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					    Sudden cardiac arrest
    Definition

    Sudden cardiac arrest is the sudden, unexpected loss of heart function, breathing and
    consciousness. Sudden cardiac arrest usually results from an electrical disturbance in your heart
    that disrupts its pumping action, stopping blood flow to the rest of your body.


    Sudden cardiac arrest is different from a heart attack, which occurs when blood flow to a portion of
    the heart is blocked. However, a heart attack can sometimes trigger an electrical disturbance that
    leads to sudden cardiac arrest.


    Sudden cardiac arrest is a medical emergency. If not treated immediately, it causes sudden
    cardiac death. With fast, appropriate medical care, survival is possible. Administering
    cardiopulmonary resuscitation (CPR) — or even just rapid compressions to the chest — can
    improve the chances of survival until emergency personnel arrive.


    Symptoms
    Sudden cardiac arrest symptoms are sudden and drastic:


     Sudden collapse

     No pulse

     No breathing

     Loss of consciousness

    Sometimes, other signs and symptoms precede sudden cardiac arrest. These may include fatigue,
    fainting, blackouts, dizziness, chest pain, shortness of breath, weakness, palpitations or vomiting.
    But sudden cardiac arrest often occurs with no warning.


    When to see a doctor
    If you have frequent episodes of chest pain or discomfort, heart palpitations, irregular or rapid
    heartbeats, unexplained wheezing or shortness of breath, fainting or near fainting, or you're
    feeling lightheaded or dizzy, see your doctor promptly. If these symptoms are ongoing, you should
    call 911 or emergency medical help.


    When the heart stops, the lack of oxygenated blood can cause brain damage in only a few
    minutes. Death or permanent brain damage can occur within four to six minutes. Time is critical
    when you're helping an unconscious person who isn't breathing. Take immediate action:


     Call 115( or whatever is our Tabriz Emergency Call Number), or the emergency number
      in your area, if you encounter someone who has collapsed or is found unresponsive. If the
      unconscious person is a child and you're alone, administer CPR, or chest compressions only, for
      two minutes before calling 911 or emergency medical help or before using a portable
      defibrillator.

     Perform CPR. Quickly check the unconscious person's breathing. If he or she isn't breathing
      normally, begin CPR. Push hard and fast on the person's chest — about 100 compressions a
      minute. If you've been trained in CPR, check the person's airway and deliver rescue breaths
      after every 30 compressions. If you haven't been trained, just continue chest compressions.
      Allow the chest to rise completely between compressions. Keep doing this until a portable
      defibrillator is available or emergency personnel arrive.

     Use a portable defibrillator, if one is available. If you're not trained to use a portable
      defibrillator, a 911 or emergency medical help operator may be able to guide you in its use.
      Deliver one shock if advised by the device, and then immediately begin CPR starting with chest
      compressions, or give chest compressions only, for about two minutes. Using the defibrillator,
      check the person's heart rhythm. If necessary, the defibrillator will administer a shock. Repeat
      this cycle until the person recovers consciousness or emergency personnel take over.

    Portable automated external defibrillators (AEDs) are available in an increasing number of places,
    including airports, casinos and shopping malls. You can also purchase them for your home. AEDs
    come with built-in instructions for their use. They're programmed to allow a shock only when
    appropriate.


    Cause
    The immediate cause of sudden cardiac arrest is usually an abnormality in your heart rhythm
    (arrhythmia), the result of a malfunction in your heart's electrical system.


    Unlike other muscles in your body, which rely on nerve connections to receive the electrical
    stimulation they need to function, your heart has its own electrical stimulator — a specialized
    group of cells called the sinus node, located in the upper right chamber (right atrium) of your
    heart. The sinus node generates electrical impulses that flow in an orderly manner through your
    heart to synchronize heart rate and coordinate the pumping of blood from your heart to the rest of
    your body.


    If something goes wrong with the sinus node or the flow of electric impulses through your heart,
    an arrhythmia can result, causing your heart to beat too fast, too slow or in an irregular fashion.
    Often, these interruptions in rhythm are momentary and harmless. But some types of arrhythmia
    can be serious and lead to a sudden stop in heart function (sudden cardiac arrest).


    The most common cause of cardiac arrest is an arrhythmia called ventricular fibrillation — when
    rapid, erratic electrical impulses cause your ventricles to quiver uselessly instead of pumping
    blood.


    Most of the time, cardiac-arrest-inducing arrhythmias don't occur on their own. In a person with a
    normal, healthy heart, a lasting irregular heart rhythm isn't likely to develop without an outside
    trigger, such as an electrical shock, the use of illegal drugs, or trauma to the chest at just the
    wrong time of the heart's cycle (commotio cordis).
    Heart conditions that can lead to sudden cardiac arrest
    More often, a life-threatening arrhythmia develops in a person with a pre-existing heart condition,
    such as:


     Coronary artery disease. Most cases of sudden cardiac arrest occur in people who have
      coronary artery disease. In coronary artery disease, your arteries become clogged with
      cholesterol and other deposits, reducing blood flow to your heart. This can make it harder for
      your heart to conduct electrical impulses smoothly.

     Heart attack. If a heart attack occurs, often as a result of severe coronary artery disease, it
      can trigger ventricular fibrillation and sudden cardiac arrest. In addition, a heart attack can
      leave behind areas of scar tissue. Electrical short circuits around the scar tissue can lead to
      abnormalities in your heart rhythm.

     Enlarged heart (cardiomyopathy). This occurs primarily when your heart's muscular walls
      stretch and enlarge or thicken. In both cases, your heart's muscle is abnormal, a condition that
      often leads to heart tissue damage and potential arrhythmias.

     Valvular heart disease. Leaking or narrowing of your heart valves can lead to stretching or
      thickening of your heart muscle, or both. When the chambers become enlarged or weakened
      because of stress caused by a tight or leaking valve, there's an increased risk of developing
      arrhythmia.

     Congenital heart disease. When sudden cardiac arrest occurs in children or adolescents, it
      may be due to a heart condition that was present at birth (congenital heart disease). Even
      adults who've had corrective surgery for a congenital heart defect still have a higher risk of
      sudden cardiac arrest.

     Electrical problems in the heart. In some people, the problem is in the heart's electrical
      system itself, instead of a problem with the heart muscle or valves. These are called primary
      heart rhythm abnormalities and include conditions such as Brugada's syndrome and long QT
      syndrome



    Risk factors
    By Mayo Clinic staff
    Because sudden cardiac arrest is so often linked with coronary artery disease, the same factors
    that put you at risk of coronary artery disease may also put you at risk of sudden cardiac arrest.
    These include:


     A family history of coronary artery disease

     Smoking

     High blood pressure

     High blood cholesterol

     Obesity
     Diabetes

     A sedentary lifestyle

     Drinking too much alcohol (more than one to two drinks a day)

    Other factors that may increase your risk of sudden cardiac arrest include:


     A previous episode of cardiac arrest or a family history of cardiac arrest

     A previous heart attack

     A personal or family history of other forms of heart disease, such as heart rhythm disorders,
      congenital heart defects, heart failure and cardiomyopathy

     Age — the incidence of sudden cardiac arrest increases with age, especially after age 45 for men
      and age 55 for women

     Being male — men are two to three times more likely to experience sudden cardiac arrest

     Using illegal drugs, such as cocaine or amphetamines

     Nutritional imbalance, such as low potassium or magnesium levels



           Complications
           By Mayo Clinic staff
           When sudden cardiac arrest occurs, your brain is the first part of your body to suffer
            because, unlike other organs, it doesn't have a reserve of oxygen-rich blood. It's
            completely dependent on an uninterrupted supply of blood. Reduced blood flow to your
            brain causes unconsciousness.
           If your heart rhythm doesn't rapidly return to its normal rhythm, brain damage occurs
            and death results. If sudden cardiac arrest lasts more than 10 minutes, survival is rare.
            Survivors of cardiac arrest may show signs of brain damage



    Tests and diagnosis
    By Mayo Clinic staff
    If you experience an episode of sudden cardiac arrest without warning and survive, your doctor
    will want to investigate what caused the cardiac arrest. Identifying the underlying problem may
    help prevent future episodes of cardiac arrest.


    Tests your doctor may recommend include:


    Electrocardiogram
    A test commonly given after cardiac arrest is an electrocardiogram (ECG). During an ECG, sensors
    (electrodes) that can detect the electrical activity of your heart are attached to your chest and
    sometimes to your limbs. An ECG measures the timing and duration of each electrical phase in
    your heartbeat and can reveal disturbances in heart rhythm. Because injured heart muscle doesn't
    conduct electrical impulses normally, the ECG may show that a heart attack has occurred. An ECG
    can detect abnormal electrical patterns, such as a prolonged QT interval, that increase your risk of
    sudden death.


    Blood tests
    Blood tests may include:


     Cardiac enzyme test. Certain heart enzymes leak into your blood if your heart has been
      damaged by a heart attack. Because a heart attack can trigger sudden cardiac arrest, it's
      important to know whether you've had a heart attack. Testing a blood sample for these
      enzymes may help indicate whether a heart attack has indeed occurred.

     Electrolyte test. A sample of your blood may also be tested for levels of electrolytes, such as
      potassium, calcium and magnesium. Electrolytes are minerals in your blood and body fluids that
      help create electrical impulses. An imbalance in the levels of these substances can increase your
      risk of arrhythmia and sudden cardiac arrest.

     Drug test. Your doctor may check your blood for evidence of drugs that have the potential to
      induce arrhythmia, including certain prescription and over-the-counter drugs and illegal drugs.

     Hormone test. Testing for hyperthyroidism may indicate this condition as the trigger for your
      cardiac arrest.

    Imaging tests
    These may include:


     Chest X-ray. An X-ray image of your chest allows your doctor to check the size and shape of
      your heart and its blood vessels. It may also indicate whether you have heart failure.

     Nuclear scan. This test, usually done along with a stress test, helps identify blood flow
      problems to your heart. Tiny amounts of radioactive material, such as thallium, are injected into
      your bloodstream. Special cameras can detect the radioactive material as it flows through your
      heart and lungs.

     Echocardiogram. This test uses sound waves to produce an image of your heart. An
      echocardiogram can help identify whether an area of your heart has been damaged by a heart
      attack and isn't pumping normally or at peak capacity (ejection fraction), or whether there are
      valvular abnormalities.

    Other tests
    Other tests that are often done include:


     Electrical system (electrophysiological) testing and mapping. This test, if needed, is
      usually done later, after you've recovered and if an underlying explanation for your cardiac
      arrest hasn't been found. With this type of test, your doctor may try to cause an arrhythmia
      while closely monitoring your heart. The test can help locate where in the heart the arrhythmia
      starts.


    During the test, thin, flexible tubes (catheters) tipped with electrodes are threaded through your
    blood vessels to a variety of spots within your heart. Once in place, the electrodes can precisely
    map the spread of electrical impulses through your heart. In addition, your cardiologist can use the
    electrodes to stimulate your heart to beat at rates that may trigger — or halt — an arrhythmia.
    This allows your doctor to observe the location of the arrhythmia.


     Ejection fraction testing. One of the most important predictors of your risk of sudden cardiac
      arrest is how well your heart is able to pump blood. Your doctor can determine your heart's
      pumping capacity by measuring what's called the ejection fraction. This refers to the percentage
      of blood that's pumped out of a filled ventricle with each heartbeat. A normal ejection fraction is
      55 to 70 percent. An ejection fraction of less than 40 percent increases your risk of sudden
      cardiac arrest.


    Your doctor can measure ejection fraction in several ways, such as with an echocardiogram,
    magnetic resonance imaging (MRI) of your heart, a nuclear medicine scan (multiple gated
    acquisition, or MUGA) of your heart or a computerized tomography (CT) scan of your heart.


     Coronary catheterization (angiogram). This test can show if your coronary arteries are
      narrowed or blocked. Along with ejection fraction, the number of obstructed blood vessels is
      another important predictor of sudden cardiac arrest.


    During the procedure, a liquid dye is injected into the arteries of your heart through a long, thin
    tube (catheter) that's advanced through an artery, usually in your leg, to arteries in your heart. As
    the dye fills your arteries, the arteries become visible on X-ray and videotape, revealing areas of
    blockage.


    Also, while the catheter is in position, your doctor may treat a blockage by performing angioplasty
    and inserting a stent to hold the artery open



    Treatments and drugs
    By Mayo Clinic staff
    Sudden cardiac arrest requires immediate action for survival.


    CPR
    Immediate cardiopulmonary resuscitation (CPR) is critical to treating sudden cardiac arrest. By
    maintaining a flow of oxygen-rich blood to the body's vital organs, CPR can provide a vital link
    until more advanced emergency care is available.


    If you don't know CPR but someone collapses unconscious near you, call 911 or
    emergency medical help. Then, if the person isn't breathing normally, immediately begin
    pushing hard and fast on the person's chest — about 100 compressions per minute,
    allowing the chest to fully rise between compressions. Do this until an automated
    external defibrillator (AED) becomes available or emergency personnel arrive.


    To perform CPR:


     Is the person conscious or unconscious?
     If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you
      OK?"

     If the person doesn't respond and two people are available, have one person call 911 or the
      local emergency number and one begin CPR.

     If you're alone and have immediate access to a telephone, call 911 or the local emergency
      number before beginning CPR — unless you think the person has become unresponsive because
      of suffocation (such as from drowning); in this special case, begin CPR for one minute and then
      call 911 or emergency medical help.

     If you're alone and rescuing a child, perform CPR for two minutes before calling 911 or
      emergency help or using an AED.

     If an AED is immediately available, deliver one shock if advised by the device, then begin CPR.

     Start chest compressions by putting the heel of one hand in the center of the person's chest and
      covering the first hand with the other hand. Keeping your elbows straight, use your upper body
      weight to push down hard and fast on the person's chest, at a rate of about 100 compressions a
      minute. For a child, you may need to use only one hand.

     If you haven't been trained in CPR, continue chest compressions until emergency medical help
      arrives.

     If you have been trained in CPR, after every 30 compressions, gently tilt the head back and lift
      the chin up to open the airway. Quickly check for normal breathing, taking no more than 10
      seconds. If the person isn't breathing, give two rescue breaths, making sure the chest rises
      after a breath. Pinch the nostrils shut and give the first rescue breath — lasting one second —
      and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't
      rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.

     If a child has not begun moving after five cycles (about two minutes) and an AED is available,
      apply it and follow the prompts. Administer one shock if so advised, then resume CPR — starting
      with chest compressions — for two more minutes before administering a second shock. If you're
      not trained to use an AED, a 911 or emergency medical help operator may be able to guide you
      in its use.

     Continue CPR or chest compressions until the person recovers consciousness and is breathing
      normally or until emergency medical personnel take over.

    Defibrillation
    Advanced care for ventricular fibrillation, a type of arrhythmia that can cause sudden cardiac
    arrest, typically includes delivery of an electrical shock through the chest wall to the heart. The
    procedure, called defibrillation, momentarily stops the heart and the chaotic rhythm. This often
    allows the normal heart rhythm to resume.


    The shock may be administered by emergency personnel or by a trained citizen if a public-use
    defibrillator, the device used to administer the shock, is available. If you're not trained to use an
    AED, a 911 or emergency medical help operator may be able to guide you in its use. Trained staff
    members at many public places are able to provide and use an AED.
    Defibrillators are available in a small, portable form and come with built-in automated instructions
    to ensure proper use. They're programmed to recognize ventricular fibrillation and send a shock
    only when it's appropriate. These portable defibrillators are available in an increasing number of
    public places, including airports, shopping malls, casinos, health clubs, and community and senior
    citizen centers.


    At the emergency room
    Once you arrive in the emergency room, the medical staff will work to stabilize your condition and
    treat possible heart attack, heart failure or electrolyte imbalances. You may be given medications
    to stabilize your heart rhythm.


    The prognosis after sudden cardiac arrest varies. Some people may be in a coma for days, weeks
    or indefinitely. Others may recover only partial function. After you recover, your doctor will discuss
    with you or your family what additional tests you may need to determine the cause of the cardiac
    arrest. Your doctor will also discuss preventive treatment options with you, to reduce your risk of
    another cardiac arrest.


    Treatments may include:


     Drugs. Doctors use various anti-arrhythmic drugs for emergency or long-term treatment of
      arrhythmias or potential arrhythmia complications. A class of medications called beta blockers is
      commonly used in people at risk of sudden cardiac arrest. Other possible drugs include
      angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers or a drug called
      amiodarone (Cordarone).


    As with any medication, anti-arrhythmic drugs may have potential side effects. For example, an
    anti-arrhythmic drug may cause your particular arrhythmia to occur more frequently — or even
    cause a new arrhythmia to appear that's as bad as or worse than your pre-existing condition.


     Implantable cardioverter-defibrillator (ICD). After your condition stabilizes, your doctor is
      likely to recommend implantation of an ICD. An ICD is a battery-powered unit that's implanted
      near your left collarbone. One or more electrode-tipped wires from the ICD run through veins to
      your heart.


    The ICD constantly monitors your heart rhythm. If it detects a rhythm that's too slow, it paces
    your heart as a pacemaker would. If it detects a dangerous heart rhythm change, it sends out low-
    or high-energy shocks to reset your heart to a normal rhythm. An ICD may be more effective than
    preventive drug treatment at reducing your chance of having a fatal arrhythmia.


     Coronary angioplasty. This procedure opens blocked coronary arteries, letting blood flow
      more freely to your heart, which may reduce your risk of serious arrhythmia. Doctors insert a
      long, thin tube (catheter) that's passed through an artery, usually in your leg, to a blocked
      artery in your heart. This catheter is equipped with a special balloon tip that briefly inflates to
      open up a blocked coronary artery. At the same time, a metal mesh stent may be inserted into
      the artery to keep it open long term, restoring blood flow to your heart. Coronary angioplasty
      may be done at the same time as a coronary catheterization (angiogram), a procedure that
      doctors do first to locate narrowed arteries to the heart.
     Coronary bypass surgery. Another procedure to improve blood flow is coronary bypass
      surgery. Bypass surgery involves sewing veins or arteries in place at a site beyond a blocked or
      narrowed coronary artery (bypassing the narrowed section), restoring blood flow to your heart.
      This may improve the blood supply to your heart and reduce the frequency of racing heartbeats.

     Radiofrequency catheter ablation. This procedure may be used to block a single abnormal
      electrical pathway. In this procedure, one or more catheters are threaded through your blood
      vessels to your inner heart. They're positioned along electrical pathways identified by your
      doctor as causing your arrhythmia. Electrodes at the catheter tips are heated with
      radiofrequency energy. This destroys (ablates) a small spot of heart tissue and creates an
      electrical block along the pathway that's causing your arrhythmia. Usually, this stops your
      arrhythmia.

     Corrective heart surgery. If you have a congenital heart deformity, a faulty valve or diseased
      heart muscle tissue due to cardiomyopathy, surgery to correct the abnormality may improve
      your heart rate and blood flow, reducing your risk of fatal arrhythmias.

     Heart transplantation. Some people with severe congestive heart failure who've experienced
      cardiac arrest may be eligible for a heart transplant. But given the lack of donor hearts,
      availability may be limited



    Prevention
    By Mayo Clinic staff
    There's no sure way to know your risk of sudden cardiac arrest, so reducing your risk is the best
    strategy. Steps to take include regular checkups, screening for heart disease, and living a heart-
    healthy lifestyle with the following approaches:


     Don't smoke, and use alcohol in moderation (no more than one to two drinks a day).

     Eat a nutritious, balanced diet.

     Stay physically active.

    If you know you have heart disease or conditions that make you more vulnerable to an unhealthy
    heart, your doctor may recommend that you take appropriate steps to improve your health, such
    as taking medications for high cholesterol or carefully managing diabetes.


    In some people with a known high risk of sudden cardiac arrest — such as those with a heart
    condition — doctors may recommend anti-arrhythmic drugs or an implantable cardioverter-
    defibrillator (ICD) as primary prevention.


    If you have a high risk of sudden cardiac arrest, you may also wish to consider purchasing an
    automated external defibrillator (AED) for home use. Before purchasing one, discuss the decision
    with your doctor; the devices can be expensive and aren't always covered by health insurance.


    If you live with someone who is vulnerable to sudden cardiac arrest, it's important that you be
    trained in CPR. The American Red Cross and other organizations offer courses in CPR and
    defibrillator use to the public. Being trained will help not only your loved one but also those in your
 community. The more people who know how to respond to a cardiac emergency, the more the
 survival rate for sudden cardiac arrest can be improved.




 References


1.   Siscovick DS, et al. Overview of sudden cardiac arrest and sudden cardiac death.
     http://www.uptodate.com/home/index.html. Accessed April 26, 2010.
2.   What is sudden cardiac arrest? National Heart, Lung, and Blood Institute.
     http://www.nhlbi.nih.gov/health/dci/Diseases/scda/scda_all.html. Accessed April 26, 2010.
3.   2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.
     Circulation. 2005;112(Suppl):IV-12.
4.   Myerburg RJ, et al. Cardiovascular collapse, cardiac arrest, and sudden cardiac death. In: Fauci AS, et al. Harrison's
     Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw Hill; 2007.
     http://www.accessmedicine.com/content.aspx?aID=2869694. Accessed April 27, 2010.
5.   Sudden cardiac death. American Heart Association.
     http://www.americanheart.org/print_presenter.jhtml?identifier=4741. Accessed April 26, 2010.
6.   Ejection fraction and heart failure. American Heart Association.
     http://www.americanheart.org/presenter.jhtml?identifier=3065321. Accessed April 27, 2010.
7.   Sayre MR, et al. Hands-only (compression-only) cardiopulmonary resuscitation: A call to action for bystander
     response to adults who experience out-of-hospital sudden cardiac arrest. Circulation. 2008;117:2162.
8.   Prevention and treatment. Heart Rhythm Society.
     http://www.hrsonline.org/PatientInfo/HeartRhythmDisorders/SCA/Prevention/index.cfm. Accessed April 27, 2010.
9.   Bollmann A, et al. Antiarrhythmic drugs in patients with implantable cardioverter-defibrillators. American Journal of
     Cardiovascular Drugs. 2005;5:371.
10. Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. May 7, 2010.
11. Field JM, et al. Part 1: Executive summary — 2010 American Heart Association guidelines for cardiopulmonary
    resuscitation and emergency cardiovascular care. Circulation. 2010;122(suppl):S640
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    ‫ایغت ًبگِبًی للجی ثَ هؼٌی ليغ غیش هٌتظشٍ ػولکشد للت ّ تٌفظ هی ثبؽذ.ایغت ًبگِبًی للجی هؼوْال ًبؽی اص‬
                    ‫اختالل الکتشیکی دس للت اعت کَ ػول پوپبژ سا ثش ُن هی صًذّ جشیبى خْى تْلف هی ؽْد.‬
  ‫ایغت ًبگِبًی للجی ثب حولَ للجی تفبّت داسدصیشا حولَ للجی ٌُگبهی سخ هیذُذ کَ جشیبى خْى ثَ ثخؾی اص للت‬
 ‫هغذّد ؽذٍ ثبؽذ. ثب ایي حبل ، حولَ للجی هی تْاًذ گبُی ًبؽی اص اختالل الکتشیکی ُن ثبؽذ کَ هٌجش ثَ آغبص ایغت‬
                                                                                     ‫ًبگِبًی للجی هی ؽْد.‬
‫ایغت للجی اگش فْسا دسهبى ًؾْد ، ثبػث هشگ ًبگِبًی للت هی ؽْد ّ ثباحیبی للجی سیْی (احیبء) ّ یب حتی فؾشدى‬
                                                 ‫عشیغ لفغَ عیٌَ -- هی تْاى ؽبًظ صًذٍ ثْدى سا اهتحبى کشد.‬




                                                                                                               ‫عالئن‬
           ‫ػالئن ایغت ًبگِبًی للت ػجبستٌذ اص:افتبدى ًبگِبًی،ًذاؽتي ًجل،ًذاؽتي تٌفظ ّ اص دعت دادى ُْؽیبسی.‬
‫گبُی اّلبت لجل اص ایغت للجی هوکي اعت ػالئوی ثشّص کٌذ هبًٌذ: خغتگی ، غؼ ، عشگیجَ ، دسد لفغَ عیٌَ ، تٌگی‬
 ‫ًفظ ، مؼف ، تپؼ للت ّ یب اعتفشاؽ ّ عپظ فشد ًبگِبى دچبس ایغت للجی هی ؽْد اهب دساغلت هْاسد ثذّى ُؾذاس‬
                                                                                          ‫اتفبق هی افتذ.‬
 ‫ّلتی للت هتْلف هی ؽْد ،کوجْد خْى حبّی اکغیژى هی تْاًذ حتی ثشای چٌذ دلیمَ ثبػث آعیت ُبی هغضی دس فشد‬
  ‫ؽْد. هشگ یب آعیت هغضی دائوی ثیؾتش اص 5::: دلیمَ ىْل ًوی کؾذ دس ایي هْاسد صهبى حیبتی اعت ٌُگبهی کَ‬
      ‫هی خْاُیذ ثَ فشدی کَ ثیِْػ اعت ّ ًفظ ًوی کؾذ، کوک کٌیذ،اثتذا ثب :11 (ؽکوبسٍ اّسژاًظ تجشیض) توبط‬
                                                                                                 ‫ثگیشیذ.‬

   ‫ثَ عشػت تٌفظ فشد ثیِْػ سا ثشسعی هی کٌیذ. اگش اّ ثَ ىْس هؼوْل ًفظ ًوی کؾذ ؽشّع ثَ احیبء کٌیذ.اگش ؽوب آهْصػ‬
  ‫احیبء دیذٍ ثبؽیذ فؾبس عخت ّ عشیغ ثَ لفغَ عیٌَ فشد حذّد 111 فؾبس دس دلیمَ سا فشاهْػ ًکٌیذ ّ ًیض تٌفظ دُبى ثَ دُبى‬
      ‫10 ثبس دس دلیمَ هی تْاًذ کوک کٌٌذٍ ثبؽذ ّ اگش آهْصػ ًذیذٍ ایذ تٌِب فؾبس دادى لفغَ عیٌَ کبفی اعت ّ تبصهبى سعیذى‬
                                                           ‫اّسژاًظ ّ آگبُی اص ثِجْدی تٌفغی فشد ایي کبس سا اداهَ دُیذ.‬




                                                                                       ‫اقذاهات برای ایست قلبی‬


                                                                                                ‫- توبط ثب ؽوبسٍ :11‬

                                                                                                    ‫- اهجبم احیبء للجی‬

                                                                                          ‫-اًجبم ػول مذ فیجشیالعیْى‬
                                                                                                ‫عٌاهل ایست قلبی‬
 ‫ػلت افلی ایغت ًبگِبًی للجی هؼوْال اختالل دس سیتن للت (آسیتوی)اعت کَ ًبؽی اص ثشّص هؾکل دس عیغتن الکتشیکی للت هی‬
                                                                                                           ‫ثبؽذ.‬

    ‫دس لغوت ساعت ثبالی للت(دُلیض ساعت)گشٍ عیٌْعی، تْلیذ پبلظ ُبی الکتشیکی هی کٌذ کَ جشیبى ثَ ىْس هٌظن اص للت ّ‬
‫ُوبٌُگ ثب مشثبى للت ثَ ّعیلَ پوپبژثَ ثمیَ ثذى هٌتمل هی ؽْداگش هؾکلی دس گشٍ عیٌْعی یب جشیبى الکتشیکی پیؼ آیذ آسیتوی‬
     ‫هی تْاًذ جذی ّ هٌجش ثَ تْلف ًبگِبًی دس ػولکشد للت (ایغت للجی) ؽْد.ؽبیغ تشیي ػلت ایغت للجی آسیتوی فیجشیالعیْى‬
                ‫ثيٌی اعت کَ ثَ احتوبل صیبد ثَ دًجبل ؽْک الکتشیکی،اعتفبدٍ اص هْاد هخذس ّ یب مشثَ ثَ لفغَ عیٌَ هی ثبؽذ.‬




                                                                           ‫آریتوی ىا ىنگاهی تيذیذ کننذه ىستنذ کو:‬

      ‫- فشد هجتال ثَ ثیوبسی ػشّق کشًّش اعت.دس ثیوبسی ػشّق کشًّش،کلغتشّل دیْاسٍ عشخشگ ثبػث هغذّد ؽذى ّ کبُؼ‬
                                                                                ‫جشیبى خْى ثَ للت هی ؽْد.‬

   ‫- فشد دچبسحولَ للجی ؽذٍ ثبؽذ هی تْاًذ هٌجش ثَ ایغت للجی ؽْد. ػالٍّ ثشایي هی تْاًذ جشاحت هبًذگبسی سا دس ثبفت ُب ثش‬
                                                                                                         ‫جبی ثگزاسد.‬

 ‫- للت ثضسگ ثبؽذ(کبسدیْهیْگشافی):دس ایي هْالغ دیْاسٍ ػنالًی للت دساص،ثضسگ ّ مخین هی ؽْد ّ هبُیچَ ُبی للت غیش‬
                                 ‫ىجیؼی هی ؽًْذ ّ دس اغلت هْاسد هٌجش ثَ آعیت ثَ ثبفت للت ّ آسیتوی ثبلمٍْ هی ؽْد.‬

 ‫- ثیوبسی هبُیچَ ُبی للت:ًؾت ّ یب ثبسیک ؽذى دسیچَ ُبی للت کَ هی تْاًذ ثبػث کؾؼ ّ مخین ؽذى ػنلَ للت ؽْدّ ثَ‬
                           ‫دلیل تٌگی دسیچَ للت ،اعتشط ُبط ًبؽی اص آى هی تْاًذ خيش ثشّص آسیتوی سا افضایؼ دُذ.‬

 ‫- ثیوبسی للجی هبدسصادی: دس کْدکبى ّ ًْجْاًبى ثب دلیل ثیوبسی للجی هبدسصادی آسیتوی خيش صا هی ثبؽذ حتی دس ثضسگغبالًی‬
                                    ‫کَ جشاحی افالحی ثشای سفغ ًمـ للجی هبدسصادی اًجبم دادٍ اًذ ًیض خيشصا اعت.‬

‫- هؾکالت الکتشیکی دس للت:دس ثشخی اص افشاد عیغتن الکتشیکی للت ثَ خْدی خْد دس ػنلَ للت یب دسیچَ ُب هؾکل ایجبد هی‬
                                                                       ‫کٌذ کَ ثب ًبم اختالالت اّلیَ آسیتوی للت اعت.‬



                                                                                                    ‫عٌاهل خطرزا‬

 ‫اص آًجب کَ ایغت للجی اغلت ثب ثیوبسی ػشّق کشًّش دس استجبه اعت ّ ُویي استجبه اعت کَ فشد سا دس هؼشك خيش لشاس هی‬
                                                                                    ‫دُذ.ػْاهل خيش صا ؽبهل:‬

                                                                           ‫- عبثمَ خبًْادگی ثشای ثیوبسی ػشّق کشًّش‬

                                                                                                     ‫- هقشف عیگبس‬

                                                                                                      ‫- فؾبس خْى ثبال‬

                                                                                                  ‫- کلغتشّل خْى ثبال‬

                                                                                                              ‫- چبلی‬

                                                                                                              ‫- دیبثت‬

                                                                                                       ‫- عجک صًذگی‬
                                                                  ‫- ًْؽیذى صیبد الکل ّ ًْؽبثَ ثیؼ اص 0 لیْاى دس سّص‬

                                                              ‫دیگش ػْاهل خيش صا ثشای افضایؼ ایغت للجی ػجبستٌذ اص:‬

                                                                                       ‫- عبثمَ خبًْادگی اص ایغت للجی‬

                                                                                                ‫- حولَ للجی دس گزؽتَ‬

          ‫- عبثمَ خبًْادگی ثشای ثیوبسیِبی للجی هثل اختالالت سیتن للجی،ًمـ ُبی هبدسصادی،ًبسعبیی للجی ّ کبسدیْهیْپبتی‬

                                            ‫- عي(ثخقْؿ ثؼذ اص عي :5 عبلگی ثشای هشداى ّ :: عبلگی ثشای صًبى)‬

                                                                     ‫- اعتفبدٍ اص هْاد هخذس اص لجیل کْکبئیي ّ آهفتبهیي‬

                                               ‫- جٌغیت(هشداى دس تب عَ ثشاثش ثیؾتش احتوبل اثتال ثَ ایغت للجی سا داسًذ)‬

                                                                          ‫- ػذم تؼبدل تغزیَ ای(کوجْد هٌیضین ّ پتبعین)‬



                                                                                               ‫دیگر عٌاهل آسیب زا‬

  ‫- ّلتی ایغت ًبگِبًی للت سخ هی دُذ هغض اّلیي اسگبًی اعت کَ آعیت هی ثیٌذصیشا ثش خالف عبیش اسگبًِب ُیچ رخیشٍ خًْی‬
‫غٌی اص اکغیژى ًذاسد ّ ثَ ىْس کبهل ّاثغتَ ثَ تبهیي ثی ّلفَ خْى اعت ّ کبُؼ جشیبى خْى ثَ هغض ثبػث ثیِْؽی هی ؽْد.‬

‫- اگش سیتن للجی فشد ثَ عشػت ثَ حبلت اّل خْد ثبصًگشدد ثَ هغض فذهَ ّاسد هی کٌذ ّ اگش ایغت للجی ثیؼ اص 10 دلیمَ ىْل‬
                                    ‫ثکؾذ ثَ ًذست فشد صًذٍ هی هبًذ ّ اگش ُن ثوبًذ دچبس آعیت ُبی هغضی ؽذیذ هی ؽْد.‬



                                                                            ‫آزهایشات ً تست ىای تشخسصی‬
‫اگش فشد تجشثَ یک ایغت ًبگِبًی للجی ثذّى ػالئن ُؾذاسی سا داؽتَ ثبؽذ پضؽک ثشسعی هی کٌذ کَ چَ چیض ثبػث ایغت للجی‬
                                    ‫ؽذٍ اعت ّ ؽٌبخت هؾکالت ًِفتَ ثَ پیؾگیشی اص حوالت آیٌذٍ للجی کوک هی کٌذ.‬

                                                                            ‫تغت ُبیی کَ پضؽک تْفیَ هی کٌذ ؽبهل:‬

                                                                                                          ‫- نٌار قلب‬

  ‫ًْاس للت هؼوْال پظ اص ایغت للجی اًجبم هی ؽْد.دس ًْاس للجی،الکتشّد هی تْاًذ فؼبلیت الکتشیکی للت سا تغخیـ دُذ.ًْاس‬
‫للت ؽبهل اًذاصٍ گیشی صهبى ّ ىْل هذت ُش فبص الکتشیکی للت اعت کَ اختالل دس سیتن للت سا ًؾبى هی دُذ ّ ػنلَ للت سا‬
                                                   ‫صخوی ًوی کٌذّ هؾخـ هی کٌذ کَ آیب حولَ للجی سخ دادٍ اعت یب ًَ.‬



                                                                                                   ‫- آزهایشات خٌى‬

                                                                                     ‫آصهبیؾبت خْى هوکي اعت ؽبهل:‬

  ‫0- تغت آًضین للت:اگش للت ثَ ػلت ایغت آعیت ثجیٌذ آًضین ُبی خبؿ للت دس خْى فشد کن هی ؽْد ّ تغت ًوًَْ خْى ثشای‬
                                                         ‫ایي آًضین ُب هوکي اعت ثَ تؾخیـ حولَ للجی کوک کٌذ.‬

 ‫2- تغت الکتشّلیت:ًوًَْ ای اص خْى فشد ثشای تؼییي عيح الکتشّلیت ُبیی هبًٌذ پتبعین،کلغین ّ هٌیضین اعت کَ دس ایي تغت‬
              ‫هْسد اعتفبدٍ لشاس هی گیشد ّ ػذم تؼبدل دس عيح ایي هْاد هی تْاًذ خيش آسیتوی ّ ایغت للجی سا افضایؼ دُذ‬
                      ‫3- تغت داسّیی:پضؽک هوکي اعت خْى سا اص ًظش داسُّبیی کَ ثبػث آسیتوی هی ؽْد،ثشسعی کٌذ.‬

                                      ‫4- تغت ُشهًْی:تغت ثشای پشکبسی تیشّئیذ اعت کَ هوکي اعت ثبػث آسیتوی ؽْد‬




                                                                                      ‫آزهایشات تصٌیر برداری -‬
 ‫- تْعو اؽؼَ ایکظ تقْیش اص لفغَ عیٌَ ثشداؽتَ هی ؽْد ّ ثَ پضؽک اجبصٍ هی دُذ تب اًذاصٍ ّ ؽکل للت ّ سگِبی خًْی سا‬
                                                          ‫ثشسعی کٌذ ّ ُوچٌیي ًبسعبیی للجی سا ًیض تؾخیـ هی دُذ‬

 ‫- اعکي ُغتَ ای:هؼوْال ُوشاٍ ثب تغت اعتشط اًجبم هی ؽْد کَ هؾکالت جشیبى خْى ثَ للت سا ؽٌبعبیی هی کٌذ.همبدیش کوی‬
‫اص سادیْاکتیْ هبًٌذ تبلین ثَ جشیبى خْى تضسیك هی ؽْد ّ دّسثیي ُبی خبفی هی تْاًذ اص ىشیك للت ّ سیَ ُب جشیبى خْى سا‬
                                                                                                    ‫تؾخیـ دُذ‬

‫- اکْکبسدیْگشام: ایي تغت اص اهْاج فْتی ثشای ایجبد تقْیش اص للت اعتفبدٍ هی کٌذ ّ ثَ ؽٌبعبیی هٌيمَ ای اص للت کَ تْعو‬
                                                                              ‫حولَ للجی آعیت دیذٍ اعت،کوک هی کٌذ.‬



                                                                                                   ‫سایر آزهایشات‬

                                                                                               ‫تغت ُبی دیگش هبًٌذ:‬

  ‫- تغت عیغتن الکتشیکی(الکتشّفیضیْلْژیکی):ایي تغت دس فْست ًیبص ّ پظ اص ثِجْدی اگش دلیلی ثشای ایغت للجی یبفت ًؾذ‬
‫،اًجبم هی ؽْد.اعتفبدٍ اص ایي تغت ثَ ػلت ًظبست ثش آسیتوی فْست هی گیشد دس ىْل تغت یک لْلَ ًبصک ّ اًؼيبق پزیش ثَ‬
     ‫ًبم کبتتش کَ دس ًْک آى الکتشّدُب اص ىشیك ػشّق خًْی ثَ ًمبه هختلف للت فشعتبدٍ هی ؽًْذ ّ هتخقـ للت هی تْاًذ‬
                                                           ‫الکتشّدُبی للت سا تحشیک کٌذ ّ هْجت تْلف آسیتوی ؽْد.‬

  ‫- کبتتشیضاعیْى ػشّق کشًّش(آًژیْگشام)ایي آصهبیؼ ًؾبى هی دُذ کَ آیب ػشّق کشًّش تٌگ ّ یب هغذّد ؽذٍ اعت یب ًَ صیشا‬
                                                        ‫تؼذادػشّق خًْی هغذّد ؽذٍ ػبهل هِن ایغت ًبگِبًی للت اعت.‬

  ‫دس ایي سّػ هبیغ سًگی اص ىشیك یک لْلَ ًبصک (کبتتش)ثَ ػشّق للت تضسیك هی ؽْد کَ هؼوْال اص عبق پب ثَ ػشّق للت‬
‫تضسیك هی ؽْد ّ ّلتی ػشّق سًگی ؽذ ثشسّی اؽؼَ ایکظ ّ ًْاس ّیذیْیی ظبُش هی ؽًْذ ّ هٌبىك هغذّد ؽذٍ لبثل تؾخیـ‬
                                                                                                   ‫هی ؽًْذ‬




                                                                                                ‫درهاى ً دارًىا‬
                                                 ‫دس ایغت ًبگِبًی للجی ًیبص ثَ الذاهبت فْسی جِت صًذٍ هبًذى فشد داسد.‬

                                                                                                           ‫- احیاء‬

   ‫احیبی للجی دیْی آًی ثشای دسهبى ایغت للجی ثغیبس حیبتی اعت ّ ثب احیب هی تْاًیذ جشیبى خْى حبّی اکغیژى سا تب سعیذى‬
            ‫اّسژاًظ ثشلشاس کٌیذ ّ احیبء یؼٌی فؾبس عخت ّ عشیغ دس لفغَ عیٌَ فشد کَ دس حذّد 110 فؾبس دس دلیمَ اعت.‬
                                                                                                      ‫برای انجام احیاء‬

     ‫- آیب فشد ُْؽیبس اعت یب ثیِْػ ّ اگش فشد ثیِْػ ثَ ًظش هی سعذ ؽبًَ ُبیؼ سا تکبى دُیذ ّ ثب فذای ثلٌذ اص اّ ثپشعیذ‬
                                                                                               ‫"حبلتبى خْة اعت؟"‬

                                                ‫- اگش دّ ًفش ُغتیذ یکی ثب اّسژاًظ توبط ثگیشد ّ دیگشی احیبءاًجبم دُذ.‬

                                  ‫- ااگش تٌِب ثْدیذ اثتذا ثشای یک دلیمَ احیبءسا اًجبم دُیذ ّ عپظ ثب اّسژاًظ توبط ثگیشیذ.‬

         ‫- یک دعت سا دس هشکض لفغَ عیٌَ فشد لشاس دادٍ ّ دعت دیگش سا ثش سّی آى ثگزاسیذ ّ ؽشّع ثَ فؾبس دادى ًوبییذ.‬

   ‫- اگش ؽخـ ثشای احیبءآهْصػ دیذٍ ثبؽذ پظ اص ُش 13 ثبس فؾشدى لفغَ عیٌَ ثَ آساهی چبًَ سا ثبال کؾیذٍ ّ تٌفظ دُبى ثَ‬
                                                                                                   ‫دُبى سا اًجبم دُیذ‬

     ‫- اداهَ احیبء ثب فؾشدى لفغَ عیٌَ تب صهبًی کَ فشد ُْؽیبسی خْد سا ثذعت ثیبّسد ّ ثَ ىْس هؼوْل تٌفظ کٌذ ّ تب سعیذى‬
                                                                                           ‫اّسژاًظ مشّسی اعت‬




                                                                                                    ‫- ضذ فیبریالسیٌى‬

                                                                                                      ‫فیجشیالعیْى ثيٌی:‬

  ‫ًْػی آسیتوی اعت کَ هی تْاًذ فشد سا دچبس ایغت ًبگِبًی للت کٌذ ّ ثَ ىْس هؼوْل لحظَ ای للت هتْلف هی ؽْد .دعتگبٍ‬
  ‫مذ فیجشیالعیْى هوکي اعت تْعو اّسژاًظ لبثل دعتشط ثبؽذ ّ افشاد آهْصػ دیذٍ ًیض دس ثغیبسی اص اهبکي ػوْهی لبدس ثَ‬
                                                                                              ‫اعتفبدٍ اص آى ُغتٌذ.‬



                                                                                                            ‫اًرژانس‬
  ‫ٌُگبهی کَ فشد ثَ اّسژاًظ هی سعذ،کبدس پضؽکی کبس خْد سا ثشای دسهبى حولَ للجی ،ًبسعبیی للجی ّػذم تؼبدل الکتشّلیتی‬
                                            ‫ؽشّع هی کٌٌذ ّ ثشخی اص داسُّب سا ثشای هٌظن کشدى سیتن للجی تجْیض هی کٌٌذ‬

‫ػالئن پظ اص ایغت للجی دس افشاد هتفبّت اعت.دس ثشخی اص افشاد ثَ هذت چٌذ سّص یب چٌذ ُفتَ ّ یب ثَ ىْس ًبهؾخـ دس کوب ثَ‬
                                                                  ‫عش هی ثشًذ ّ دس ثشخی دیگش ثَ عشػت ثِجْد هی یبثذ‬

                                                                           ‫پضؽک ثشای دسهبى پیؾگیشاًَ پٌذ تْفیَ داسد‬

                                                                                               ‫دسهبى هوکي اعت ؽبهل :‬

  ‫- داسُّب: پضؽکبى ثب اعتفبدٍ اص داسُّبی هختلف مذ آسیتوی دسهبى سا ؽشّع هی کٌٌذ.ایي داسُّبی احتوبلی ػجبستٌذ اص آًضین‬
                                              ‫ُبی هِبسکٌٌذٍ،آًژیْتبًغیي،هغذّد کٌٌذٍ ُبی کلغین ّ داسّیی ثَ ًبم آهیْداسّى‬

 ‫داسُّبی مذ آسیتوی هوکي اعت ػْاسك جبًجی داؽتَ ثبؽذ ثَ ػٌْاى هثبل یک داسّی مذ آسیتوی هوکي اعت ثبػث ثِجْد آى‬
                                                                        ‫ؽْد ّ لی هٌجش ثَ آسیتوی ُبی جذیذ ُن ؽْد‬

 ‫- آًژیْپالعتی ػشّق کشًّش:ایي سّػ ثبص کشدى ػشّق کشًّش هغذّد ؽذٍ اعت کَ اجبصٍ هی دُذ جشیبى خْى آصاداًَ ثَ للت‬
‫هٌتمل هی ؽْد ّ خيش آسیتوی سا کبُؼ هی دُذ.پضؽکبى لْلَ ًبصکی ثَ ًبم کبتتش سا اص ىشیك عبق پب ثَ ػشّق هغذّد ؽذٍ للت‬
      ‫ُذایت هی کٌٌذ.ایي کبتتش دس ًْک خْد یک ثبدکٌک ّیژٍ داسد کَ ثشای ثبص کشدى ػشّق کشًّش هغذّد ؽذٍ هٌبعت اعت.‬
   ‫- ػول جشاحی ثبی پظ ػشّق کشًّش:یکی دیگش اص سّػ ُب ثَ هٌظْس ثِجْد جشیبى خْى اعت.ػول جشاحی ثبی پظ ؽبهل‬
                  ‫دّخت سگ یب ؽشیبى ػشّق کشًّش هغذّد یب تٌگ ؽذٍ اعت کَ جشیبى خْى دّثبسٍ ثَ للت ثبص هی گشدد‬



     ‫- ثغبهذ سادیْیی کبتتش:ایي سّػ هوکي اعت ثشای جلْگیشی اص هغیش الکتشیکی غیش ىجیؼی ثبؽذ .دس ایي سّػ یک یب چٌذ‬
 ‫کبتتش اص ىشیك سگ ُبی خًْی للت کؾیذٍ هی ؽْد ّ پضؽکبى اص ىشیك الکتشّدُب ،هغیشُبی الکتشیکی سا ؽٌبعبیی هی کٌذ ّ‬
                                                                             ‫اص ایي ىشیك آسیتوی هتْلف هی ؽْد.‬

  ‫- ػول جشاحی للت افالحی:اگش فشد ًبٌُجبسی هبدسصادی للجی ،هؼیْة ثْدى دسیچَ للت ّهبخیچَ ُبی للت ّ کبسدیْهیْپبتی‬
                                                                   ‫داؽتَ ثبؽذ ثب ایي ػول خيش آسیتوی کبُؼ هی یبثذ‬

   ‫- پیًْذ للت: ثشخی اص افشاد اص ىشیك پیًْذ للت،ًبسعبیی ُب سا ػول هی کٌٌذ الجتَ ثب تْجَ ثَ ّجْد افشاد اُذا کٌٌذٍ ایي ػول‬
                                                                                                          ‫اًجبم هی ؽْد‬



                                                                                                            ‫پیشگیری‬
‫ُیچ سّػ دسهبًی هيوئٌی ثشای ایغت للجی ّجْد داسد اهب هی تْاى خيش اثتال ثَ ایي ثیوبسی سا کبُؼ داد سّػ ُبی پیؾگیشی‬
                                                            ‫ؽبهل هؼبیٌبت هٌظن،غشثبلگشی اعت سّؽِبی دیگش ؽبهل:‬

                                                                               ‫- عیگبس ًکؾیذى ّ تؼبدل دس هقشف الکل‬

                                                                                             ‫- داؽتي سژین غزایی هتؼبدل‬

                                                                                                  ‫- اًجبم فؼبلیت جغوبًی‬

 ‫پضؽک ثشای ثِجْد عالهت تْفیَ ُبیی اص جولَ هقشف داسّ ُب ثشای پبییي آّسدى کلغتشّل ثبال ّ یب دیبثت ثَ فشد هی دُذ ّ‬
                                                                           ‫ًیض داسُّبی مذ آسیتوی ُن اعتفبدٍ هی ؽْد‬

  ‫اگش ؽوب ثب فشدی کَ دس هؼشك خيش ایغت ًبگِبًی للجی ثبؽذ هْاجَ هی ؽْیذ،ثبیذ احیبء سا آهْصػ ثجیٌیذ صیشا ثب ایي کبس ثَ‬
                                                                                               ‫فشد کوک خْاُیذ کشد‬

				
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posted:11/1/2011
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