ADULT BLS AND ACLS.pptx

acls and bls

1. ADULT BLS AND ACLS

2. OBJECTIVES: At the end of this lecture you would be able to: i dentify the steps of adult basic life support. r ecognise the signs of someone needing CPR. p erform high quality CPR for an adult. d escribe the steps of airway control and management. d iscuss the management of cardiac arrest. e numerate the drug used during cardiac arrest management.

3. INDIAN SCENARIO Heart attacks are the leading cause of death in India . one -fifth of the deaths in India are from coronary heart disease. By the year 2020 ,it will account for one-third of all the deaths in the country. There is an estimate of 45 million coronary artery disease in India . With the increasing number of young Indians hooked to roller coastal lifestyle and falling pray to coronary artery disease,the future looks even grimmer Despite recent gains, less than 40% of adults receive layperson-initiated CPR, and fewer than 12% have an AED applied before EMS arrival.

4. LIFE IS WHY?

5. DEFINITION OF CPR Cardiopulmonary resuscitation (CPR) is an emergency procedure that combines chest compressions often with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is cardiac arrest.

6. CPR CONSISTS OF- CHEST COMPRESSION AIRWAY BREATHING

7. HIGH-QUALITY CPR IS WHY? EARLY RECOGNITION AND CPR ARE CRUCIAL FOR SURVIVAL FROM CARDIAC ARREST. BY LEARNING HIGH-QUALITY CPR, YOU WILL HAVE THE ABILITY TO IMPROVE PATIENT OUTCOMES AND SAVE MORE LIVES

8. Building Blocks of CPR

9. ADULT-CHAIN OF SURVIVAL (OUT HOSPITAL CARDIAC ARREST)

10. IN HOSITAL CARDIAC ARREST

11. CHAIN OF SURVIVAL- INCLUDING 6TH STEP : RECOVERY

12. BLS ALGORITHM

13. LOCATING CAROTID PULSE LOCATE THE TRACHEA(ON THE SIDE CLOSEST TO YOU) USE 2-3 FINGERS. SLIDE THE FINGERS INTO THE GROOVE BETWEEN THE TRACHEA AND THE MUSCLES AT THE SIDE OF NECK(STERNOCLEIDOMASTOID MUSCLE) ONCE AT A SIDE. FEEL FOR A PULSE FOR AT LEAST 5 SECONDS BUT NOT MORE THAN 10 SECONDS.

14. AIRWAY MANEUVERS

15. POCKET MASKS

16. BAG-MASK DEVICE TO PROVIDE POSITIVE PRESSURE VENTILATION. CAN BE USED WITH OR WITHOUT OXYGEN. IF NOT ATTACHED TO O2, IT PROVIDES 21% OXYGEN FROM ROOM AIR. BAG-SELF INFLATING MASK

17. TECHNIQES TO HOLD PERFORM A HEAD TILT PLACE NARROW PORTION AT THE BRIDGE OF NOSE. USE THUMB AND INDEX FINGER TO MAKE A “ C” USE REMAINING FINGERS TO LIFT THE ANGLES OF THE JAW(3 FINGER FORMS A “E” SHAPE. EACH BREATH OVER 1 SECOND-CHECK FOR CHEST RISE SIMULTANEOUSLY.

18. AUTOMATED EXTERNAL DEFIBRILLATOR(AED) AED A LIGHTWEIGHT , PORTABLE, COMPUTERIZED DEVICE. CAN IDENTIFY AN ABNORMAL HEART RHYTHM THAT NEEDS A SHOCK. EASY TO USE.

19. PLACEMENT OF PADS ANTEROLATERAL ANTEROPOSTERIOR

20. HOW TO USE AN AED

21. BLS-SEQUENCE VERIFY SCENE SAFETY CHECK FOR RESPONSIVENESS CALL FOR HELP ASSESS FOR BREATHING AND PULSE SIMULTANEOUSLY START CPR RESQUE BREATHING GET AED CONTINUE TILL ALS PROVIDER TAKES OVER

22. WHAT IS ACLS? Advanced cardiac life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest ,stroke and other life threatening cardiovascular emergency ,as well as the knowledge and skills to deploy those interventions.

23. ACLS ALGORITHM

24. PULSELESS VT VENTRICULAR FIBRILLATION

25. ASYSTOLE PULSELESS ELECTRICAL ACTIVITY

26. CPR QUALITY Push hard (at least 2inches o 5cm and fast (100-120/min) and allow complete chest recoil. Minimise interruptions in compressions Avoid excessive ventilation . Change compression every 2 min or sooner if fatigued. If no advanced airway ,30:2 compression -ventilation ratio Quantitative waveform capnography -if PETCO2 is low or decreasing,reassess CPR quality SHOCK ENERGY FOR DEFIBRILLATION BIPHASIC : Manufacturer recommendation( eg. initial dose of 120-200J ),if unknown use maximum available second and subsequent doses should be equivalent ,and higher doses may be considered . MONOPHASIC (360 J)

27. DRUG THERAPY Epinephrine IV/IO dose:1mg every 3-5min Amiodarone IV/IO dose -First dose: 300mg bolus -second dose: 150mg or lidocaine IV /IO dose : -First dose:1-1.5mg /kg -Second dose :0.5 -0.75mg/kg ADVANCED AIRWAY Endotracheal intubation or supraglotic advanced airway waveform capnography or capnometry to cofirm and monitor ET Tube placement Once advanced airway in place give one breath every 6seconds (10 breaths per minute) with continuous chest compressions

28. REVERSIBLE CAUSES H ypovolemia H ypoxia H ydrogen ion(Acidosis) H ypo-/ Hyperkalemia H ypothermia T ension pneumothorax T amponade,Cardiac T oxins T hrombosis,Pulmonary T hrombosis,Coronary 5 H’S 5 T’S

29. RETURN OF SPONTANEOUS CIRCULATION(ROSC) Pulse and blood pressure Abrupt sustained increase in PETCO2(typically more than or equal to 40mm Hg) Spontaneous arterial pressure waves with intraarterial monitoring

30. QUICK RECAP- HIGH QUALITY CPR START COMPRESSION WITHIN 10 SECONDS. PUSH HARD AND PUSH FAST. AT LEAST 5 CM FOR ADULTS. COMPRESS AT A RATE OF 100 TO 120 PER MINUTES. ALLOW COMPLETE CHEST RECOIL. MINIMIZE INTERRUPTIONS. GIVE EFFECTIVE BREATHS AVOID EXCESSIVE VENTILATION This Photo by Unknown Author is licensed under CC BY-SA