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Useful for : :
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10%
15%
15%
B
Breathing
C
Circulation
(advanced airways)
Approach to ACLS
Airway
Breathing
Circulation
Defibrillation
(open)
(Bag-valve-mask)
(chest compression)
(defibrillator/AED)
Secondary Survey
Airways
Breathing
Circulation
DDx
(advanced airways)
(placement & effectiveness confirmation
(IV access & IV drugs)
(underlying problems)
(3)
The Brain:
CPR Initial Goal:
* Restarting the heart
CPR Ultimate Goal:
* Restoring neurological function
Therefore the term:
Cardio-pulmonary-cerebral Resuscitation
(4)
Time:
Probability of survival & neurological recovery decline sharply with
time
Progressive death of brain cells starts 4 minutes after cardiac arrest
,
Post-resuscitation Care:
12-Leads ECG
Chest Radiograph
CHAIN OF SURVIVAL
HEALTHY CHOICES
EARLY RECOGNITION
EARLY ACCESS
EARLY CPR
EARLY DEFIBRILLATION
HEALTHY CHOICES
RISK FACTORS
- Cannot Control
Age
Gender
Family History
Race
Lack of Exercise
Diabetes
Being Overweight
Smoking
Be
Smoke-free
Be
Physically Active
Control
Eat
Blood Pressure
Healthy
Maintain
Diabetes
Alcohol
Reduce
Stress
Regularly
Body Check-up
Post-menopause
Female
EARLY RECOGNITION
Warning Signs for Heart Disease & Stroke
Disease
Pain
Shortness of Breath
Nausea
Sweating
Fear
Heart
EARLY RECOGNITION
Stroke
Weakness
Trouble Speaking
Vision Problems
Headache
Dizziness
Early access
2min CPR
(
2min CPR
Early Access
999 () / 27353355 ()
,
()
Early CPR
CPR (Cardio- Pulmonary resuscitation)
Airway
Clear
Open
Maintain
Breathing
Look
Listen
Feel
Circulation
Airway
Clear
/
Airway
Open
Airway
Maintain
Breathing
5-10 (10 )
: /
: ( Noisy Breathing )
() :
Breathing
,
(layman protocol )
1,
500-600 (Tidal volume)
>>>
>>
Breathing
10-125-6
12-20 (3-5
12 :
20 :
EARLY CPR
Responsive
Rest
Medication
Experience Chest Pain
Reassurance
Unresponsive
Begin CPR
Recovery Position
CPR
()
, 30:2 CPR ()
Push hard and push fast , 100
: 1 - 2
,
2 ( 5 30:2)
()
, 30:2 CPR () 15:2 ()
Push hard and push fast , 100
:
: 1/3 1/2
,
2 ( 5 30:2 / 815:2)
()
60,,
30:2 CPR () 15:2 ()
Push hard and push fast , 100
() ()
: ()
: 1/3 1/2
,
2 ( 5 30:2 / 815:2)
, ,
A
B
2
C
,
10 - 12
CPR,
3- 4%
2- 3
ACLS
ET Tube,
LMA, Combi tube CPR
8-10
1,
500-600 (Tidal volume)
Activate
2min CPR
2min CPR
Airway
Breathing
Circulation
()
()
1 to 2
1/3 1/2
100
30:2
30:2 () 15:2 ()
CPR AED
CPR
CPR
(75%)
- Pulseless VT
Pulseless Ventricular Tachycardiac
150
- VF
Ventricular Fibrillation
VT
Polymorphic VT
>
>
120
+-
Monomorphic VT
>
Amiodarone
Medtronic CR Plus
Cardiac Science
Powerheart AED
G3
Laerdal FR2
Defibrillation
Monophasic
360J
Defibrillation
Biphasic dose
150-200J for truncated
exponential waveform
(BTE)
120J for
rectilinear biphasic
waveform (RLB)
If unknown , 200J for
ANY biphasic
VF5min,
AED
VF5min,CPR
2min
(CPR AED)
CPR, AED
(8 / 25)
AED
1
2
2
2
(
CPR2
ABC)
(CPR
2
ABC)
(AED
2ABC)
Up IV
Drugs
Apply
Cardiac
Monitoring
Defibrillation
After
Care
EARLY REHABILITATION
(,/,
: Abdominal thrusts
: 30:2 CPR
(x )
, .
(,/,
:
(x )
,
Defibrillation protocol
Guildline 2005
http://www.americanheart.org/presenter.jhtml?identifier
=3035517
http://ww2.heartandstroke.ca/Page.asp?PageID=33&Articl
eID=4466&Src=heart&From=SubCategory
http://www.erc.edu/index.php/guidelines_download_2005/
en/?
QUESTIONS?