European Resuscitation Council

ADULT ADVANCED LIFE SUPPORT (ALS)

GUIDELINES FOR PREVENTION OF IN-HOSPITAL CARDIAC ARREST

European Resuscitation Council
RECOGNISING THE CRITICALLY ILL PATIENTS RESPONSE TO CRITICAL ILLNESS Medical emergency team (MET)

APPROPRIATE PLACEMENT OF PATIENTS

RESUSCITATION DECISIONS Many European countries have no formal policy for recording DNAR decisions Consider do not attempt resuscitation (DNAR) when the patient: does not wish to have CPR will not survive cardiac arrest even if CPR is attempted

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IN-HOSPITAL RESUSCITATION

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ALS TREATMENT ALGORITHM

AIRWAY MANAGEMENT AND VENTILATION

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BASIC AIRWAY MANAGEMENT

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Head tilt and chin lift

Jaw thrust

ADJUNCTS TO BASIC AIRWAY TECHNIQUES Oropharyngeal airways

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Bag-mask ventilation

OTHER AIRWAY DEVICES Laryngeal Tube

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DRUGS AND FLUIDS

- DRUGS European Resuscitation Council
Vasopressors Adrenaline Anti-arrhythmics Amiodarone

Other drugs Atropine Theophylline

- INTRAVENOUS FLUIDS
Hartmanns solution, Ringers solution
Intravenous fluid to flush peripherally injected drugs into the central circulation

ELECTRICAL THERAPIES
DEFIBRILLATION
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Passage across the myocardium of an electrical current of sufficient magnitude to depolarise a critical mass of myocardium and restoration of coordinated electrical activity
USE OF DEFIBRILLATORS: - Adults - Children older than 8 years - NO defibrillation in children less than 1 year

ELECTRICAL THERAPIES
AUTOMATED EXTERNAL DEFIBRILLATOR (AED)
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CARDIOVERSION
is used to convert atrial or ventricular tachyarrhythmias PACING Consider pacing in patients with symptomatic bradycardia

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PAEDIATRIC BASIC LIFE SUPPORT (PBLS)

PEADIATRIC BASIC LIFE SUPPORT(PBLS)

European Resuscitation Council

MANY CHILDREN RECEIVE NO RESUSCITATION AT ALL BECAUSE THE RESCUERS FEAR DOING HARM. APPLYING OF THE SAME GUIDANCE FOR ALL ADULTS AND CHILDREN ARE FEASIBLE ! ! ! ! ! ! ENHANCED TRAINING FOR HEALTHCARE PROFESSIONALS.

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PBLS

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RESCUE BREATHS

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brachial pulse / INFANT

PBLS
AGE C : V RATIO /RATE 15:2 / 100 min POSITION Tips of 2 fingers on the lower third of the sternum RESCUE BREATHS Mouth-to mouth and nose ventilation NO AED

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Infant < 1 year of age

Child 1 year to puberty

30:2 / 100 min lone rescuer

The heel of one hand over the lower third of the sternum, lift the fingers

Mouth-to mouth ventilation

YES paediatric pads /programmes

CHEST COMPRESSION RESCUE BREATHS

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FOREIGN BODY AIRWAY OBSTRUCTION (FBAO)

Back blows, chest thrusts and abdominal thrusts all
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increase intrathoracic pressure and can expel foreign bodies from the airway

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PAEDIATRIC ADVANCED LIFE SUPPORT (PALS)

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PALS

REPETITION
European Resuscitation Council

1. Name 3 causes of airway obstruction. 2. Name 2 types of airway in-hospital devices. 3. Name 2 drugs commonly used in ALS. 4. What is the age limit 4 defibrillator usage? 5. What electrical therapies can be performed in the hospital? 6. What is the C:V ratio in an infant life support? 7. What is the major cause of cardio-pulmonary arrest in: - children? - adult?