WordNet

support materially or financially; "he does not support his natural children"; "The scholarship supported me when I was in college"
financial resources provided to make some project possible; "the foundation provided support for the experiment" (同)financial support, funding, backing, financial backing
the financial means whereby one lives; "each child was expected to pay for their keep"; "he applied to the state for support"; "he could no longer earn his own livelihood" (同)keep, livelihood, living, bread and butter, sustenance
a military operation (often involving new supplies of men and materiel) to strengthen a military force or aid in the performance of its mission; "they called for artillery support" (同)reinforcement, reenforcement
the act of bearing the weight of or strengthening; "he leaned against the wall for support" (同)supporting
aiding the cause or policy or interests of; "the president no longer has the support of his own party"; "they developed a scheme of mutual support"
any device that bears the weight of another thing; "there was no place to attach supports for a shelf"
supporting structure that holds up or provides a foundation; "the statue stood on a marble support"
the activity of providing for or maintaining by supplying with money or necessities; "his support kept the family together"; "they gave him emotional support during difficult times"
something providing immaterial assistance to a person or cause or interest; "the policy found little public support"; "his faith was all the support he needed"; "the team enjoyed the support of their fans"
give moral or psychological support, aid, or courage to; "She supported him during the illness"; "Her children always backed her up" (同)back_up
play a subordinate role to (another performer); "Olivier supported Gielgud beautifully in the second act"
increase in price or value; "the news caused a general advance on the stock market" (同)rise
an amount paid before it is earned (同)cash advance
rise in rate or price; "The stock market gained 24 points today" (同)gain
pay in advance; "Can you advance me some money?"
situated ahead or going before; "an advance party"; "at that time the most advanced outpost was still east of the Rockies" (同)advanced, in advance
being ahead of time or need; "gave advance warning"; "was beforehand with her report" (同)beforehand
cause to move forward; "Can you move the car seat forward?" (同)bring forward
move forward, also in the metaphorical sense; "Time marches on" (同)progress, pass_on, move on, march on, go_on
move forward; "we have to advance clocks and watches when we travel eastward" (同)set ahead
bring forward for consideration or acceptance; "advance an argument" (同)throw out
develop further; "We are advancing technology every day"
the period during which something is functional (as between birth and death); "the battery had a short life"; "he lived a long and happy life" (同)lifetime, life-time, lifespan
a characteristic state or mode of living; "social life"; "city life"; "real life"
the course of existence of an individual; the actions and events that occur in living; "he hoped for a new life in Australia"; "he wanted to live his own life without interference from others"
the organic phenomenon that distinguishes living organisms from nonliving ones; "there is no life on the moon"
the period between birth and the present time; "I have known him all his life"
the period from the present until death; "he appointed himself emperor for life"
living things collectively; "the oceans are teeming with life"
the experience of being alive; the course of human events and activities; "he could no longer cope with the complexities of life" (同)living
a living person; "his heroism saved a life"
a motive for living; "pottery was his life"
farther along in physical or mental development; "the childs skeletal age was classified as `advanced"; "children in the advanced classes in elementary school read far above grade average"
ahead of the times; "the advanced teaching methods"; "had advanced views on the subject"; "a forward-looking corporation"; "is British industry innovative enough?" (同)forward-looking, innovative, modern
far along in time; "a man of advanced age"; "advanced in years"; "a ripe old age"; "the ripe age of 90" (同)ripe
ahead in development; complex or intricate; "advanced technology"; "a sophisticated electronic control system" (同)sophisticated
(of societies) highly developed especially in technology or industry; "advanced societies"; "an advanced country technologically"
at a higher level in training or knowledge or skill; "an advanced degree"; "an advanced text in physics"; "special seminars for small groups of advanced students at the University"
comparatively late in a course of development; "the illness had reached an advanced stage"; "an advanced state of exhaustion"
sustained or maintained by aid (as distinct from physical support); "a club entirely supported by membership dues"; "well-supported allegations"
held up or having the weight borne especially from below; "supported joints in a railroad track have ties directly under the rail ends"

PrepTutorEJDIC

…‘を'『支える』 / 〈家族など〉‘を'『養う』,扶養する / 〈人・主義など〉‘を'『支持する』,擁護する / (精神的に)〈人〉‘を'力づける;(金銭的に)〈人〉‘を'援助する / 〈見解など〉‘を'立証する,裏書きする / …‘に'耐える,がまんする / 〈U〉(…を)『支えること』,(…の)支持,援助《+of+名》 / 〈U〉(重さを支える)支柱,突っ張り / 〈C〉『扶養する人』;〈U〉生活費 / 〈U〉(精神的)支え,(経済的)援助
…'を'『前進させる』,前に出す / 〈事〉'を'『進める』,促進する / (ある階級・地位などに)〈人〉'を'昇進させる《+『名』〈人〉+『to』+『名』》 / 《『advance』+『名』〈人〉+『名』〈金〉=『advance』+『名』〈金〉+『to』+『名』〈人〉》〈人〉‘に'〈金〉'を'前払いする,融資する / 〈時間・期日〉'を'早める;〈時計〉‘の'時間を早める / (…に向かって)『前進する』,進む《+『on』(『upon, toward』)+『名』》 / (…に)昇進する《+『to』(『in』)+『名』》 / 〈事が〉進歩する,はかどる / 〈時が〉進む / 〈値段・価値が〉上がる / 〈U〉〈C〉『進むこと』,前進 / 〈U〉(…の)流れ,進行《+『of』+『名』》 / 〈U〉〈C〉(…の)進歩,発達《+『of』+『名』》 / 〈U〉〈C〉(…への)昇進,出世《+『to』+『名』》 / 〈C〉(…の)前払い,前払い金《+『on』+『名』》 / 《複数形で》(人に)言い寄ること,取り入ること《+『to』+『名』》 / 前進している / 前もっての
〈U〉(無生物と区別して,生物が持っている)『生命』,命 / 〈U〉《集合的に》『生物』,生き物 / 〈U〉(死後の)霊,霊的存在 / 〈C〉人間(person) / 〈U〉『一生』,生涯 / 〈C〉『寿命』,活動(有効,耐久)期間 / 〈U〉『人生』,現世,世間 / 〈C〉〈U〉『生活』,暮らし,生き方,暮らし方 / 〈C〉『伝記』(biography) / 〈U〉『生気』,活気,元気(vitality)
進出した,前進した / 進歩した / 上級の,高等の / (時が)進んだ,進行した

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/01/27 15:48:22」(JST)

wiki en

An ALS Rescue Unit of Palm Beach County Fire-Rescue used for EMS in Palm Beach County, Florida.

Advanced Life Support (ALS) is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation (breathing).

Components of ALS[edit]

A HSE advanced paramedic vehicle, at Aviva Stadium, Dublin, Ireland

These include:

Tracheal intubation
Rapid sequence intubation
Cardiac monitoring
Cardiac defibrillation
Transcutaneous pacing
Intravenous cannulation (IV)
Intraosseous (IO) access and intraosseous infusion
Surgical cricothyrotomy
Needle cricothyrotomy
Needle decompression of tension pneumothorax
Advanced medication administration through parenteral and enteral routes (IV, IO, PO, PR, ET, SL, topical, and transdermal)
Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS) or Pediatric Education for Pre-Hospital Providers (PEPP)
Pre-Hospital Trauma Life Support (PHTLS), Basic Trauma Life Support (BTLS) or International Trauma Life Support (ITLS)

2010 changes[edit]

ALS is a treatment consensus for cardiopulmonary resuscitation in cardiac arrest and related medical problems, as agreed in Europe by the European Resuscitation Council, most recently in 2010.

2010 revisions include:

greater emphasis on continuous (uninterrupted) chest compression
less emphasis on airway and breathing
promotion of the intraosseous infusion of drugs and fluids if IV access not readily available
further demotion of the precordial thump
ongoing simplification
expanded role for post-arrest hypothermia and emphasis on post-arrest normo-glycaemial.....

ALS algorithms[edit]

ALS assumes that basic life support (bag-mask administration of oxygen and chest compressions) are administered.

The main algorithm of ALS, which is invoked when actual cardiac arrest has been established, relies on the monitoring of the electrical activity of the heart on a cardiac monitor. Depending on the type of cardiac arrhythmia, defibrillation is applied, and medication is administered. Oxygen is administered and endotracheal intubation may be attempted to secure the airway. At regular intervals, the effect of the treatment on the heart rhythm, as well as the presence of cardiac output, is assessed.

Medication that may be administered may include adrenaline (epinephrine), amiodarone, atropine, bicarbonate, calcium, potassium and magnesium. Saline or colloids may be administered to increase the circulating volume.

While CPR is given (either manually, or through automated equipment such as AutoPulse), members of the team consider eight forms of potentially reversible causes for cardiac arrest, commonly abbreviated as "6Hs & 5Ts" according to 2005/2010 AHA Advanced Cardiac Life Support (ACLS).^[1]^[2]^[3]^[4] Note these reversible causes are usually taught and remembered as 4Hs and 4Ts^[5]—including hypoglycaemia and acidosis with hyper/hypokalaemia and 'metabolic causes' and omitting trauma from the T's as this is redundant with hypovolaemia—this simplification aids recall during resuscitation.

Hs and Ts[edit]

Main article: Hs and Ts

Hs

Hypoxia: low oxygen levels in the blood
Hypovolemia: low amount of circulating blood, either absolutely due to blood loss or relatively due to vasodilation
Hyperkalemia or hypokalemia: disturbances in the level of potassium in the blood, and related disturbances of calcium or magnesium levels.
Hypothermia/Hyperthermia: body temperature not maintained
Hydrogen ions (Acidosis)
Hypoglycemia: Low blood glucose levels

Ts

Tension pneumothorax: increased pressure in the thoracic cavity, leading to decreased venous return to the heart
Tamponade: fluid or blood in the pericardium, compressing the heart
Toxic and/or therapeutic: chemicals, whether medication or poisoning
Thromboembolism and related mechanical obstruction (blockage of the blood vessels to the lungs or the heart by a blood clot or other material)

As of December 2005, Advanced Life Support guidelines have changed significantly. A major new worldwide consensus has been sought based upon the best available scientific evidence. The ratio of compressions to ventilation's is now recommended as 30:2 for adults, to produce higher coronary and cerebral perfusion pressures. Defibrillation is now administered as a single shock, each followed immediately by two minutes of CPR before rhythm is re-assessed (five cycles of CPR). See Advanced Cardiac Life Support

Other conditions[edit]

ALS also covers various conditions related to cardiac arrest, such as cardiac arrhythmias (atrial fibrillation, ventricular tachycardia), poisoning and effectively all conditions that may lead to cardiac arrest if untreated, apart from the truly surgical emergencies (which are covered by Advanced Trauma Life Support).

Who performs ALS[edit]

Many healthcare providers are trained to administer some form of ALS.

In out-of-hospital settings trained emergency medical technicians, paramedics or medics typically provide this level of care. Canadian paramedics may be certified in either ALS (Advance Care Paramedic-ACP) or in Basic Life Support (Primary Care Paramedic-PCP) (see paramedics in Canada). Emergency medical technicians (EMTs) are often skilled in ALS, although they may employ slightly modified version of the Medical algorithm. In the United States, Paramedic level services are referred to as Advanced Life Support (ALS). Services staffed by basic EMTs are referred to as Basic Life Support (BLS), as those staffed by EMT-Intermediates are called Intermediate Life Support (ILS). In the Republic of Ireland, Advanced Life Support (ALS) is provided by an Advanced paramedic. Advanced Paramedic (AP) is the highest clinical level (level 6) in pre-hospital care in the Republic of Ireland based on the standards set down by PHECC, the Irish regulatory body for pre-hospital care and ambulance services. This terminology extends beyond emergency cardiac care to describe all capabilities of the providers.

In hospitals, ALS is usually given by a team of physicians (DOs and MDs) and nurses (RNs), with some clinical paramedics practicing in certain systems. Cardiac arrest teams, or "Code Teams", generally include junior doctors or senior nurses and technicians from various specialties such as emergency medicine, anesthetics, general or internal medicine.

References[edit]

^ Part 7.2: Management of Cardiac Arrest - 112 (24 Supplement): IV-58 - Circulation
^ ACLS: Principles and Practice. p. 71–87. Dallas: American Heart Association, 2003. ISBN 0-87493-341-2.
^ ACLS for Experienced Providers. p. 3-5. Dallas: American Heart Association, 2003. ISBN 0-87493-424-9.
^ "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Part 7.2: Management of Cardiac Arrest." Circulation 2005; 112: IV-58 – IV-66.
^ Resuscitation Council UK adult ALS algorithm 2005

External links[edit]

UK Resuscitation Council ALS page
About First Aid ALS Definition

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 成人における二次救命処置（ACLS） advanced cardiac life support acls in adults
2. 小児に対する二次救命処置ガイドライン guidelines for pediatric advanced life support
3. 突然の心停止を呈した成人に対する二次救命処置を支持するデータ supportive data for advanced cardiac life support in adults with sudden cardiac arrest
4. 一次・二次救命処置における効果のはっきりしていない治療 therapies of uncertain benefit in basic and advanced cardiac life support
5. 蘇生のための開胸術：手技 resuscitative thoracotomy technique

English Journal

Changes in chemical composition and antioxidative properties of rye ginger cakes during their shelf-life.

Zieliński H, del Castillo MD, Przygodzka M, Ciesarova Z, Kukurova K, Zielińska D.SourceDivision of Food Science, Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Tuwima 10, P.O. Box 55, 10-718 Olsztyn 5, Poland. haziel@pan.olsztyn.pl
Food chemistry.Food Chem.2012 Dec 15;135(4):2965-73. doi: 10.1016/j.foodchem.2012.07.009. Epub 2012 Jul 14.
Changes in chemical composition and antioxidative properties of rye ginger cakes during their shelf-life were investigated in this study. In particular, the changes in antioxidants content, antioxidative and reducing capacity, and Maillard reaction development in rye ginger cakes after long-term sto
PMID 22980898

Geriatric renal palliative care.

Swidler MA.SourceRenal Division, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029. mark.swidler@mssm.edu.
The journals of gerontology. Series A, Biological sciences and medical sciences.J Gerontol A Biol Sci Med Sci.2012 Dec;67(12):1400-9. doi: 10.1093/gerona/gls202. Epub 2012 Oct 10.
Elderly patients with advanced chronic kidney disease or who are on dialysis should be able to live as fully and comfortably as possible. Geriatric patients are most interested in outcomes that will optimize mental and physical function and limit suffering and pain. Nephrologists must help them answ
PMID 23051980

Japanese Journal

異種協調型災害情報支援システム実現に向けた基盤技術の構築

鳥海不二夫,篠田孝祐,榊剛史,栗原聡,風間一洋,野田五十樹
人工知能学会論文誌 29(1), 113-119, 2014
… Traditionally, the support in the event of a disaster were based on hardware, the expertise are strongly required to rescuers. … On the other hand, in the case of the Great East Japan Earthquake, many engineers try to develope information support systems for the victims by information technologies. … It can be estimated that one of the reasons to realize these systems is generally utilization of information infrastructures such as web in our daily life. …
NAID 130003382430