Date post: | 28-Dec-2015 |
Category: |
Documents |
Upload: | kristina-jones |
View: | 214 times |
Download: | 0 times |
Passing Resus
• Pass mark slightly higher than other clinical skills (easier to kill someone!!)
• Percentage passed last year =• Its the station where most students fail
• Key to passing – staying calm!!!!
• Patient MAY NOT BE DEAD when you walk in
A = Airway
• Obstructed?
• Head tilt • Chin lift• Jaw thrust
• Suction• Oropharyngeal airway• (Nasopharyngeal airway)
B= Breathing
• Chest movement• Respiratory rate• Sats• Auscultate in 4 main
areas• Oxygen – prongs?
Mask? Mask + reservoir bag?
• O2 – 15L/min
C = Circulation
• Pulse • Blood pressure
• Capillary refill• Warm peripheries –
hands and feet
• IV access – 250-500ml fluid ASAP!
Confirming arrest
• Measure pulse and watch for resps for 10s
• NB - Airway must be patent or they won’t be able to breathe
Hearts definitely stopped...
• CPR 30:2 until defib arrives• 2 breaths should be given with bag valve mask
To defib or not to defib• (video of defib is on eemec)
• Take your time and look at the rhythm on the screen
• Shockable – VF/ VT
• Non- shockable – PEA/Asystole
Drugs
• Need to know doses and timing of 3 drugs
• Non shockable – Adrenaline 1mg immediately and then every 2nd cycle of CPR (Atropine 3mg if PEA <50bpm only once)
• Shockable – Adrenaline 1mg (not immediate) every second cycle, Amiodarone 300mgs after fourth cycle
Reversible causes
• Hypoxia – give oxygen• Hypovolaemia – give fluids/blood• Hypo/hyperkalaemia/metabolic- correct
imbalance• Hypothermia – warm patient• Tension pneumothorax – decompress• Tamponade – drainage of fluid (refer to surgeon)• Toxins – antidotes/dialysis• Thrombosis – anticoagulants