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B = Breathing

• L = LOOK chest …1,2, 3, 4, 5, 6,

movement 7, 8, 9, 10

HE IS

• BREATHING

L = LISTEN at the

victim’s mouth for breath

sounds

• F = FEEL for air on your

cheek

NO MORE THAN 10 S

IF HE IS BREATHING NORMALLY

• Turn him into the recovery position

• Chek for continued breathing DO NOT

CONFUSE

BARELY BREATH

NOISY GASPS

WITH

NORMAL

BREATHING

• L = LOOK chest …1,2, 3, 4, 5, 6,

movement 7, 8, 9, 10

HE ISN’T

• BREATHING

L = LISTEN at the

victim’s mouth for breath

sounds

• F = FEEL for air on your

cheek

NO MORE THAN 10 S

CHEST COMPRESSION

Place the heel of one hand in the centre of the victim’s

• chest; place the heel of your hand on top of the first

hand. Interlook the fingers of your hands.

Ensure that pressure is not applied over the victim’s

ribs. Do not apply any pressure over the upper

abdomen or the bottom end of bony sternum

Position yourself vertically above the victim’s chest and,

• with your arm straight

Press down on the sternum 4-5 cm.

• After each compression, release all the pressure on the

• chest without losing contact between your hands and

the sternum

Take approxmately the same amuont of time for

• compression and relaxation. Minimise interruptions in

chest compression.

GUIDELINES CHANGES

1.Increase the number of chest

compressions 30:2

2.No cheking carotid pulse

3.One-shock versus three-shock

sequence

4.Time of adrenaline

Coronary Artery Perfusion Pressure

Improves With Longer Series of Chest

Compressions in Adult Victims

Coronary Artery Pressure at 5:1 ratio

Pressure at 15:2 ratio

GUIDELINES CHANGES

1.Increase the number of chest

compressions 30:2

2.No cheking carotid pulse

3.One-shock versus three-shock

sequence

4.Time of adrenaline

CHECK CIRCULATION

• If the patient has NO signs of life –lack of movement,

normal breathing, coughing- start CPR

• Those experienced in clinical assessment should assess

the CAROTID PULSE whilst simultaneously looking for

signs of lif for not more than 10 s

If there is doubt start CPR immediately

MUST BE AVOID DELAY IN DIAGNOSIS

!

VENTILATION

BAG-MASK MOUTH TO MASK

VENTILATION VENTILATION

• One person holds the

facemask in place using a

jaw thrust with both hands

• An assistant squeezes the

bag

10 BREATHS min -1

DO NOT

HYPERVENTILATE

D = Defibrillation

DEFIBRILLATORS

• Automated External Defibrillators AED

The defibrillators assess the rhythm with waveform

analysis and give automatically a shock.

• Manual defibrillators

It is used healthcare rescuers because they have to do

diagnosis and give a shock. It’s used for synchronised

cardioversion

• Semi-autometed external defibrillator

The defibrillators assess the rhythm with waveform

analysis and the rescuer has to give a shock.

ELECTRODE POSITION

Apply paddles or self-adhesive pads to the chest

SEQUENCE FOR USE OF AN AED

1. MAKE sure you, the victim and any bystanders are safe.

2. If the victim is unresponsive and not breathing normally,

send someone for the AED and to call for an ambulance.

3. Start CPR according to the guidelines for BLS

4. As soon as the defibrillator arrives:

-switch on the defibrillator and attach the electrode pads

-ensure that no body touches the victim while the AED is

unlysing the rhythm

5. If a shock is indicated: push shock button as directed

6. If no shock indicated: immediately resume CPR

7. Continue until:

-qualifield help arrives and takes over

-the victim starts to breathe normally

-you become exhaustead

AED

ALGORITHM

GUIDELINES CHANGES

1.Increase the number of chest

compressions 30:2

2.No cheking carotid pulse

3.One-shock versus three-shock

sequence

4.Time of adrenaline

PRECORDIAL THUMP

Consider giving a single precordial thump when cardiac

arrest is confirmed rapidly after a witnessed, sudden

collapse and a defibrillator is not immediatele to hand.

Using the ulnar edge of a tightly cleneched fist, deliver a

sharp impact to the lower half of the sternum from a

height of about 20 cm.

A precordial thump is most likely to be successful in

converting VT to sinus rhythm.

Successful treatment of VF is much less likely: if it was

given within the first 10 s of VF

SOMMINISTRATION ROUTE

• INTRAVENOUS: drugs injected perperipherally must be

followed by a flush of at least 20 ml.

insertion of central venous catheter requires

interrumpion of CPR

• TRACHEAL ROUTE: if intravenous can’t be established.

Unpredictable plasma concentration are achieved and

equipotent dose is unknown.

DOSE: three to ten times higher diluited in 10 ml

HOSPITAL

RESUSCITATION

ADRENALINE

• Adrenaline is the first drug used in cardiac arrest of

any aetiology: it is included in the ALS ALGORITHM

for use 1 mg every 3-5 min of CPR

• Its primary efficacy is due to its alpha-adrenergic vasoconstrictive

effects causing systemic vasoconstriction, which increases

coronary and cerebral perfusion pressures.

• The beta adrenergic actions of adrenaline increases miocardial

oxygen consumption, ectopic ventricular arrhythmias and

transient hypoxaemia due to pulmonary arteriovenous shunting.

CPR 2 min - SHOCK

CPR 2 min – ADRENALINE - SHOCK


PAGINE

45

PESO

4.34 MB

AUTORE

Atreyu

PUBBLICATO

+1 anno fa


DESCRIZIONE DISPENSA

Materiale didattico per il corso di ANESTESIOLOGIA del prof. Vito Aldo Peduto, in collaborazione con la Dott.ssa Simonetta Tesoro e si interessa di studiare ogni aspetto farmacologico e clinico dell'anestesia. Questo file riguarda i seguenti argomenti: Advanced Life Support; arresto cardiaco e procedure di rianimazione; il massaggio cardiaco, l'intubazione; la resipirazione bocca a bocca, la ventilazione; defribrillatore e defribillazione; iniezioni di atropina, lidocaina, adrenalina.


DETTAGLI
Corso di laurea: Corso di laurea magistrale in medicina e chirurgia (ordinamento U.E. - 6 anni) (PERUGIA, TERNI)
SSD:
Università: Perugia - Unipg
A.A.: 2011-2012

I contenuti di questa pagina costituiscono rielaborazioni personali del Publisher Atreyu di informazioni apprese con la frequenza delle lezioni di ANESTESIOLOGIA e studio autonomo di eventuali libri di riferimento in preparazione dell'esame finale o della tesi. Non devono intendersi come materiale ufficiale dell'università Perugia - Unipg o del prof Tesoro Simonetta.

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