ACLS Presentation
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WHAT IS CPR?Cardiopulmonary resuscitation (CPR) isan emergency technique that anyone canlearn to help someone whose heart and/or
breathing has stopped.
It can keep a victim alive until skilled help
arrives or the victim is transferred to ahospital.
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WHATS NEW IN 2010 GUIDELINES
Key changes and continued points of emphasisfrom the 2005 BLS Guidelines include thefollowing:
Immediate recognition of SCA based on assessingunresponsiveness and absence of normalbreathing (i.e., the victim is not breathing or onlygasping)
Look, Listen, and Feel removed from the BLSalgorithm
Encouraging Hands-Only CPR by lay-rescuer
Sequence change to chest compressions before
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CONCEPT OF BLS
All You Need is!
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FIRST ACTIONSAssess Responsiveness,
Gentle Shake/Tap and Shout
Lay Rescuer:Call for Help
Health Care Provider (HCP):Also Check Breathing then all for
Help
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FIRST ACTIONSPosition the Victim
Position the Rescuer
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CHECK PULSE
No Pulse Check for lay rescuer
Assume cardiac arrest if an adult suddenlycollapses or an unresponsive victim is not
breathing normally.
Healthcare provider should take
no more than 10 seconds
if no definite pulse, within that time period, startchest compressions
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Focus on High Quality CPR adequate rate (at least 100/minute)
adequate depth
adults: a compression depth of at least 2 inches (5cm)
infants and children: a depth of least one third theanterior-posterior (AP) diameter of the chest or about1.5 inches (4 cm) in infants and about 2 inches (5 cm)
in children
allow complete chest recoil after eachcompression
minimize interruptions in compressions
avoid excessive ventilation
CLOSED CHEST COMPRESSIONS
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TWONORMALBREATHS
(ONESECONDEACH)
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Place paddles on the chestand assess rhythm
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If PEA or Asystole
No shock
Give Adrenaline 1mg every 3-5
min IV or 2.5 mg TT or
Vasopressin 40 IU single dose
Continue CPR @ CV 30:2
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DEFIBRILLATIONTypes Precordial Thump
Manual DefibrillatorsAEDs (Automated External Defibrillators)
ICDs (Internal Cardioverter Defibrillators)
Ideal Time:Immediately After Cardiac Arrest
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DEFIBRILLATION Turn the defibrillator on. Place the paddles after applying electrode
gel, or apply AED pads.
Correct paddle placement is essential.Charge to desired level. Shout: One, I am clear; Two, you are
clear; Three, All are clear.
Deliver the energy by pressing bothbuttons simultaneously.
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AEDSAdvantages Easier to operate.
Little education
needed. Quicker operation.
Rhythm detection.
Hands Off
defibrillation. Rhythm monitoring.
Disadvantages
CPR must be stoppedfor 10-15 secs.
Interruption inanalysis by agonalbreathing, transport,radio receivers.
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SECONDARY SURVEY Lay rescuers should not interrupt chest
compressions to palpate pulses or check forROSC
Lay rescuers should continue CPR until an AED arrives the victim wakes up EMS personnel take over CPR
Healthcare providers should interrupt chest compressions as infrequently as
possible
no longer than 10 seconds except for specific interventions such as insertion of
an advanced airway or use of a defibrillator
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CONSCIOUS ADULT WITH CHOKED AIRWAY
In signs of severe airway obstruction: act quickly to relieve the obstruction.
In mild obstruction when victim is coughing
forcefully do not interfere with the patients spontaneous
coughing and breathing efforts.
Attempt to relieve the obstruction only if signs of
severe obstruction develop: the cough becomes silent
respiratory difficulty increases accompanied by stridor
victim becomes unresponsive
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SELF RESCUESelf Administered Hemlich Maneuver:
To treat own complete FBAO oneshould perform Heimlich maneuver as
on any other victim getting inward andupward thrusts to the diaphragm.Failing this, victim should press the
upper abdomen quickly over any firmsurface e.g. back of a chair, side of atable, porch railing.
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BLS
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FINGERSWEEPBLS
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