- 1. RDT HOSPITALS EVERYCARING PERSONSRESPONSIBILITY
2.
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- American Heart Association (AHA)
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- European Resuscitation Council (ERC)
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- Heart and Stroke Foundation of Canada (HSFC)
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- Resuscitation Council of Southern Africa (RCSA)
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- Australia and New Zealand Council on Resuscitation
(ANZCOR)
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- Anti-American Heart Foundation (IAHF)
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- Japan Resuscitation Council (JRC) International observer to
ILCOR
InternationalLiaison Committee on Resuscitation 3.
- At least two international experts from different organizations
review each topic
- Minimum database requirements for every search strategy,
include:
-
- Cochrane Systematic Reviews.
- Every reviewer rates the level and quality of evidence using a
standardized international evidence evaluation form.
- There are separate international task forces for each of the
following areas: BLS, ALS, Pediatric, Neonatal, ACS/MI, and
Stroke.
- An additional interdisciplinary task force addresses topics
that affect all groups.
InternationalLiaison Committee on Resuscitation 4. HISTORY OF
CPR
- 3000 BC - first artificial mouth to mouth ventilation
- 1780 first attempt of newborn resuscitation by blowing
- 1874first experimental direct cardiac massage
- 1901first successful direct cardiac massage in man
- 1946first experimental indirect cardiac massage
anddefibrillation
- 1960indirect cardiac massage
- 1980development of cardiopulmonary resuscitation due tothe
works of Peter Safar
5. FACTS AND STATISTICS
- DEATH FROM SUDDEN CARDIAC ARREST IS NOT INEVITABLE. IF MORE
PEOPLE KNEW CPR, MORE LIVES COULD BE SAVED.
- ABOUT 75 PERCENT TO 80 PERCENT OF ALL OUT-OF-HOSPITAL CARDIAC
ARRESTS HAPPEN AT HOME & 94% OF SUDDEN CARDIAC ARREST VICTIMS
DIE BEFORE REACHING THE HOSPITAL
- EFFECTIVE BYSTANDER CPR, PROVIDED IMMEDIATELY AFTER CARDIAC
ARREST, CAN DOUBLE A VICTIMSCHANCE OF SURVIVAL.
- APPROXIMATELY 95 PERCENT OF SUDDEN CARDIAC ARREST VICTIMS DIE
BEFORE REACHING THE HOSPITAL.
- ONLY 27.4 PERCENT OF OUT-OF-HOSPITAL SUDDEN CARDIAC ARREST
VICTIMS RECEIVE BYSTANDER CPR
- CARDIAC ARREST OCCURS TWICE AS FREQUENTLY IN MEN COMPARED TO
WOMEN.
- THERE HAS NEVER BEEN A CASE OF HIV TRANSMITTED BY
MOUTH-TO-MOUTH CPR.
- IF CPR IS STARTED WITHIN 4 MINUTES OF COLLAPSE AND
DEFIBRILLATION PROVIDED WITHIN 10 MINUTES A PERSON HAS A 40% CHANCE
OF SURVIVAL.
- SURVIVAL < 6% WORLDWIDE AVERAGE
6. CARDIAC ARREST
CARDIAC EXTRA-CARDIAC 7. DIAGNOSIS OF CARDIAC ARREST 8. 9.
OBJECTIVES OF CPR
- Provide oxygen to brain, heart, other vital organs until more
expert/definitive medical treatment available.
- CPR within 4 minutes of arrest
- Early bystander intervention
10. PHYSIOLOGY DURING CPR
- 1. CIRCULATORY PHYSIOLOGY
11. ELEMENTS OF BLS
- A INITIAL ASSESSMENT,THEN AIRWAYMAINTENANCE
- B EXPIRED AIR VENTILATION (RESCUE BREATHING)
12. CHAIN OF SURVIVAL
- Early access to emergency services
13. PRINCIPLES OF BLS
14. BLS- HELLO + HELP
- Determine if the patient is conscious by tapping and shouting
"Are you OK?"
- If no response have someone call for the crash cart
15. BLS- Airway
- POSITION THE PATIENT ON HIS / HER BACK.
- OPEN THE AIRWAY WITH A HEAD-TILT CHIN-LIFT OR
16. AIRWAY ADJUNCTS
17. AIRWAY ADJUNCTS
18. B-BREATHING LOOK- for the chest to rise and fall LISTEN -
for air escaping during exhalation FEEL - for the flow of air CHECK
BREATHINGFOR NO LONGER THAN 10 SECS 19. B-BREATHING
- IF SAFE, USE RECOVERY POSITION
20. RECOVERY POSITION
- REDUCE THE RISK OF AIRWAY OBSTRUCTION AND ASPIRATION
- NEAR A TRUE LATERAL POSITION
- NO PRESSURE ON THE CHEST TO IMPAIR BREATHING
21. B-BREATHING
22. BLS - BREATHING
- Give a sufficient tidal volume to producevisible chest
rise
- Avoid rapid or forceful breaths
- Pinch the victims nose, and create an airtight mouth-to-mouth
seal
Take a normal breath prior to giving a rescue ventilation &
ventilations that are approximately 1 second in length. 23. TYPES
OF BREATHING
24. BLS- CIRCULATION ASSESSMENT Check for a pulse by
palpating(feeling) the carotid artery.THE HEALTHCARE PROVIDER
SHOULD TAKE NO MORE THAN10 SECONDSCHECK FOR A PULSE 25. BLS-
CIRCULATION
- DO YOU DEFINITELY FEEL PULSE WITHIN 10 SECONDS?
- CONTINUE WITH RESCUE BREATHING
- REASSESS FOR SIGNS OF A CIRCULATION ABOUTEVERY MINUTE
26. BLS- CIRCULATION
- DO YOU DEFINITELY FEEL PULSE WITHIN
- CONTINUE WITH RESCUE BREATHING
27. BLS- CIRCULATION
- Chest compressions consist of rhythmic applications of pressure
over the lower half of the sternum
- These compressions create blood flow by increasing
intrathoracic pressure and directly compressing the heart
- Chest compressions can produce systolic arterial pressure peaks
of 60 to 80 mm Hg
28. BLS- CIRCULATION
29. BLS- CIRCULATION The victim should lie supine on a hard
surface(eg, backboard or floor), with the rescuer kneeling beside
the victims thorax Correct compression technique and posture.Elbows
straight, eyes looking at the top of your hands, counting each
compression 30. COMPRESSIONVENTILLATION RATIO
- A compression-ventilation ratio of 30:2 is recommended
-
- increase the number of compressions
-
- reduce the likelihood of hyperventilation
-
- minimize interruptions in chest compressions for
ventilation
31. COMPRESSIONVENTILLATION RATIO
- Once an advanced airway is in place, the compressing rescuer
should give continuous chest compressions at a rate of 100 per
minute without pauses for ventilation.
- The rescuer delivering ventilation provides 8 to 10 breaths per
minute.
- NOTE: The outcome of chest compressionswithout ventilations is
significantlybetter than the outcome of no CPR foradult cardiac
arrest
32. DEFIBRILLATION
- All BLS providers should be trained to provide defibrillation
because VF is the most common rhythm found in adults with
witnessed, non traumatic SCA
- Survival rates are highest when immediate bystander CPR is
provided and defibrillation occurs within 3 to 5 minutes.
- Unwitnessed cardiac arrest -rescuers may give a period of CPR
(e.g., about 5 cycles or about 2 minutes) before checking the
rhythm and attempting defibrillation.
33. 34. MONOPHASIC Vs BIPHASIC
- 1st-shock efficacy of monophasic < 1st-shock efficacy of
biphasic
- Goal: delivery of current through chest to the heart to
depolarize myocardial cells and eliminate VF/VT
-
- delivers current of one polarity