Exercise date Time Seminary room KAIM

Lecture PA

14.00 – 15.30h

3.11.2010

Wednesday

10.00-10.45h DM 4ab 29.10.2010Friday

KAIM

12.00- 12.45h Substitute date 3.12.2010

Friday

TEST

14.00- 14.45 h Substitute date

Substitute date is for students, who were not able to arrive for normal date.3.12.2010 14.00h TEST: 10 MCQ First aid ( Basic life support adults, Pediatric basic life support, Shock, Wounds, Heat Stroke, Burns , Emergency Rescue and Transfer – Removal from Automobile,…Literature: First Aid Manual, Latest Update, St John Ambulance Association, 2005, www.erc.com, Moule P., Albarran J., 2009: Practical resuscitation for healthcare professionalswww. books.google.com

First aid fundamentals (28th October 2010)1st part : education Department of anaesthesiology and inten. medicine, SNP 1 st.2nd part :education Department of Traumatology, Rastislavova 43 st.

Seminary room KAIM 2nd floor, SNP st. 1, we ask students to wait for teacher on the 2nd floor in front of University Department of Anaesthesiology & Intensive Care

Paediatric basic life support

Monika Grochová MD, PhDKlinika anestéziológie a intenzívnej

medicíny LF UPJŠ a UNLP Košice

• www.erc.eduwww.resus.org.uk

• Resuscitation (2005, 2010) 67 Supplement

• Resuscitation (2005, 2010) 67

Basic life support

Airway – airways opening

Breathing – arteficial ventilation

Circulation – recovery of circulation

CBA adults

Paediatric basic life support

• simplification based on the knowledge that many children receive no resuscitation at all because rescuers fear doing harmAge:

- An infant is a child under 1 year of age

- a child is between 1 year and puberty

25 kg, 8. years

CPR IN CHILDREN

• Adult CPR techniques can be used on children

• Compressions 1/3 of the depth of the chest

30

30

Approach safely

Check response

Shout for help

Open airway

BASIC LIFE SUPPORT (BLS)

head tilt and chin lift,

Cam

pbel

l

Approach safely

Check response

Shout for help

Open airway

Check breathing

BASIC LIFE SUPPORT (BLS)

Look, listen and feel for NORMAL breathing

Breathing• Take a breath and cover the mouth and nasal apertures of the infant with your mouth, makingsure you have a good seal • Blow steadily into the infant’s mouth and nose over 1—1.5 s, sufficient to make the chest visibly rise

• Take another breath and repeat this sequencefive times

BreathingNo effective breathing:- the airway may be obstructed

• Open the child’s mouth and remove any visible obstruction.

• Ensure that there is adequate head tilt and chin lift,try the jaw thrust method

• Make up to five attempts to achieve effective breaths; if still unsuccessful, move on to chestcompressions

Breathing, circulation

• look for signs of a circulation any movement, coughing normal breathing=circulation is

present (not agonal gasps, which are infrequent, irregular

breaths)

Basic life support

• Chest compressions– To 1. year 2 fingers (2 thumbs circular)– Over 1. yer one hand/two hands– Low part of sternum– Thumb over processus xiphoideus– Compression by 1/3 of antero-posterior

distance– AED– Children > 1 year– Smaller size of pads for children to 8 years– 50 – 75 J (4 J/kg)

Chest compression

Chest compressions

• to depress the sternum by approximately one third of the depth of the chest

• and repeat at a rate of about 100 min−1

Chest compressions : breaths

30:2

AED IN CHILDREN

• Age > 8 years• use adult AED

• Age 1-8 years• use paediatric

pads / settings if available (otherwise use adult mode)

• Age < 1 year• use only if

manufacturer instructions indicate it is safe

AED DEFIBRILLATION

ATTACH PADS TO CASUALTY’S BARE CHEST

ANALYSING RHYTHM - DO NOT TOUCH VICTIM

SHOCK INDICATED

• Stand clear• Deliver shock

SHOCK DELIVERED FOLLOW AED INSTRUCTIONS

30 2

Recovery position

Approach safely

5 rescue breaths

Check response

Shout for help

Open airway

Check breathing

Call 112

30 chest cmpressions

Approach safely

Check response

Shout for help

Open airway

Check breathing

Call 112

Attach AED

Follow voice prompts

Anatomical diferencies of airwais by children

Postresuscitation care

• Aproppriate tissue perfusion• Cooling – if unconsiousness after

CPR– 32 – 34°C of body core 12 – 24 hours– Warming 0,25 – 0,5°C / hour– AE- infection, koagulopathy, glykémia,

ións, circulation– Avoid hyperthermia - antipyretics

ETICS and CPR

• Start – not start• Parents´presens during CPR

• Decision to stp CPR- team leader, not parents

CPR of newborn

Newborn resuscitation• Lungs distension- ambu- bag with face mask,

in term newborn f: 30-60/minif bradycardia persists - increase oxygen concentration

• Mecónium – desuflation by weak newborns• Compressions- breathing ratio 3:1

90 compressionsií and 30 breaths• Adrenalín, if despite art. Vent.with O2 bradycardia

<60/mindose 0,01-0,03 mg/kg i.v., into ETT 5-7 x more

• Check HR every 30 sekúnd, STOP if HR > 60/min• Circulation support evective only by lungs

distension • Temperature of body core maintenance

Foreign body airway obstruction

– Combination of methods needed– 5 hits back blows– 5 chest compressions (till 1year) /

abdominal thrusts over 1 year– Horisontal rib´s position – abdominal organs

damage risk

ANY QUESTIONS?