Cardio-pulmonary arrest. Cardio-Pulmonary Resuscitation in the world of modern protocols of the European resuscitation association Speaker: Head of the department of emergency medicine, TSMU І.Horbachevsky Ljakhovych R.М. Provide patency of airways support, find out if there are signs of life • Patient’s response • Provide patency of airways support • Check respiration and pulse (not more than 10 sec) …to confirm or oppose the circulatory arrest. Patency of airways support Suction units (aspirators) Resuscitation should be viewed as a protest against ungrounded death. A belief in true sense of human longevity and the importance to maintain human life. Scientist V.А. Nehovsky One of the most important tasks of becoming a physician is to acquire the skill of cardio-pulmonary-cerebral resuscitation, which allows to renew vital functions of life. Patency of airways support Respiratory mask Patency of airways support Laryngeal mask Laryngeal tube Intensive therapy– a complex of temporary methods of artificial maintenance of vital life functions in decompensated stages, which is directed to provision of life support. Resuscitology – study about revival of the organism; prophylaxis and treatment of terminal stages. ( according to V.А. Nehovsky). Patency of airways support laryngeal tubes laryngeal tubes Patency of airways support Combitube Terminal state is divided into several stages: 1. Preagony 2. Terminal pause 3. Agony 4. Clinical death Patency of airways support Respiratory mask and Ambu bag Patency of airways support A set for conicopuncture Main signs of clinical death: Absence of pulsation on magistral arteries (carotid and femoral), Pupils are fixed and dilated, non-reactive to light, Absence of independent breathing. Additional signs : Change in skin colour (grey or cyanotic), Absence of consciousness, Absence of reflexes and loss of muscle tone Portable set of respiratory equipment Support of artificial ventilation of lungs Oxygen therapy Training equipment for developing skills of patency of airways support First stage of resuscitation - provision of first aid ( basic life support). First step – maintenance of airway patency. Provide airway patency Check for sign of life • Patient’s reaction • Provide airway patency • Evaluate respirations and pulse (not more then 10 seconds) … to confirm stopping of circulation кровообігу Maintain airway patency Evaluate sings of circulation Confirmed ceasing of blood circulation Call resuscitation team CPR 30:2 Up to the point of hooking up a defibrillator/monitor Precardiac stroke • Immediate treatment of observed and monitored circulatory arrest in VF/VT • Perform, if defibrillator is unavailable Chest compressions • 30:2 • depth 4-5 сm • 100 min-1 • “center of chest” • Avoid • Exhaustion • Breaks “Quick Evaluation” Conduct ECG , classic electrodes, self adhesive electrodes. Provision of airway patency Determination of signs of life Call resuscitation team CPR 30:2 Until defibrillator/monitor is hooked up Evaluation of rhythm To defibrillation (VF/VT without pulse) No defibrillation (PEA/ asystole) During CPR: 1 Defibrillation 150-360 J Biphasic or 360 J Monophasic Immediately start CPR 30:2 2 min. •Rule out problems that can be corrected •Check placement and function of electrodes •Check: IV availability airway patency and oxygen •After airway support conduct chest compressions continuously •Inject adrenalin every 3-5 mins. •Choose: amiodarone, atropine, magnesium Immediately start CPR 30:2 2 min. Rhythms prior to defibrillation (VF/VT) Evaluate rhythm Prior to defibrillation (VF/VT without pulse) 1 Defibrillation 150 J biphasic First defibrillation • 150 - 200 J biphasic • Immediate CPR 30:2 2 min After performing defibrillation •Continue CPR for the next 2 min •Stop CPR only when patient has signs of circulation •Defibrillation – priority •Adrenalin 1 mg •Аmiodarone 300 mg (post 3) Rhythm not before defibrillation Asystole/PEA Asystole/РЕА During CPR: • Check for electrode connection • Adrenalin 1 mg i. v. every 3-5 min. • Rule out/ treatable condition Potentially treatable conditions: •Hypoxia •Hypovolemia •Hypo/hyperkalemia and metabolic disruptions •Hypothermia •Tension pneumothorax •Тamponade (Pericardial) •Тoxins •Тhromboembolism (coronary or pulmonary) During CPR: • Rule out potentially treatable conditions • Check placement of electrodes • Check: IV availability Airway patency and oxygen • After maintenance of airway patency conduct continuous chest compressions • Inject adrenalin every 3-5 mins. • Choose : Amiodarone, atropine, magnesium Algorithm action during performance of CPR Summary • Algorithm ALS standardizes a way of treatment of circulatory arrest in adults • Allows to increase effectiveness of treatment. Thank you for attention!
© Copyright 2024