the resuscitation guidelines 2005
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The Resuscitation Guidelines 2005. The slides here are modified from the 2005 Resuscitation Council (UK) Guidelines for the Management of Adult Cardiac Arrest. They have been prepared for the University of Dundee Medical Students. …. to confirm cardiac arrest. Open Airway - PowerPoint PPT PresentationTRANSCRIPT
The Resuscitation Guidelines 2005
The slides here are modified from the 2005 Resuscitation Council (UK) Guidelines for the Management of Adult Cardiac Arrest. They have been prepared for the University of Dundee Medical Students.
…. to confirm cardiac arrest
• Patient response• Open airway• Check for normal
breathing– caution agonal breathing
• Check for signs of life
Open Airway Look for signs of life
…. to confirm cardiac arrest
• Pulse check if trained to do so
• Take no more than 10 seconds for assessment of both breathing and pulse.
Open Airway Look for signs of life
CPR 30:2Until defibrillator / monitor attached
Check 123,
ABC
Call Ambulance orResuscitation Team
Cardiac arrest confirmed
Chest compression• 30:2 • Compressions
– “Centre of chest”– 4-5 cm depth– 100 min-1
• Uninterrupted compressions when airway secured
• Avoid– Provider fatigue– Interruptions
CPR 30:2Until defibrillator/monitor attached
AssessRhythm
Open Airway Look for signs of life
Call Resuscitation Team
ALSAlgorithm
How to assess ECG rhythm?
• ECG monitoring leads
• Self-adhesive electrodes
• ‘Quick-look’ paddles
ECG monitoring leads
• 3-lead system approximates to I, II, III
• Colour coded• Remove hair• Apply over bone• Lead setting (II)
Self-adhesive electrodes
• Hands-free • Remove excess chest
hair• Dry chest if necessary• Continue CPR whilst
applying
‘Quick-look’ paddles
• Hold still• Apply firm pressure• Use coupling agent –
gel pads
If using an automated external defibrillator (AED)
• When AED arrives switch on
• Follow voice and visual prompts
• Perform other skills according to your training e.g. pocket mask ventilation, IV access, drugs
Shockable Rhythms(VF/Pulseless VT)
CPR 30:2Until defibrillator/monitor attached
AssessRhythm
Shockable(VF/Pulseless VT)
Non-shockable(PEA/Asystole)
Open Airway Look for signs of life
Call Resuscitation Team
ALSAlgorithm
Precordial thump
– Rapid treatment of a witnessed and monitored VF/VT cardiac arrest
– Use if defibrillator not immediately available
Shockable Rhythm(VF/Pulseless VT)
1 Shock150 – 360J Biphasic
360J Monophasic
Immediately ResumeCPR 30:2For 2 min
Still a Shockable Rhythm(VF/Pulseless VT)
1 Shock150 – 360J Biphasic
360J Monophasic
Immediately ResumeCPR 30:2For 2 min
1
2
Still a Shockable Rhythm(VF/Pulseless VT)
Give 1 mg Adrenaline IV
1 Shock150 – 360J Biphasic
360J Monophasic
Immediately ResumeCPR 30:2For 2 min
Still a Shockable Rhythm(VF/Pulseless VT)
Give 300 mg Amiodarone IV
1 Shock150 – 360J Biphasic
360J Monophasic
Immediately ResumeCPR 30:2For 2 min
3
4
VF/Pulseless VT
• Check pulse if– Organised rhythm seen after 2 min CPR– Patient showing signs of life
• Adrenaline 1mg IV every 2 loops– Just before alternate shocks
• Amiodarone given once only
Defibrillation energies
• Vary with manufacturer
• Check local equipment
• If unsure, deliver 200 J (do not delay shock)
• Energy levels for defibrillators in this hospital/university 360 J monophasic (150 Joules for biphasic models)
Non-shockable RhythmsPEA/Asystole
CPR 30:2Until defibrillator/monitor attached
AssessRhythm
Shockable(VF/Pulseless VT)
Non-shockable(PEA/Asystole)
Open Airway Look for signs of life
Call Resuscitation Team
ALSAlgorithm
Non-Shockable Rhythm (PEA/Asystole)
Immediately Resume CPR 30:2 For 2 min
Give 1mg Adrenaline IV
Still a Non-Shockable Rhythm
(PEA/Asystole)
Immediately Resume CPR 30:2 For 2 min
PEA/Asystole
• Check pulse if– A change to an organised rhythm seen
after 2 min CPR– Patient showing signs of life
• Adrenaline 1mg IV every 2 loops as soon as IV access is achieved
• In asystole and PEA (heart rate <60) Atropine 3mg is given once only
During CPR: Correct reversible causes Check electrode position and
contact Attempt/verify:
IV accessAirway and oxygen
Give uninterruptedcompressions when airwaysecure
Give adrenaline every 3–5 min. Consider: amiodarone,
atropine, magnesium
Airway and ventilation
• Secure airway:– tracheal tube– LMA
• Once airway secured, if possible, do not interrupt chest compressions for ventilation
• Avoid hyperventilation
Reversible CausesHypoxia Tension pneumothoraxHypovolaemia Tamponade, cardiacHypo/hyperkalaemia/metabolic ToxinsHypothermia Thrombosis (coronary or pulmonary)
• Any Questions regarding cardiopulmonary resuscitation can be referred to Susan Somerville, Resuscitation Officer, University of Dundee, via email: