ACLS.pptx

acls

1. BLS & ACLS

2. https://www.youtube.com/watch?v=n7kqiAu2gC8&t=29s

3. Chest Compression

4. Pocket Mask & Bag Mask

5. High Quality CPR: It improves a victim chances of survival . Characteristics: Start compression within 10 seconds. Push hard & push fast: Compress at a rate of 100 to 120/min with a depth of – At least 5 cm adults At least one third the depth of the chest approx. 5 cm, for children At least one third the depth of the chest approx. 4 cm, for infants. 3. Allow complete chest recoil. 4. Minimize interruptions. 5. Give effective breaths. 6. Avoid excessive ventilation.

6. AED: https://www.youtube.com/watch?v=YWyU1IRaMGs https://www.youtube.com/watch?v=f0jTjCdL7SI (Full BLS video)

7. Paediatrics: https://www.youtube.com/watch?v=n65HW1iJUuY

8. Infant Chest Compression:

9. Infant Choking:

10. SYSTEMATIC APPROACH :

11. Initial Assessment: Visualization & Scene safety. BLS Assessment

12. Primary Assessment: The ABCDE’s of the Primary Assessment are: (A)   Airway : Maintain airway and use advanced airway if needed. Ensure confirmation of placement of an advanced airway and secure the advanced airway device. (B)   Breathing : Give bag-mask ventilation, provide supplemental oxygen, and avoid excessive ventilation. Also, adequacy of ventilation and oxygenation should be monitored during this step. (C)   Circulation : Obtain IV access, attach ECG leads, identify and monitor arrhythmias, giving fluids if needed, and use defibrillation if appropriate.

13. (D)   Disability : Perform a general neurological assessment which should include assessment of responsiveness, level of consciousness, and pupil reflex.  AVPU acronym  may help. (Alert, Voice, Painful, Unresponsive) (E) Exposure : Ensure that clothing is removed so that a complete visual assessment can be performed. This visual assessment should include looking for signs of trauma, bleeding, burns, or medical alert bracelets.

14. Secondary Assessment:  The secondary assessment includes a search for underlying causes for the emergency and if possible a focused medical history. Performing the focused medical history can be simplified using the SAMPLE .  (S)Signs and symptoms;  (breathing difficulty, Tachypnoea, tachycardia, fever, headache, abdominal pain, bleeding) (A)Allergies ; (medication, food, associated reaction)

15. (M)Medications ; ( last dose, patients medication details) (P)Past medical history ; (current & previous illness, family health history, past surgery) (L)Last Oral Intake ; ( time & nature of last intake of liquid or food)   (E)Events : Leading Up To Present Illness or injury, hazards at scene, time of onset

16. This search for underlying causes, also known as differential diagnosis, requires a review of all of the H’s and T’s of ACLS. 5 H’s : Hypovolemia Hypoxia Hydrogen ion (acidosis) Hypo-Hyper kalemia Hypothermia 5 T’s: Tension Pneumothorax Cardiac Temponade Toxins Pulmonary Thrombosis Coronary Thrombosis

17. ACS https://www.youtube.com/watch?v=Njx9xqsZt9w

18. https://www.youtube.com/watch?v=jeEMP7Sv2GI

19. Types of stroke: Ischemic stroke : 87% of all strokes is usually caused by an occlusion of an artery to a region of the brain. Haemorrhagic stroke : 13% of all strokes occurs when a blood vessel in the brain suddenly rupture into the surrounding tissue. Fibrinolytic therapy is contraindicated. Avoid anticoagulant.

20. STROKE: 8 D’s of Stroke care: D etection : rapid recognition of stroke signs & symptoms D ispatch : early activation & dispatch of EMS by phone. D elivery : rapid EMS stroke identification, management, triage, transport, & prehospital notification. D oor : emergency ED & immediate assessment by the stroke team. D ata : rapid clinical evaluation. D ecision : establishing stroke diagnosis & therapy selection. D rug/Device : administration of fibrinolytic. D isposition : rapid admission to the stroke unit.

21. ACLS:

22. Effective High-Performance Team Dynamics Understanding Team Roles Whether you are a team member or a team leader during a resuscitation attempt, you should  understand not only your role but also the roles of other members.   How to communicate and work as a member or as a leader of a high-performance team

23. Role of the Team Leader The role of the team leader is - Organizes the group Monitors individual performance of team members Backs up team members Trains and coaches Facilitates understanding Focuses on comprehensive patient care.

24. Role of the Team Member Team members must be proficient in performing the skills. It is essential to the success of the resuscitation attempt that members of a high-performance team are Clear about role assignments Prepared to fulfill their role responsibilities Well practiced in resuscitation skills Knowledgeable about the algorithms Committed to success

25. Clear Roles and Responsibilities: Every member of the team should know his or her role and responsibilities.

26. When roles are unclear, team performance suffers. Signs of unclear roles include - Performing the same task more than once. Missing essential tasks. Team members having multiple roles even if there are enough providers. To avoid inefficiencies, the team leader must clearly delegate tasks. Team members should communicate when and if they can handle additional responsibilities. The team leader should encourage team members to participate in leadership and not simply follow directions blindly.

27. Knowing Your Limitations: Not only should everyone on the team know his or her own limitations and capabilities, but the team leader should also be aware of them. This allows the team leader to evaluate team resources and call for backup of team members when assistance is needed. During the stress of an attempted resuscitation, do not practice or explore a new skill. If you need extra help, request it early. It is not a sign of weakness or incompetence to ask for help.

28. Constructive Interventions: During a resuscitation attempt, the leader or a member of a high-performance team may need to intervene if an action that is about to occur may be inappropriate at the time. Although constructive intervention is necessary, it should be tactful. Team leaders should avoid confrontation with team members. Instead, conduct a debriefing afterward if constructive criticism is needed.

29. What to Communicate Knowledge Sharing Sharing information is a critical component of effective team performance. When resuscitative efforts are ineffective, talk as a team, like, “Well, we’ve observed the following on the Primary Assessment Have we missed something?” Members of a high-performance team should inform the team leader of any changes in the patient’s condition to ensure that decisions are made with all available information.

30. How to Communicate Closed-Loop Communicate The team leader should use closed-loop communication: The team leader gives a message, order, or assignment to a team member. 2.By receiving a clear response and eye contact, the team leader confirms that the team member heard and understood the message. 3. The team leader listens for confirmation of task performance from the team member before assigning another task.

31. Clear Messages: Clear messages consist of concise communication spoken with a controlled tone of voice. All healthcare providers should deliver messages with a calm and direct manner without yelling or shouting. Unclear communication can lead to unnecessary delays in treatment or to medication errors. Only one person should talk at any time.

32. Mutual Respect: The best high-performance teams should share a mutual respect for each other and work together in a team. To have a high-performance team, everyone must abandon ego and respect each other during the resuscitation attempt, regardless of any additional training or experience that the team leader or specific team members may have. https://www.youtube.com/watch?v=aMBugLXCPWY