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Immediate Life Support PowerPoint Presentation

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Description : Check out this medical presentation on Emergency Medical Services (EMS), which is titled "Immediate Life Support", to know about the Causes and Prevention of Cardiac Arrest.

Tags : Emergency Medical Services, EMS, Immediate Life Support, Causes, Prevention, Cardiac Arrest

Published on : Aug 06, 2021 | Views : 4260 | Downloads : 31

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Slide 1-

Immediate Life Support Revision Lecture
Slide 2-

Causes and Prevention of Cardiac Arrest
Slide 3-

Early recognition prevents: Cardiac arrests and deaths Admissions to ICU Inappropriate resuscitation attempts Chain of survival
Slide 4-

Early recognition of the deteriorating patient Most arrests are predictable Hypoxia and hypotension are common antecedents Delays in referral to higher levels of care
Slide 5-

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Slide 6-

Recognition of the deteriorating patient Example escalation protocol based on Scottish early warning score (SEWS)
Slide 7-

Recognition of the deteriorating patient Several alternative systems to cardiac arrest team e.g. Medical emergency team (MET) Track changes in physiology e.g. Early warning scores Trigger a response if abnormal values: Call senior nurse Call doctor Call resuscitation team
Slide 8-

The ABCDE approach to the deteriorating patient Airway Breathing Circulation Disability Exposure
Slide 9-

ABCDE approach Underlying principles: Complete initial assessment Treat life-threatening problems Reassessment Assess effects of treatment/interventions Call for help early
Slide 10-

ABCDE approach Personal safety Patient responsiveness First impression Vital signs Respiratory rate, SpO2, pulse, BP, GCS, temperature
Slide 11-

ABCDE approach Airway Causes of airway obstruction: CNS depression Blood Vomit Foreign body Trauma Infection Inflammation Laryngospasm Bronchospasm
Slide 12-

ABCDE approach Airway Recognition of airway obstruction: Talking Difficulty breathing, distressed, choking Shortness of breath Noisy breathing Stridor, wheeze, gurgling See-saw respiratory pattern, accessory muscles
Slide 13-

ABCDE approach Airway Treatment of airway obstruction: Airway opening Head tilt, chin lift, jaw thrust Simple adjuncts Advanced techniques e.g. LMA, tracheal tube Oxygen
Slide 14-

ABCDE approach Breathing Recognition of breathing problems: Look Respiratory distress, accessory muscles, cyanosis, respiratory rate, chest deformity, conscious level Listen Noisy breathing, breath sounds Feel Expansion, percussion, tracheal position
Slide 15-

ABCDE approach Breathing Treatment of breathing problems: Airway Oxygen Treat underlying cause e.g. antibiotics for pneumonia Support breathing if inadequate e.g. ventilate with bag-mask +
Slide 16-

ABCDE approach Circulation Primary Acute coronary syndromes Arrhythmias Hypertensive heart disease Valve disease Drugs Inherited cardiac diseases Electrolyte/acid base abnormalities Secondary Asphyxia Hypoxaemia Blood loss Hypothermia Septic shock Causes of circulation problems:
Slide 17-

ABCDE approach Circulation Recognition of circulation problems: Look at the patient Pulse - tachycardia, bradycardia Peripheral perfusion - capillary refill time Blood pressure Organ perfusion Chest pain, mental state, urine output Bleeding, fluid losses
Slide 18-

ABCDE approach Circulation Treatment of circulation problems: Airway, Breathing Oxygen IV/IO access, take bloods Treat cause Fluid challenge +
Slide 19-

ABCDE approach Circulation Acute Coronary Syndromes Unstable angina or myocardial infarction Treatment Aspirin 300 mg orally (crushed/chewed) Nitroglycerine (GTN spray or tablet) Oxygen guided by pulse oximetry Morphine (or diamorphine) Consider reperfusion therapy (PCI, thrombolysis)
Slide 20-

ABCDE approach Disability Recognition AVPU or GCS Pupils Treatment ABC Treat underlying cause Blood glucose If < 4 mmol l-1 give glucose Consider lateral position Check drug chart
Slide 21-

ABCDE approach Exposure Remove clothes to enable examination e.g. injuries, bleeding, rashes Avoid heat loss Maintain dignity
Slide 22-

Any questions?
Slide 23-

Early recognition of the deteriorating patient may prevent cardiac arrest Most patients have warning symptoms and signs before cardiac arrest Airway, breathing or circulation problems can cause cardiac arrest ABCDE approach to recognise and treat patients at risk of cardiac arrest Summary
Slide 24-

Advanced Life Support Algorithm
Slide 25-

ALS algorithm ILS providers should use those skills in which they are proficient If using an AED – switch on and follow the prompts Ensure high quality chest compressions Ensure expert help is coming
Slide 26-

Adult ALS Algorithm
Slide 27-

Patient response Open airway Check for normal breathing Caution agonal breathing Check circulation Check for signs of life To confirm cardiac arrest… Unresponsive? Not breathing or only occasional gasps
Slide 28-

Cardiac arrest confirmed 2222
Slide 29-

Cardiac arrest confirmed
Slide 30-

Chest compression 30:2 Compressions Centre of chest 5-6 cm depth 2 per second (100-120 min-1) Maintain high quality compressions with minimal interruption Continuous compressions once airway secured Switch compression provider every 2 min to avoid fatigue
Slide 31-

Shockable and Non-Shockable
Slide 32-

Uncoordinated electrical activity Coarse/fine Exclude artefact Movement Electrical interference Shockable (VF) Shockable (VF) Bizarre irregular waveform No recognisable QRS complexes Random frequency and amplitude
Slide 33-

Shockable (VT) Shockable (VT) Polymorphic VT Torsade de pointes Monomorphic VT Broad complex rhythm Rapid rate Constant QRS morphology
Slide 34-

Automated External Defibrillation If not confident in rhythm recognition use an AED Start CPR whilst awaiting AED to arrive Switch on and follow AED prompts
Slide 35-

AED algorithm
Slide 36-

Manual defibrillation Plan all pauses in chest compressions Brief pause in compressions to check rhythm Do chest compressions when charging Ensure no-one touches patient during shock delivery Very brief pause in chest compressions for shock delivery Resume compressions immediately after the shock
Slide 37-

Shockable (VF / VT)
Slide 38-

Shockable (VT)
Slide 39-

Shockable (VF / VT)
Slide 40-

Shockable (VF / VT)
Slide 41-

Shockable (VF / VT)
Slide 42-

Vary with manufacturer Check local equipment If unsure, deliver highest available energy DO NOT DELAY SHOCK Energy levels for manual defibrillators on this course Manual defibrillation energies
Slide 43-

If VF / VT persists
Slide 44-

Non-Shockable
Slide 45-

Absent ventricular (QRS) activity Atrial activity (P waves) may persist Rarely a straight line trace Adrenaline 1 mg IV then every 3-5 min Non-shockable (Asystole) Non-Shockable (Asystole)
Slide 46-

Clinical features of cardiac arrest ECG normally associated with an output Adrenaline 1 mg IV then every 3-5 min Non-shockable (Asystole) Non-Shockable (PEA)
Slide 47-

During CPR During CPR Ensure high-quality CPR: rate, depth, recoil Plan actions before interrupting CPR Give oxygen Consider advanced airway and capnography Continuous chest compressions when advanced airway in place Vascular access (intravenous, intraosseous) Give adrenaline every 3-5 min Correct reversible causes
Slide 48-

Reversible causes
Slide 49-

Airway and ventilation Secure airway: Supraglottic airway device e.g. LMA, i-gel Tracheal tube Do not attempt intubation unless trained and competent to do so Once airway secured, if possible, do not interrupt chest compressions for ventilation Avoid hyperventilation Capnography
Slide 50-

Immediate post-cardiac arrest treatment
Slide 51-

Resuscitation team Roles planned in advance Identify team leader Importance of non-technical skills Task management Team working Situational awareness Decision making Structured communication SBAR or RSVP
Slide 52-

Any questions?
Slide 53-

Importance of high quality chest compressions Minimise interruptions in chest compressions Shockable rhythms are VF/pulseless VT Non-shockable rhythms are PEA/Asystole Use an AED if not sure about rhythms Correct reversible causes of cardiac arrest Role of resuscitation team Summary
Slide 54-

Immediate Life Support Course Slide set All rights reserved © Resuscitation Council (UK) 2010