Transcript
CPR 2010CPR 2010
ADULTADULTA A dvanceddvanced
C C ardiacardiac L L ifeife
S S upportupport
Rule #1:Rule #1:
Always start with BLS.Always start with BLS.
PPush Hard, ush Hard, PPush Fastush Fast
FFull Chest ull Chest RRecoilecoil
MMinimizeinimizeInterruptionInterruption
30 : 230 : 2until intubateduntil intubated
100%100% Oxygen Oxygen
When intubated:
Do not HyperventilationAmbu every 6 – 8 seconds
Rule #2:Rule #2:
Always Always PulsePulse + + EKGEKGq q 22 minutesminutes
Rule #2:Rule #2:
PulsePulse + + EKGEKG== ==
CPR?CPR? SHOCK?SHOCK?
q q 22 minutesminutes
VFVFVT VT (pulseless)
AsystoleAsystolePEAPEA
Rule #3:Rule #3:
Drug.Drug.
Adrenaline1 mg IV q 3-5 min
Amiodarone300 mg IV push
Atropine0.5 mg IV q 3-5 min0.5 mg IV q 3-5 min
Rule #4:Rule #4:
Advanced AirwayAdvanced AirwayAfter CPR & ShockAfter CPR & Shock
CombitubeCombitube
Rule #5:Rule #5:
Find theFind the Cause Cause TreatTreat it. it.andand
55HHTT
H y p o t h e r m i aH y p o v o l e m i aH y p o x i aH y p e r / H y p o K a l e m i aH + i o n ( a c i d o s i s )
T e n s i o n P n e u m o t h o r a xC a r d i a c Ta m p o n a d eT o x i nT h r o m b o s i s – H e a r tT h r o m b o s i s L u n g
PULSELESS ARRESTPULSELESS ARREST
BradycardiaBradycardia
TachycardiaTachycardiawithwith Pulse Pulse
< 60/min< 60/min
> 100/min> 100/min
Cause or Effect?
55HHTT
H y p o t h e r m i aH y p o v o l e m i aH y p o x i aH y p e r / H y p o K a l e m i aH + i o n ( a c i d o s i s )
T e n s i o n P n e u m o t h o r a xC a r d i a c Ta m p o n a d eT o x i nT h r o m b o s i s – H e a r tT h r o m b o s i s L u n g
Poor Tissue Perfusion?Poor Tissue Perfusion?
Hypotension?
Altered mental status?
Signs of shock?
Ischemic chest pain?
Acute heart failure?
Atropine0.5 mg IV q 3-5 min0.5 mg IV q 3-5 min
max. 3 mgmax. 3 mg
DopamineIV drip 2-10 mcg/kg/minIV drip 2-10 mcg/kg/min
AdrenalineIV IV dripdrip 2-10 mcg/kg/min 2-10 mcg/kg/min
Transcutaneous PacingTranscutaneous Pacing
Poor Tissue Perfusion?Poor Tissue Perfusion?
Hypotension?
Altered mental status?
Signs of shock?
Ischemic chest pain?
Acute heart failure?
Poor Tissue PerfusionPoor Tissue Perfusion
SynchronizedSynchronizedCardioversionCardioversion
Tachyarrhythmia withTachyarrhythmia with
Why Cardioversion?Why Cardioversion?
Prevent “R on T”
PULSELESS ARRESTPULSELESS ARREST
BradycardiaBradycardia““with Pulse”with Pulse”
TachycardiaTachycardia““with Pulse”with Pulse”
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