Case scenarios in basic life support for resusciation

Special case scenarios in basic life support

1. Case scenarios

2. opioids

3. opioids Medications for pain relief Hydrocodone,morphine,fentanyl,heroin Respiratory depression – respiratory arrest – cardiac arrest

4. Opioid emergency Scene assessment – communicate with bystANDERS OBSERVE THE VICTIM-LOOK FOR SIGNS ASSESS the surroundings

5. antidote

6. Opioid-associated life threatening emergency response sequence

7. Heart attack

8. Signs

9. Time is heart muscle Early recognition Early ems activation Early transport-90 min Give aspirin if indicated Be prepared to start cpr –if unresponsive

10. stroke

11. Warning signs

12. Time is brain Early recognition-3 hr window period Early triage ,evaluation & management Early treatment decisions Gold standard treatment for ischemic stroke –iv alteplase within 3 hrs of onset

13. drowning

14. Preventable cause of death Outcome depends on duration & severity of hypoxia Remove the victim from site & begin resuscitation Provide cpr – rescue breaths Give 5 cycles of cpr ≈ 2 min prior to ems activation Mouth-mouth ventilation , chest compressions –difficult in water Waterslide,alcohol intoxication,diving,trauma - SUSPECT SPINAL CORD INJURY-IMMOBILISATION IF DEFIBRILLATION – DRY THE CHEST

15. HYPOTHERMIA

16. UNRESPONSIVE VICTIM + HYPOTHERMIA – HEART RATE & BREATHING WILL BE SLOW TRANSPORT VICTIM TO A RE-WARMING CENTER START CPR ,IF NO PULSE > 10 SEC REMOVE WET CLOTHES ,VENTILATE WITH WARM,HUMIDIFIED O2 IF VF PRESENT,DELIVER SHOCK SIMILAR TO NORMOTHERMIC CARDIAC ARREST VICTIM AFTER ROSC,WARM AT 32º - 34ºC

17. ANAPHYLAXIS

18. SIGNS OF ALLERGIC REACTION MILD STUFFY NOSE,SNEEZING ITCHING OF SKIN,MUCOUS MEMBRANES RAISED RED RASH SEVERE BREATHING-SWELLING OF AIRWAY,ABNORMAL BREATH SOUNDS SKIN-HIVES,FLUSHING,SWELLING OF LIPS,TONGUE,FACE CIRCULATION-TACHYCARDIA,HYPOTENSION,COLD EXTREMITIES GI-STOMACH CRAMPS,DIARRHEA

19. CRITERIA FOR ANAPHYLAXIS SIGNS THAT COME QUICKLY & RAPIDLY WORSE SKIN CHANGES LIFE THREATENING AIRWAY,BREATHING,CIRCULATION INVOLVEMENT OF 2 OR MORE BODY SYSTEMS

20. AUTOINJECTOR

21. RESPONSE ACTIVATE EMS GIVE/HELP THE PERSON INJECT EPINEPHRINE USING AN AUTOINJECTOR GET AED GIVE 2 ND DOSE OF EPINEPHRINE IF SYMPTOM PERSISTS IF UNRESPONSIVE,START CPR.

22. PREGNANCY

23. DURING CPR,LEFT UTERINE DISPLACEMENT IS ADVISED-AORTO CAVAL COMPRESSION BY KEEPING WEDGE UNDER HIP ANTICIPATE DIFFICULT AIRWAY CHEST COMPRESSIONS-SLIGHTLY HIGHER THAN NORMAL IV SHOULD BE SECURED ABOVE LEVEL OF DIAPHRAGM IF NO ROSC WITHIN 4 MIN – EMERGENCY HYSTEROTOMY DELIVERY WITHIN 5 MIN OF INITIATION OF RESUSCITATIVE EFFORTS THERAPEUTIC HYPOTHERMIA ADVISED WITH CONTINUOUS FETAL MONITORING SEARCH & TREAT CAUSE OF ARREST SIMULTANEOUSLY