Tadalafil gehört zur Gruppe der PDE5-Hemmer und wirkt über eine hochselektive Blockade des Enzyms Phosphodiesterase Typ 5. Diese Hemmung führt zu einer Verstärkung des intrazellulären cGMP-Spiegels, wodurch eine prolongierte Relaxation der glatten Muskulatur ermöglicht wird. Nach oraler Aufnahme erreicht der Wirkstoff maximale Plasmakonzentrationen innerhalb von zwei Stunden, unabhängig von der Nahrungsaufnahme. Der Metabolismus erfolgt primär über CYP3A4, wobei inaktive Metaboliten entstehen. Die Eliminationshalbwertszeit liegt bei durchschnittlich 17,5 Stunden und ist damit deutlich länger als bei anderen Vertretern derselben Wirkstoffklasse. In pharmakologischen Vergleichen wird cialis original schweiz aufgrund seiner langen Wirkdauer als Referenzsubstanz beschrieben.

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Look for Danger *
Must Look for Danger and wear Gloves , Goggles| Take Action to Remove Danger or Remove Pt from Danger | Take Control of Situation| Gets Bystanders to Assist
Elicit a Response
Talk & Touch | Use (COWS) Can you hear me, Open your Eyes, What’s your name, Squeeze my Hands to Determine Conscious State and apply either AVPU or GCS | Gains Consent to look after casualty or Implied Consent if unconscious Call Ambulance | 112 from a mobile phone | Gets bystander to call and asks for bystander to return with further info and stay on line| Be ready to answer the call takers questions Positions Appropriately (No response)-Supine position or Side position |Checks for Movement, Colour, and Whether the Casualty is Breathing Normally, If talking Checks Airway -? Signs of Life
Head Tilt, Chin Lift | Clears airway with Fingers or Suction | Back Blows x 5 |Chest Thrusts x 5 Check Breathing - Gives 2 Breaths if Not
Breathing
Appropriate Head Tilt | Seals mouth and nose correctly | Normal breath, Small Breath, Cheek Puff |Turns head to look down chest for rise and fall Compressions x 30
Places pt on hard surface | Correct hand placement | Correct depth | Correct Rate| Checks placement if ribs are Broken Defibrillation
Checks Safety | Prepares Chest, Applies Pads Correctly, Fol ows Prompts, Checks No one is Touching Pt Prior to Administering Shock | CPR Between Shocks | Oxygen if SEEP | If Embedded Object - Ring Bandage | Direct Pressure | Elevation | Pad & Bandage | If Continued Bleeding - Removes Bandage – Applies New Pad | Constrictive Bandage if uncontrol ed bleeding | Preserves Amputated Part Correctly| Replaces /Preserves Tooth| Uses Non-Stick Dressing | Dressing Taped 3 sides for sucking chest wounds Explains that ambulance is coming and that they wil be looked after until they arrive | Pets are OK if applicable, Family notified if applicable| Sensitive to Cultural and Head-Neck-Chest-Abdomen-Pelvis-Limbs-Back-Spine | Looks or asks for Painful Sites, Irregularity, Lacerations, Swel ing, Deformity, Un-Natural Movement, Crepitus, Tenderness (PILSDUCT), Abrasions, Contusions, Bleeding| SCALD For Burns| Medical Alert Bracelets Pulse Rate/Rhythm, Respiratory Rate/Rhythm, Respiratory Effort, Respiratory sounds | Skin- Colour, Temp, Appearance | Conscious State| Pupils | Blood Pressure If Trained Postures Patient as required |Sitting| Legs Elevated | Anatomical Splinting | RICE | Sling Applied | Cooling or Warming |Spinal Alignment, Cervical Col ar if Trained| Padding, Use of Vinegar, Seawater, Hot Water | Cool Water| Warm Water, Fanning , Flushing, Give sips of water/milk/ Consult Poisons Info 13 11 26 | Pressure Immobilisation Technique| Assist with Medications: Epipen for Anaphylaxis |Ventolin 4x4x4 for Asthma| “Heart” Medications for Cardiac Chest Pain| FAST for Stroke Allergies, Medications, Past Medical History, Last Meal, Events Leading up to Injury/Illness Provoking Factors | Quality | Region/Radiation |Severity out of /10 What was pain score out of 10 initially -What it is now – Cardiac Chest Pain v Respiratory Pain Differential Diagnosis |Time of Onset Name - Age –History of What Happened - What you found - Treatment - Observations - AMPLE - PQRST - Pension/Health/Ambulance Card Number First Aid Report, Incident/Accident Report, Workcover Report| Self Appraisal/Seek Feedback to Evaluate Performance| Peer Support| Counselling

Source: http://firstaid.ecampus.com.au/content/lessons/15/Module%206%20-%20First%20Aid%20Emergencies%20Continued/Content/Projects/Res/library/skills-guidelines.pdf