CHAKRADHAR HOSPITALS

ICU NURSING PROVIDING HIGH QUALITY NURSING CARE

BLS – ACLSAHA GUIDELINES 2010

DR.CH PAVAN KUMAR MBBS

CHAKRADHAR HOSPITALS.

ACLS BLS

HIGH QUALITY CPR

• MONITORING OF HIGH QUALITY CPR– INTER ARTERIAL PULSE PRESSURE <

20mmhg– PULSE WAVE CAPNOGRAPHY WITH END

TIDAL CO2 < 10mmhg

H AND T

• HYPOVOLEMIA• HYPOXIA

• HYDRROGEN ION ACIDOSIS

• HYPER OR HYPOKALEMIA

• HYPOTHERMIA• HYPOGLYCAEMIA

• TABLET• TAMPONADE• TENSION

PNEUMOTHORAX• THROMBOSIS

(PUL , CORONARY )• TRAUMA

H

• HYPOXIA– CONFIRM B/L CHEST RAISE ,VBS– CHECK O2 SOURCE– ADVANCED AIRWAY

• HYPOVOLEMIA– SET IO IV ACCESS– GIVE FLUID BOLUSES– REASSESS

H• HYDROGEN ION ACIDOSIS– RESPIRATORY ACIDOSIS DON’T

HYPERVENTILLATE–METABOLIC ACIDOSIS START SODA

BICARB• HYPER HYPOKALEMIA–HYPERKALEMIA• CALCIUM CHLORIDE 10 % 10ML IN 5 MINS

–HYPOKALEMIA • POTASSIUM CHLORIDE 20mmol• MAGNESIUM SULFATE 50 % SOLN 5 ML(10 MMOL IN 30 MINS)

• Hyper/Hypothermia– If too hot, cool down– If too cold, warm up

• Hypo/Hyperglycemia– Accu-check and correct if needed.

H

• Tablets (drug OD, accidents)– Support circulation while you find an antidote or rever

reverse drug. (poison control)

• Tamponade– (chest trauma, chest malignancy, recent central line insertion,

JVD, narrow pulse pressure, electrical alternans etc…)– Pericardial centesis                            

• Tension Pneumothorax– (chest asymmetry, tympani, diminished breath sounds, high

peak pressures, JVD, tracheal deviation, severe respiratory distress etc…)

– Vent tension in chest– Support ventilation and oxygenation with BVM and intubate as

necessary

T

• Thrombosis (coronary or pulmonary)– Consider fibrinolysis for suspected coronary or

pulmonary embolus.– CPR is not a absolute contraindication for

fibrinolysis.

• Trauma– Inspect body completely. Remove all clothes.– Secure airway– Control external bleeding with tamponade while

concurrently delivering volume with isotonic crystalloids and blood products.

– Look for internal bleeding (tap the abdomen if suspicious for internal bleed)and take to

T

PROVIDING BEST ICU CARE