢɨɞɚɪɨɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɤɚɩɟɥɶɧɨ ɜ ɬɟɱɟɧɢɟ ɧɟ |
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ɦɟɧɟɟ ɦɢɧɭɬ ɜɨ ɜɪɟɦɹ ɦɟɞɢɰɢɧɫɤɨɣ ɷɜɚɤɭɚɰɢɢ |
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ɫɦ «ɉɪɢɥɨɠɟɧɢɟ 40» ɫɬɪ 91) |
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• ɋɢɧɯɪɨɧɢɡɢɪɨɜɚɧɧɚɹ ɷɥɟɤɬɪɨɤɚɪɞɢɨɜɟɪɫɢɹ Ⱦɠ ɤɝ |
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ɧɚ ɮɨɧɟ ɢɧɮɭɡɢɢ Ⱥɦɢɨɞɚɪɨɧɚ |
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Ɏɢɛɪɢɥɥɹɰɢɹ-ɬɪɟɩɟɬɚɧɢɟ |
ɇɟ ɬɪɟɛɭɟɬ ɥɟɱɟɧɢɹ ɧɚ ɷɬɚɩɟ ɨɤɚɡɚɧɢɹ ɫɤɨɪɨɣ |
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ɩɪɟɞɫɟɪɞɢɣ ɧɨɪɦɨɢɥɢ |
ɦɟɞɢɰɢɧɫɤɨɣ ɩɨɦɨɳɢ |
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ɛɪɚɞɢɫɢɫɬɨɥɢɱɟɫɤɚɹ |
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ɩɟɪɫɢɫɬɢɪɭɳɚɹ |
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ɩɨɫɬɨɹɧɧɚɹ ɮɨɪɦɚ |
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ɝɟɦɨɞɢɧɚɦɢɤɚ ɫɬɚɛɢɥɶɧɚɹ |
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ɉɚɪɨɤɫɢɡɦɚɥɶɧɚɹ |
• Ʉɚɬɟɬɟɪɢɡɚɰɢɹ ɜɟɧɵ ɢɥɢ ɜɧɭɬɪɢɤɨɫɬɧɵɣ ɞɨɫɬɭɩ |
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ɬɚɯɢɤɚɪɞɢɹ ɫ ɲɢɪɨɤɢɦ |
- Ⱦɢɚɡɟɩɚɦ - ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɢɥɢ ɜ ɦɵɲɟɱɧɨ |
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ɤɨɦɩɥɟɤɫɨɦ QRS |
- Ɍɪɢɮɨɫɚɞɟɧɢɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɛɨɥɸɫɨɦ |
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ɦɨɧɨɦɨɪɮɧɚɹ |
ɉɪɢ ɨɬɫɭɬɫɬɜɢɢ ɷɮɮɟɤɬɚ |
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ɋɨɫɬɨɹɧɢɟ ɫɪɟɞɧɟɣ |
- Ʌɢɞɨɤɚɢɧ ɦɝ ɤɝ ɜ ɜɟɧɧɨ ɜɜɨɞɢɬɶ ɬɨɥɶɤɨ ɪɚɫɬɜɨɪ |
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ɬɹɠɟɫɬɢ ɝɟɦɨɞɢɧɚɦɢɤɚ |
ɪɚɡɜɟɞɟɧɢɟ ɪɚɫɬɜɨɪɚ ɜ ɫɨɨɬɧɨɲɟɧɢɢ |
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ɫɬɚɛɢɥɶɧɚɹ |
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229 |
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