{"id":2947,"date":"2025-11-30T10:00:00","date_gmt":"2025-11-30T03:00:00","guid":{"rendered":"https:\/\/nurseanesthetist1999.com\/?p=2947"},"modified":"2025-11-30T23:39:38","modified_gmt":"2025-11-30T16:39:38","slug":"may-soc-dien","status":"publish","type":"post","link":"https:\/\/nurseanesthetist1999.com\/?p=2947","title":{"rendered":"M\u00e1y S\u1ed1c \u0110i\u1ec7n"},"content":{"rendered":"\n
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N\u1ebfu b\u1ea1n \u0111\u1ec3 \u00fd th\u00ec th\u1eddi gian g\u1ea7n \u0111\u00e2y m\u00e1y s\u1ed1c \u0111i\u1ec7n \u0111\u01b0\u1ee3c trang b\u1ecb ph\u1ed5 bi\u1ebfn h\u01a1n t\u1ea1i Vi\u1ec7t Nam. M\u1ed9t v\u00ed d\u1ee5 d\u1ec5 th\u1ea5y, g\u1ea7n \u0111\u00e2y trong m\u1ed9t l\u1ea7n th\u0103m b\u1ec7nh t\u1ea1i b\u1ec7nh vi\u1ec7n t\u01b0, m\u00ecnh \u0111\u1ec3 \u00fd th\u1ea5y m\u00e1y s\u1ed1c \u0111i\u1ec7n \u0111\u01b0\u1ee3c trang b\u1ecb t\u1ea1i m\u1ed7i t\u1ea7ng c\u1ee7a b\u1ec7nh vi\u1ec7n. Hay kh\u00f4ng \u1edf \u0111\u00e2u xa t\u1ea1i c\u01a1 s\u1edf y t\u1ebf m\u00ecnh \u0111ang l\u00e0m vi\u1ec7c, vi\u1ec7c ki\u1ec3m tra t\u00ecnh tr\u1ea1ng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a m\u00e1y s\u1ed1c \u0111i\u1ec7n lu\u00f4n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n m\u1ed7i ng\u00e0y v\u00e0 vi\u1ec7c t\u00e1i \u0111\u00e0o t\u1ea1o c\u00e1c tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng m\u00e1y s\u1ed1c \u0111i\u1ec7n lu\u00f4n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n h\u00e0ng n\u0103m. Vi\u1ec7c hi\u1ec3u r\u00f5 nguy\u00ean l\u00fd ho\u1ea1t \u0111\u1ed9ng v\u00e0 s\u1eed d\u1ee5ng \u0111\u00fang c\u00e1ch thi\u1ebft b\u1ecb n\u00e0y l\u00e0 v\u00f4 c\u00f9ng c\u1ea7n thi\u1ebft, kh\u00f4ng ch\u1ec9 \u0111\u1ed1i v\u1edbi nh\u00e2n vi\u00ean y t\u1ebf m\u00e0 c\u00f2n gi\u00fap c\u1ed9ng \u0111\u1ed3ng c\u00f3 th\u00eam ki\u1ebfn th\u1ee9c \u0111\u1ec3 \u1ee9ng ph\u00f3 hi\u1ec7u qu\u1ea3 v\u1edbi nh\u1eefng t\u00ecnh hu\u1ed1ng kh\u1ea9n c\u1ea5p, t\u1eeb \u0111\u00f3 n\u00e2ng cao c\u01a1 h\u1ed9i c\u1ee9u s\u1ed1ng ng\u01b0\u1eddi b\u1ec7nh [1].<\/p>\n<\/div><\/div>\n\n\n\n

N\u1ed9i dung b\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c tham kh\u1ea3o t\u1eeb c\u00e1c li\u1ec7u ch\u00ednh d\u01b0\u1edbi \u0111\u00e2y<\/strong> :<\/p>\n\n\n\n

[1] NHLBI, NIH (2023).\u00a0How Do Defibrillators Work<\/a>.\u00a0<\/p>\n\n\n\n

[2] Goyal A, Chhabra L, Singh B, Cooper JS (2025).\u00a0Defibrillation<\/a>. StatPearls – NCBI Bookshelf.\u00a0<\/p>\n\n\n\n

[3] FDA (2023).\u00a0How AEDs in Public Places Can Restart Hearts<\/a>.\u00a0<\/p>\n\n\n\n

[4] Liddle R, Davies CS, Colquhoun M, Handley AJ (2003).\u00a0The automated external defibrillator<\/a>. PMC.<\/p>\n\n\n\n

I. M\u00e1y s\u1ed1c \u0111i\u1ec7n l\u00e0 g\u00ec?<\/h2>\n\n\n\n

M\u00e1y s\u1ed1c \u0111i\u1ec7n (defibrillator) l\u00e0 m\u1ed9t thi\u1ebft b\u1ecb \u0111i\u1ec7n t\u1eed y t\u1ebf s\u1eed d\u1ee5ng m\u1ed9t xung \u0111i\u1ec7n n\u0103ng l\u01b0\u1ee3ng cao \u0111\u1ec3 kh\u1eed c\u1ef1c \u0111\u1ed3ng lo\u1ea1t c\u00e1c t\u1ebf b\u00e0o c\u01a1 tim, nh\u1eb1m ch\u1ea5m d\u1ee9t c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp tim nguy hi\u1ec3m v\u00e0 cho ph\u00e9p n\u00fat xoang nh\u0129 (n\u00fat ph\u00e1t nh\u1ecbp t\u1ef1 nhi\u00ean c\u1ee7a tim) t\u00e1i l\u1eadp m\u1ed9t nh\u1ecbp \u0111\u1eadp hi\u1ec7u qu\u1ea3 [2]. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ng\u1eebng tim \u0111\u1ed9t ng\u1ed9t do rung th\u1ea5t ho\u1eb7c nh\u1ecbp nhanh th\u1ea5t v\u00f4 m\u1ea1ch<\/strong>, s\u1ed1c \u0111i\u1ec7n l\u00e0<\/strong> ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 nh\u1ea5t<\/strong>, gi\u00fap t\u0103ng \u0111\u00e1ng k\u1ec3 t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t c\u1ee7a b\u1ec7nh nh\u00e2n [1].<\/p><\/div>\n\n\n\n

Ngo\u00e0i ch\u1ee9c n\u0103ng s\u1ed1c \u0111i\u1ec7n (defibrillation)<\/strong> cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p ng\u1eebng tim, m\u00e1y s\u1ed1c \u0111i\u1ec7n c\u00f2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 th\u1ef1c hi\u1ec7n\u00a0chuy\u1ec3n nh\u1ecbp (cardioversion)<\/strong>\u00a0\u2013 m\u1ed9t th\u1ee7 thu\u1eadt t\u01b0\u01a1ng t\u1ef1 nh\u01b0ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n c\u00f3 ki\u1ec3m so\u00e1t h\u01a1n, th\u01b0\u1eddng d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp tim kh\u00f4ng nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng ngay l\u1eadp t\u1ee9c nh\u01b0ng g\u00e2y ra tri\u1ec7u ch\u1ee9ng ho\u1eb7c c\u00f3 nguy c\u01a1 bi\u1ebfn ch\u1ee9ng, nh\u01b0 rung nh\u0129 (Atrial Fibrillation – AF) ho\u1eb7c nh\u1ecbp nhanh tr\u00ean th\u1ea5t (Supraventricular Tachycardia – SVT).<\/p><\/div>\n\n\n\n

C\u00f3 nhi\u1ec1u lo\u1ea1i m\u00e1y s\u1ed1c \u0111i\u1ec7n kh\u00e1c nhau, \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf cho c\u00e1c m\u00f4i tr\u01b0\u1eddng v\u00e0 \u0111\u1ed1i t\u01b0\u1ee3ng s\u1eed d\u1ee5ng kh\u00e1c nhau:<\/p><\/div>\n\n\n\n

\"\"<\/figure>
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+<\/strong> M\u00e1y s\u1ed1c \u0111i\u1ec7n ngo\u00e0i t\u1ef1 \u0111\u1ed9ng (Automated External Defibrillator – AED):<\/strong>\u00a0\u0110\u00e2y l\u00e0 lo\u1ea1i m\u00e1y \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 s\u1eed d\u1ee5ng cho c\u1ea3 ng\u01b0\u1eddi kh\u00f4ng chuy\u00ean v\u00e0 nh\u00e2n vi\u00ean y t\u1ebf. AED c\u00f3 kh\u1ea3 n\u0103ng t\u1ef1 \u0111\u1ed9ng ph\u00e2n t\u00edch nh\u1ecbp tim v\u00e0 \u0111\u01b0a ra h\u01b0\u1edbng d\u1eabn b\u1eb1ng gi\u1ecdng n\u00f3i, ch\u1ec9 \u0111\u1ecbnh c\u00f3 c\u1ea7n s\u1ed1c \u0111i\u1ec7n hay kh\u00f4ng [3]. M\u00e1y th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u1eb7t \u1edf nh\u1eefng n\u01a1i c\u00f4ng c\u1ed9ng nh\u01b0 s\u00e2n bay, trung t\u00e2m th\u01b0\u01a1ng m\u1ea1i, tr\u01b0\u1eddng h\u1ecdc.<\/p><\/div>\n<\/div><\/div>\n\n\n\n

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+<\/strong> M\u00e1y s\u1ed1c \u0111i\u1ec7n th\u1ee7 c\u00f4ng (Manual Defibrillator):<\/strong>\u00a0Lo\u1ea1i n\u00e0y ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng b\u1edfi nh\u00e2n vi\u00ean y t\u1ebf \u0111\u01b0\u1ee3c \u0111\u00e0o t\u1ea1o chuy\u00ean s\u00e2u. Ng\u01b0\u1eddi s\u1eed d\u1ee5ng ph\u1ea3i t\u1ef1 ph\u00e2n t\u00edch \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 (ECG), ch\u1ecdn m\u1ee9c n\u0103ng l\u01b0\u1ee3ng th\u00edch h\u1ee3p v\u00e0 th\u1ef1c hi\u1ec7n s\u1ed1c \u0111i\u1ec7n [2]. M\u00e1y th\u01b0\u1eddng c\u00f3 nhi\u1ec1u ch\u1ee9c n\u0103ng ph\u1ee9c t\u1ea1p h\u01a1n, bao g\u1ed3m theo d\u00f5i ECG, t\u1ea1o nh\u1ecbp (pacing) v\u00e0 chuy\u1ec3n nh\u1ecbp (cardioversion).<\/p><\/div>\n<\/div>

\"\"<\/figure><\/div>\n\n\n\n
\"\"<\/figure>
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+<\/strong> M\u00e1y s\u1ed1c \u0111i\u1ec7n c\u1ea5y gh\u00e9p (Implantable Cardioverter Defibrillator – ICD):<\/strong>\u00a0L\u00e0 m\u1ed9t thi\u1ebft b\u1ecb nh\u1ecf \u0111\u01b0\u1ee3c c\u1ea5y d\u01b0\u1edbi da ng\u1ef1c ho\u1eb7c b\u1ee5ng c\u1ee7a b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao b\u1ecb r\u1ed1i lo\u1ea1n nh\u1ecbp tim nguy hi\u1ec3m. ICD li\u00ean t\u1ee5c theo d\u00f5i nh\u1ecbp tim v\u00e0 t\u1ef1 \u0111\u1ed9ng ph\u00e1t xung \u0111i\u1ec7n khi ph\u00e1t hi\u1ec7n nh\u1ecbp tim b\u1ea5t th\u01b0\u1eddng [1].<\/p><\/div>\n<\/div><\/div>\n\n\n\n

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+<\/strong> M\u00e1y s\u1ed1c \u0111i\u1ec7n \u0111eo ngo\u00e0i (Wearable Cardioverter Defibrillator – WCD):<\/strong>\u00a0\u0110\u00e2y l\u00e0 m\u1ed9t thi\u1ebft b\u1ecb \u0111eo \u0111\u01b0\u1ee3c, th\u01b0\u1eddng d\u01b0\u1edbi d\u1ea1ng \u00e1o vest, d\u00e0nh cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao b\u1ecb r\u1ed1i lo\u1ea1n nh\u1ecbp tim nh\u01b0ng ch\u01b0a \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n c\u1ea5y ICD ho\u1eb7c \u0111ang ch\u1edd c\u1ea5y gh\u00e9p. WCD c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n nh\u1ecbp t\u1ef1 \u0111\u1ed9ng.<\/p><\/div>\n<\/div>

\"\"<\/figure><\/div>\n\n\n\n

II. Nguy\u00ean l\u00fd ho\u1ea1t \u0111\u1ed9ng c\u1ee7a m\u00e1y s\u1ed1c \u0111i\u1ec7n<\/h2>\n\n\n\n

Tim c\u1ee7a ch\u00fang ta ho\u1ea1t \u0111\u1ed9ng nh\u01b0 m\u1ed9t m\u00e1y b\u01a1m li\u00ean t\u1ee5c nh\u1edd v\u00e0o h\u1ec7 th\u1ed1ng d\u1eabn truy\u1ec1n \u0111i\u1ec7n \u0111\u1eb7c bi\u1ec7t. Trong h\u1ec7 th\u1ed1ng n\u00e0y,\u00a0n\u00fat xoang nh\u0129 (sinoatrial node – SA node)<\/strong>, n\u1eb1m \u1edf t\u00e2m nh\u0129 ph\u1ea3i, \u0111\u00f3ng vai tr\u00f2 l\u00e0 m\u00e1y t\u1ea1o nh\u1ecbp t\u1ef1 nhi\u00ean, ph\u00e1t ra c\u00e1c xung \u0111i\u1ec7n \u0111\u1ec1u \u0111\u1eb7n. C\u00e1c xung \u0111i\u1ec7n n\u00e0y sau \u0111\u00f3 lan truy\u1ec1n qua t\u00e2m nh\u0129, l\u00e0m t\u00e2m nh\u0129 co b\u00f3p, r\u1ed3i d\u1eabn \u0111\u1ebfn\u00a0n\u00fat nh\u0129 th\u1ea5t (atrioventricular node – AV node)<\/strong>, v\u00e0 ti\u1ebfp t\u1ee5c lan xu\u1ed1ng t\u00e2m th\u1ea5t qua b\u00f3 His v\u00e0 m\u1ea1ng Purkinje, khi\u1ebfn t\u00e2m th\u1ea5t co b\u00f3p \u0111\u1ec3 b\u01a1m m\u00e1u \u0111i kh\u1eafp c\u01a1 th\u1ec3. Qu\u00e1 tr\u00ecnh n\u00e0y di\u1ec5n ra m\u1ed9t c\u00e1ch c\u00f3 t\u1ed5 ch\u1ee9c v\u00e0 nh\u1ecbp nh\u00e0ng, t\u1ea1o n\u00ean nh\u1ecbp tim b\u00ecnh th\u01b0\u1eddng (nh\u1ecbp xoang – sinus rhythm) [2].<\/p>\n

\u00a0<\/p><\/div>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Khi x\u1ea3y ra rung th\u1ea5t (Ventricular Fibrillation – VF) ho\u1eb7c nh\u1ecbp nhanh th\u1ea5t v\u00f4 m\u1ea1ch (Pulseless Ventricular Tachycardia – pVT), ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n c\u1ee7a tim tr\u1edf n\u00ean h\u1ed7n lo\u1ea1n, c\u00e1c t\u1ebf b\u00e0o c\u01a1 tim co b\u00f3p kh\u00f4ng \u0111\u1ed3ng b\u1ed9, khi\u1ebfn tim kh\u00f4ng th\u1ec3 b\u01a1m m\u00e1u hi\u1ec7u qu\u1ea3 [2].<\/p><\/div>\n\n\n\n

Nguy\u00ean l\u00fd ho\u1ea1t \u0111\u1ed9ng c\u1ee7a m\u00e1y s\u1ed1c \u0111i\u1ec7n d\u1ef1a tr\u00ean vi\u1ec7c t\u1ea1o ra m\u1ed9t d\u00f2ng \u0111i\u1ec7n \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t, \u0111i qua c\u01a1 tim. D\u00f2ng \u0111i\u1ec7n n\u00e0y c\u00f3 t\u00e1c d\u1ee5ng:<\/p><\/div>\n\n\n\n

+ Kh\u1eed c\u1ef1c \u0111\u1ed3ng lo\u1ea1t (Defibrillation):<\/strong>\u00a0Xung \u0111i\u1ec7n l\u00e0m ng\u1eebng ho\u1ea1t \u0111\u1ed9ng \u0111i\u1ec7n h\u1ed7n lo\u1ea1n c\u1ee7a t\u1ea5t c\u1ea3 c\u00e1c t\u1ebf b\u00e0o c\u01a1 tim c\u00f9ng m\u1ed9t l\u00fac. \u0110i\u1ec1u n\u00e0y gi\u1ed1ng nh\u01b0 vi\u1ec7c “kh\u1edfi \u0111\u1ed9ng l\u1ea1i” h\u1ec7 th\u1ed1ng \u0111i\u1ec7n c\u1ee7a tim [1].\u2028<\/p>\n

+ T\u00e1i l\u1eadp nh\u1ecbp xoang:<\/strong>\u00a0Sau khi t\u1ea5t c\u1ea3 c\u00e1c t\u1ebf b\u00e0o c\u01a1 tim \u0111\u01b0\u1ee3c kh\u1eed c\u1ef1c, hy v\u1ecdng r\u1eb1ng n\u00fat xoang nh\u0129 \u2013 b\u1ed9 ph\u1eadn ph\u00e1t nh\u1ecbp t\u1ef1 nhi\u00ean c\u1ee7a tim (sinoatrial node – SA node) \u2013 s\u1ebd c\u00f3 c\u01a1 h\u1ed9i t\u00e1i l\u1eadp m\u1ed9t nh\u1ecbp \u0111\u1eadp b\u00ecnh th\u01b0\u1eddng v\u00e0 c\u00f3 t\u1ed5 ch\u1ee9c (nh\u1ecbp xoang – sinus rhythm) [2].<\/p>\n

T\u00f3m l\u1ea1i, vi\u1ec7c s\u1ed1c \u0111i\u1ec7n c\u00f3 vai tr\u00f2 d\u1eadp t\u1eaft c\u00e1c r\u1ed1i lo\u1ea1n<\/strong> nh\u1ecbp<\/strong> nhanh \u0111ang chi\u1ebfm quy\u1ec1n ch\u1ee7 nh\u1ecbp c\u1ee7a nh\u1ecbp xoang, gi\u00fap nh\u1ecbp xoang tr\u1edf l\u1ea1i v\u1edbi vai tr\u00f2 ch\u1ee7 nh\u1ecbp<\/strong> (<\/span>Kh\u00f4ng n\u00ean hi\u1ec3u sai r\u1eb1ng s\u1ed1c \u0111i\u1ec7n l\u00e0 ph\u01b0\u01a1ng ph\u00e1p d\u00f9ng d\u00f2ng \u0111i\u1ec7n k\u00edch th\u00edch tim \u0111\u1eadp) .<\/span><\/p><\/div>\n\n\n\n

\"\"<\/figure>\n\n\n\n

III. Ph\u00e2n lo\u1ea1i m\u00e1y s\u1ed1c \u0111i\u1ec7n<\/h2>\n\n\n\n

C\u00e1c d\u1ea1ng s\u00f3ng \u0111i\u1ec7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong s\u1ed1c \u0111i\u1ec7n bao g\u1ed3m:\u2028<\/p>\n

+ S\u00f3ng \u0111\u01a1n pha (Monophasic):<\/strong>\u00a0D\u00f2ng \u0111i\u1ec7n ch\u1ec9 \u0111i theo m\u1ed9t h\u01b0\u1edbng t\u1eeb \u0111i\u1ec7n c\u1ef1c n\u00e0y sang \u0111i\u1ec7n c\u1ef1c kia.\u2028<\/p>\n

+ S\u00f3ng hai pha (Biphasic):<\/strong>\u00a0D\u00f2ng \u0111i\u1ec7n \u0111i theo m\u1ed9t h\u01b0\u1edbng, sau \u0111\u00f3 \u0111\u1ea3o chi\u1ec1u \u0111i theo h\u01b0\u1edbng ng\u01b0\u1ee3c l\u1ea1i. C\u00e1c m\u00e1y s\u1ed1c \u0111i\u1ec7n hi\u1ec7n \u0111\u1ea1i ch\u1ee7 y\u1ebfu s\u1eed d\u1ee5ng d\u1ea1ng s\u00f3ng hai pha v\u00ec ch\u00fang hi\u1ec7u qu\u1ea3 h\u01a1n trong vi\u1ec7c kh\u1eed rung th\u1ea5t v\u1edbi m\u1ee9c n\u0103ng l\u01b0\u1ee3ng th\u1ea5p h\u01a1n, gi\u1ea3m thi\u1ec3u t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim [2].<\/p><\/div>\n\n\n\n

IV. C\u1ea5u t\u1ea1o c\u01a1 b\u1ea3n c\u1ee7a m\u00e1y s\u1ed1c \u0111i\u1ec7n<\/h2>\n\n\n\n

M\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u lo\u1ea1i, nh\u01b0ng m\u1ed9t m\u00e1y s\u1ed1c \u0111i\u1ec7n c\u01a1 b\u1ea3n th\u01b0\u1eddng bao g\u1ed3m c\u00e1c th\u00e0nh ph\u1ea7n ch\u00ednh sau:\u2028<\/p>\n

+ Ngu\u1ed3n \u0111i\u1ec7n v\u00e0 t\u1ee5 \u0111i\u1ec7n:<\/strong>\u00a0Ngu\u1ed3n \u0111i\u1ec7n cung c\u1ea5p n\u0103ng l\u01b0\u1ee3ng, sau \u0111\u00f3 \u0111\u01b0\u1ee3c t\u00edch tr\u1eef trong t\u1ee5 \u0111i\u1ec7n. T\u1ee5 \u0111i\u1ec7n c\u00f3 nhi\u1ec7m v\u1ee5 ph\u00f3ng ra n\u0103ng l\u01b0\u1ee3ng \u0111i\u1ec7n d\u01b0\u1edbi d\u1ea1ng m\u1ed9t xung duy nh\u1ea5t [2].\u2028<\/p>\n

+ \u0110i\u1ec7n c\u1ef1c (Pads\/Paddles):<\/strong>\u00a0\u0110\u00e2y l\u00e0 b\u1ed9 ph\u1eadn ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi da b\u1ec7nh nh\u00e2n.\u2028<\/p>\n

Paddles (b\u1ea3n s\u1ed1c):<\/strong>\u00a0Th\u01b0\u1eddng d\u00f9ng cho m\u00e1y s\u1ed1c \u0111i\u1ec7n th\u1ee7 c\u00f4ng, y\u00eau c\u1ea7u ng\u01b0\u1eddi d\u00f9ng gi\u1eef ch\u1eb7t v\u00e0 \u1ea5n m\u1ea1nh v\u00e0o ng\u1ef1c b\u1ec7nh nh\u00e2n.
Internal paddles (b\u1ea3n s\u1ed1c trong):<\/strong>\u00a0\u0110\u01b0\u1ee3c s\u1eed d\u1ee5ng trong ph\u1eabu thu\u1eadt, khi b\u00e1c s\u0129 tr\u1ef1c ti\u1ebfp \u0111\u1eb7t c\u00e1c b\u1ea3n c\u1ef1c v\u00f4 tr\u00f9ng n\u00e0y l\u00ean b\u1ec1 m\u1eb7t qu\u1ea3 tim \u0111\u1ec3 s\u1ed1c \u0111i\u1ec7n tr\u1ef1c ti\u1ebfp.
Pads (mi\u1ebfng d\u00e1n):<\/strong>\u00a0D\u00f9ng cho c\u1ea3 AED v\u00e0 m\u00e1y th\u1ee7 c\u00f4ng, l\u00e0 lo\u1ea1i mi\u1ebfng d\u00e1n c\u00f3 gel d\u1eabn \u0111i\u1ec7n, ti\u1ec7n l\u1ee3i v\u00e0 an to\u00e0n h\u01a1n.<\/p><\/div>\n\n\n\n

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\"\"
Paddles<\/strong><\/figcaption><\/figure>\n\n\n\n
\"\"
Internal paddles<\/strong> for defibrillation are positioned on the anterior and posterior aspects of the heart.<\/figcaption><\/figure>\n\n\n\n
\"\"
Pads<\/strong><\/figcaption><\/figure>\n<\/figure>\n\n\n\n
<\/div>\n\n\n\n

B\u1ed9 ph\u1eadn ph\u00e2n t\u00edch \u0111i\u1ec7n tim (ECG analysis):<\/strong>\u00a0\u0110\u1eb7c bi\u1ec7t quan tr\u1ecdng \u0111\u1ed1i v\u1edbi AED, b\u1ed9 ph\u1eadn n\u00e0y ph\u00e2n t\u00edch nh\u1ecbp tim c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh xem c\u00f3 ph\u1ea3i l\u00e0 nh\u1ecbp c\u1ea7n s\u1ed1c \u0111i\u1ec7n hay kh\u00f4ng [4].\u2028<\/p>\n

Giao di\u1ec7n ng\u01b0\u1eddi d\u00f9ng:<\/strong>\u00a0Bao g\u1ed3m m\u00e0n h\u00ecnh hi\u1ec3n th\u1ecb th\u00f4ng tin ECG, m\u1ee9c n\u0103ng l\u01b0\u1ee3ng, th\u1eddi gian, v\u00e0 c\u00e1c n\u00fat \u0111i\u1ec1u khi\u1ec3n (s\u1ea1c, s\u1ed1c, ch\u1ecdn n\u0103ng l\u01b0\u1ee3ng). \u0110\u1ed1i v\u1edbi AED, c\u00f2n c\u00f3 h\u01b0\u1edbng d\u1eabn b\u1eb1ng gi\u1ecdng n\u00f3i \u0111\u1ec3 ch\u1ec9 d\u1eabn ng\u01b0\u1eddi d\u00f9ng t\u1eebng b\u01b0\u1edbc [3].\u2028<\/p>\n

C\u00e1c ph\u1ee5 ki\u1ec7n kh\u00e1c:<\/strong>\u00a0Bao g\u1ed3m dao c\u1ea1o (\u0111\u1ec3 c\u1ea1o l\u00f4ng ng\u1ef1c b\u1ec7nh nh\u00e2n n\u1ebfu c\u1ea7n), kh\u0103n lau, gel d\u1eabn \u0111i\u1ec7n (n\u1ebfu d\u00f9ng paddles), v\u00e0 pin\/ngu\u1ed3n s\u1ea1c.<\/p><\/div>\n\n\n\n

IV. Ch\u1ec9 \u0111\u1ecbnh v\u00e0 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/h2>\n\n\n\n

Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/h3>\n\n\n\n

Rung th\u1ea5t (Ventricular Fibrillation – VF):<\/strong>\u00a0L\u00e0 t\u00ecnh tr\u1ea1ng tim rung l\u00ean m\u1ed9t c\u00e1ch h\u1ed7n lo\u1ea1n, kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng b\u01a1m m\u00e1u, d\u1eabn \u0111\u1ebfn ng\u1eebng tim l\u00e2m s\u00e0ng. \u0110\u00e2y l\u00e0 ch\u1ec9 \u0111\u1ecbnh c\u1ea5p c\u1ee9u h\u00e0ng \u0111\u1ea7u c\u1ee7a s\u1ed1c \u0111i\u1ec7n (defibrillation) [2].\u2028
Nh\u1ecbp nhanh th\u1ea5t v\u00f4 m\u1ea1ch (Pulseless Ventricular Tachycardia – pVT):<\/strong>\u00a0L\u00e0 t\u00ecnh tr\u1ea1ng tim \u0111\u1eadp nhanh b\u1ea5t th\u01b0\u1eddng t\u1eeb t\u00e2m th\u1ea5t, nh\u01b0ng kh\u00f4ng t\u1ea1o ra m\u1ea1ch v\u00e0 huy\u1ebft \u00e1p, c\u0169ng d\u1eabn \u0111\u1ebfn ng\u1eebng tim. S\u1ed1c \u0111i\u1ec7n l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 ch\u1ea5m d\u1ee9t nh\u1ecbp n\u00e0y [2].\u2028
Chuy\u1ec3n nh\u1ecbp (Cardioversion):<\/strong>\u00a0\u0110\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh c\u00f3 m\u1ea1ch (t\u1ee9c l\u00e0 tim v\u1eabn \u0111\u1eadp v\u00e0 c\u00f3 huy\u1ebft \u00e1p, nh\u01b0ng nh\u1ecbp qu\u00e1 nhanh g\u00e2y tri\u1ec7u ch\u1ee9ng n\u1eb7ng) nh\u01b0 rung nh\u0129 (Atrial Fibrillation – AF) k\u00e8m \u0111\u00e1p \u1ee9ng th\u1ea5t nhanh, nh\u1ecbp nhanh tr\u00ean th\u1ea5t (Supraventricular Tachycardia – SVT) ho\u1eb7c nh\u1ecbp nhanh th\u1ea5t c\u00f3 m\u1ea1ch (Ventricular Tachycardia – VT with pulse) khi c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c kh\u00f4ng hi\u1ec7u qu\u1ea3 ho\u1eb7c b\u1ec7nh nh\u00e2n kh\u00f4ng \u1ed5n \u0111\u1ecbnh.<\/p><\/div>\n\n\n\n

Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/h3>\n\n\n\n

Kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh tuy\u1ec7t \u0111\u1ed1i<\/strong>\u00a0\u0111\u1ed1i v\u1edbi s\u1ed1c \u0111i\u1ec7n khi b\u1ec7nh nh\u00e2n c\u00f3 rung th\u1ea5t ho\u1eb7c nh\u1ecbp nhanh th\u1ea5t v\u00f4 m\u1ea1ch. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c s\u1ed1c \u0111i\u1ec7n \u0111\u1ec3 c\u1ee9u s\u1ed1ng b\u1ec7nh nh\u00e2n v\u01b0\u1ee3t tr\u1ed9i h\u01a1n m\u1ecdi r\u1ee7i ro ti\u1ec1m \u1ea9n [2].\u2028
L\u01b0u \u00fd:<\/strong>\u00a0C\u1ea7n c\u1ea9n tr\u1ecdng khi b\u1ec7nh nh\u00e2n c\u00f3 m\u00e1y t\u1ea1o nh\u1ecbp tim ho\u1eb7c thi\u1ebft b\u1ecb ICD c\u1ea5y gh\u00e9p. Kh\u00f4ng \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c tr\u1ef1c ti\u1ebfp l\u00ean v\u00f9ng c\u00f3 thi\u1ebft b\u1ecb c\u1ea5y gh\u00e9p \u0111\u1ec3 tr\u00e1nh l\u00e0m h\u1ecfng thi\u1ebft b\u1ecb.<\/p><\/div>\n\n\n\n

V. H\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng m\u00e1y s\u1ed1c \u0111i\u1ec7n<\/h2>\n\n\n\n

S\u1eed d\u1ee5ng m\u00e1y s\u1ed1c \u0111i\u1ec7n, \u0111\u1eb7c bi\u1ec7t l\u00e0 AED, \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 \u0111\u01a1n gi\u1ea3n h\u00f3a t\u1ed1i \u0111a, nh\u01b0ng lu\u00f4n \u0111\u00f2i h\u1ecfi s\u1ef1 c\u1ea9n th\u1eadn v\u00e0 hi\u1ec3u bi\u1ebft v\u1ec1 c\u00e1c b\u01b0\u1edbc th\u1ef1c hi\u1ec7n.<\/p><\/div>\n\n\n\n

B\u01b0\u1edbc 1: Chu\u1ea9n b\u1ecb<\/h3>\n\n\n\n

1. \u0110\u1ea3m b\u1ea3o an to\u00e0n m\u00f4i tr\u01b0\u1eddng:<\/strong>
Ki\u1ec3m tra khu v\u1ef1c xung quanh b\u1ec7nh nh\u00e2n kh\u00f4 r\u00e1o, kh\u00f4ng c\u00f3 n\u01b0\u1edbc ho\u1eb7c ch\u1ea5t l\u1ecfng d\u1eabn \u0111i\u1ec7n.
Kh\u00f4ng c\u00f3 v\u1eadt kim lo\u1ea1i ti\u1ebfp x\u00fac v\u1edbi b\u1ec7nh nh\u00e2n ho\u1eb7c gi\u01b0\u1eddng b\u1ec7nh.
Tr\u00e1nh xa c\u00e1c v\u1eadt li\u1ec7u d\u1ec5 ch\u00e1y n\u1ed5 (v\u00ed d\u1ee5: oxy n\u1ed3ng \u0111\u1ed9 cao).\u2028<\/p>\n

2. \u0110\u1eb7t b\u1ec7nh nh\u00e2n:<\/strong>\u00a0\u0110\u1eb7t b\u1ec7nh nh\u00e2n n\u1eb1m ng\u1eeda tr\u00ean m\u1ed9t b\u1ec1 m\u1eb7t c\u1ee9ng, ph\u1eb3ng.\u2028<\/p>\n

3. B\u1ed9c l\u1ed9 v\u00f9ng ng\u1ef1c:<\/strong>\u00a0C\u1edfi b\u1ecf qu\u1ea7n \u00e1o \u0111\u1ec3 b\u1ed9c l\u1ed9 ho\u00e0n to\u00e0n v\u00f9ng ng\u1ef1c c\u1ee7a b\u1ec7nh nh\u00e2n.\u2028<\/p>\n

4. Chu\u1ea9n b\u1ecb da:<\/strong>
N\u1ebfu ng\u1ef1c b\u1ec7nh nh\u00e2n c\u00f3 nhi\u1ec1u l\u00f4ng, h\u00e3y c\u1ea1o s\u1ea1ch l\u00f4ng \u1edf c\u00e1c v\u1ecb tr\u00ed s\u1ebd d\u00e1n \u0111i\u1ec7n c\u1ef1c \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o ti\u1ebfp x\u00fac t\u1ed1t.
Lau kh\u00f4 da n\u1ebfu c\u00f3 m\u1ed3 h\u00f4i ho\u1eb7c n\u01b0\u1edbc.
Th\u00e1o b\u1ecf c\u00e1c mi\u1ebfng d\u00e1n thu\u1ed1c ho\u1eb7c v\u1eadt kim lo\u1ea1i (nh\u01b0 trang s\u1ee9c) kh\u1ecfi v\u00f9ng ng\u1ef1c.<\/p><\/div>\n\n\n\n

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  1. <\/li>\n<\/ol>\n\n\n\n

    B\u01b0\u1edbc 2: Th\u1ef1c hi\u1ec7n s\u1ed1c \u0111i\u1ec7n <\/h3>\n\n\n\n

    *** V\u1edbi m\u00e1y s\u1ed1c \u0111i\u1ec7n ngo\u00e0i t\u1ef1 \u0111\u1ed9ng (AED) ***<\/h4>\n\n\n\n

    AED th\u01b0\u1eddng c\u00f3 h\u01b0\u1edbng d\u1eabn b\u1eb1ng gi\u1ecdng n\u00f3i v\u00e0 h\u00ecnh \u1ea3nh \u0111i k\u00e8m.\u2028<\/p>\n

    1. B\u1eadt m\u00e1y:<\/strong>\u00a0Nh\u1ea5n n\u00fat ngu\u1ed3n \u0111\u1ec3 b\u1eadt AED. M\u00e1y s\u1ebd b\u1eaft \u0111\u1ea7u ph\u00e1t ra h\u01b0\u1edbng d\u1eabn b\u1eb1ng gi\u1ecdng n\u00f3i.\u2028<\/p>\n

    2. D\u00e1n \u0111i\u1ec7n c\u1ef1c:<\/strong>
    M\u1edf g\u00f3i \u0111i\u1ec7n c\u1ef1c v\u00e0 b\u00f3c l\u1edbp b\u1ea3o v\u1ec7.
    D\u00e1n m\u1ed9t \u0111i\u1ec7n c\u1ef1c v\u00e0o ph\u00eda tr\u00ean b\u00ean ph\u1ea3i ng\u1ef1c (d\u01b0\u1edbi x\u01b0\u01a1ng \u0111\u00f2n).
    D\u00e1n \u0111i\u1ec7n c\u1ef1c c\u00f2n l\u1ea1i v\u00e0o ph\u00eda d\u01b0\u1edbi b\u00ean tr\u00e1i c\u1ee7a x\u01b0\u01a1ng s\u01b0\u1eddn, h\u01a1i l\u1ec7ch sang m\u1ed9t b\u00ean, c\u00e1ch n\u00fam v\u00fa v\u00e0i cm (v\u1ecb tr\u00ed t\u01b0\u01a1ng \u1ee9ng v\u1edbi m\u1ecfm tim) [3].
    \u0110\u1ea3m b\u1ea3o \u0111i\u1ec7n c\u1ef1c d\u00e1n ch\u1eb7t v\u00e0o da, kh\u00f4ng c\u00f3 b\u1ecdt kh\u00ed.<\/p><\/div>\n\n\n\n

    \"\"<\/figure>\n\n\n\n

    3. \u0110\u1ec3 m\u00e1y ph\u00e2n t\u00edch nh\u1ecbp tim:<\/strong>
    M\u00e1y AED s\u1ebd y\u00eau c\u1ea7u “Kh\u00f4ng ch\u1ea1m v\u00e0o b\u1ec7nh nh\u00e2n” \u0111\u1ec3 ph\u00e2n t\u00edch nh\u1ecbp tim.
    \u0110\u1ea3m b\u1ea3o kh\u00f4ng ai ch\u1ea1m v\u00e0o b\u1ec7nh nh\u00e2n trong qu\u00e1 tr\u00ecnh n\u00e0y.
    M\u00e1y s\u1ebd b\u00e1o c\u00e1o li\u1ec7u c\u00f3 c\u1ea7n s\u1ed1c \u0111i\u1ec7n hay kh\u00f4ng.\u2028<\/p>\n

    4. Th\u1ef1c hi\u1ec7n s\u1ed1c \u0111i\u1ec7n (n\u1ebfu m\u00e1y ch\u1ec9 \u0111\u1ecbnh):<\/strong>
    N\u1ebfu m\u00e1y AED ch\u1ec9 \u0111\u1ecbnh s\u1ed1c \u0111i\u1ec7n, h\u00e3y \u0111\u1ea3m b\u1ea3o t\u1ea5t c\u1ea3 m\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1u “CLEAR” (kh\u00f4ng ai ch\u1ea1m v\u00e0o b\u1ec7nh nh\u00e2n ho\u1eb7c v\u1eadt g\u00ec ti\u1ebfp x\u00fac v\u1edbi b\u1ec7nh nh\u00e2n).
    Nh\u1ea5n n\u00fat “S\u1ed1c” (th\u01b0\u1eddng l\u00e0 n\u00fat nh\u1ea5p nh\u00e1y m\u00e0u \u0111\u1ecf).
    Sau khi s\u1ed1c \u0111i\u1ec7n, m\u00e1y AED s\u1ebd h\u01b0\u1edbng d\u1eabn ti\u1ebfp t\u1ee5c h\u1ed3i s\u1ee9c tim ph\u1ed5i (CPR).\u2028<\/p>\n

    5. Ti\u1ebfp t\u1ee5c h\u1ed3i s\u1ee9c tim ph\u1ed5i (CPR):<\/strong>\u00a0
    Th\u1ef1c hi\u1ec7n CPR ngay l\u1eadp t\u1ee9c sau s\u1ed1c \u0111i\u1ec7n (30 l\u1ea7n \u00e9p tim, 2 l\u1ea7n th\u1ed5i ng\u1ea1t) v\u00e0 ti\u1ebfp t\u1ee5c cho \u0111\u1ebfn khi AED ph\u00e2n t\u00edch l\u1ea1i nh\u1ecbp tim ho\u1eb7c nh\u00e2n vi\u00ean y t\u1ebf \u0111\u1ebfn [3].<\/p><\/div>\n\n\n\n

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