Lekha ThomasPaediatric FBAO Treatment Ineffective cough Effective cough Encourage cough Continue to...
Transcript of Lekha ThomasPaediatric FBAO Treatment Ineffective cough Effective cough Encourage cough Continue to...
Lekha Thomas
Adult basic life support including choking
Paediatric basic life support and FBAO
Anaphylaxis
AED
The majority of cases of sudden cardiac arrest occur in adults out of hospital, and are of cardiac origin.
One third of all people developing MI die before reaching hospital and most of them die within an hour of the onset of symptoms- the presenting rhythm in most of these deaths is VF and with each minutes delay in defibrillation chance of successful outcome fall by 7-10%
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call999
30 chest compressions
2 rescue breaths
Approach safelyApproach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
Approach safely
Check responseApproach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
Shake shoulders gently
Ask “Are you all right?”
If he responds• Leave as you find him.
• Find out what is wrong.
• Reassess regularly.
Check response
Shout for helpApproach safelyApproach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
Open airwayApproach safelyApproach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
Check breathingApproach safelyApproach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
Look, listen and feel for NORMAL breathing
Check breathing
Occurs shortly after the heart stops in up to 40% of cardiac arrests
Described as barely, heavy, noisy or gasping breathing
Recognise as a sign of cardiac arrest
Abnormal breathing
Approach safelyApproach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
Call 999
30 Chest compressionsApproach safelyApproach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
• Place the heel of one hand in the centre of the chest
• Place other hand on top • Interlock fingers or avoid putting
pressure on the side of the chest• Compress the chest
– Rate 100 – 120 min-1
– Depth 5 – 6 cm– Equal compression : relaxation
• When possible change CPR operator every 2 min
Chest compressions
2 Rescue breathsApproach safelyApproach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
Rescue breaths
Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Take about 1 second Allow chest to fall Repeat
Continue CPR
30 2
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 999
30 chest compressions
2 rescue breaths
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Paediatric FBAO Treatment
Ineffective cough Effective cough
Encourage coughContinue to checkfor deteriorationto ineffectivecoughor relief ofobstruction
babies under 1 year
children over 1 year
If at any point the child becomes unconscious, commence CPR
5 back blows5 abdominal thrusts
Defibrillators• MANUAL DEFIBRILLATORS• AUTOMATED EXTERNAL DEFIBRILLATORS (AED’s)• FULLY AUTOMATED AED• SEMI AUTOMATIC AED
Debrillation Defibrillation is the passage of an
electrical current of sufficient magnitude across the myocardium to depolarise a critical mass of cardiac muscle simultaneously
Enables the natural pacemaker tissue to resume control.
Successful defibrillation is defined as absence of VF/VT at 5 secs after a shock delvery.
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Defibrillation
Defibrillation success changes with time -
Minutes Elapsed
1 2 3 4 5 6 7 8 9 10 11
80% chance of success
60% chance of success
20% chance of success
Virtually no chance of success
Automated External Defibrillators
Factors Affecting Defibrillation
•Time between onset of VF/VT & defibrillation•Pad position
Environmental Factors
•Wet areas.
•Risk of explosion- petrol stations.
Safety FactorsRemove Oxygen from the vicinity of the pt
Check pt for……….•…Jewellery•…Pacemaker•…GTN/Hormone/Nicotine patches
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What is anaphylaxis?
Anaphylaxis is:– A severe, life-threatening, generalized or systemic hypersensitivity reaction
Anaphylaxis is characterised by:
– Rapidly developing, life threatening, Airway and/or Breathing and or Circulation problems
– Usually with skin and/or mucosal changes
Signs and symptoms Airway swelling , hoarse voice, stridor Breathing problems- wheeze,
tachypnoea, cyanosis Circulation- tachycardia, hypotension,
pale ,clammy and reduced level of consciousness
Skin and mucosal changes- urticaria and angioedema
Abdominal pain , vomiting and diarrhoea
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Who gets anaphylaxis?
• Mainly children and young adults
• Commoner in females
• Incidence seems to be increasing
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About 20 anaphylaxis related deaths reported each yr in the UK-
Risk of death is increased in those with pre-existing asthma, particularly if asthma is poorly controlled
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Differential diagnosis
Life-threatening conditions:
• Asthma - can present with similar symptoms and signs to anaphylaxis, particularly in children
• Septic shock - hypotension with petechial/purpuric rash
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Differential diagnosis
Non-life-threatening conditions:• Vasovagal episode
• Panic attack
• Breath-holding episode in a child
• Idiopathic (non-allergic) urticaria or angioedema
Seek help early if there are any doubts about the diagnosis
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Treatment of anaphylactic reactions
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Auto-injectors … (e.g. Anapen, Epipen)
• For self-use by patients or carers
• Should be prescribed by allergyspecialist
• For those with severe reactions and difficult to avoid trigger
Guidelines and posters available atwww.resus.org.uk