BY
ISLAM GHANEMASSISTANT LECTURER OF CARDIOLOGY
ZAGAZIG UNIVERSITYEGYPT2014
CARDIAC ARREST(ALS MANAGEMENT)
INTRODUCTION
Cardiac arrest also known as cardiopulmonary arrest or circulatory arrest is the end of normal circulation of the blood due to failure of the heart to contract effectively
Also referred as a sudden cardiac arrest (SCA) Cardiac arrest is a medical emergency that in
certain situations is potentially reversible if treated early
Unexpected cardiac arrest sometimes leads to death almost immediately this is called sudden cardiac death (SCD)
CLASSIFICATION
Based upon the ECG rhythm
1 SHOCKABLE
The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia
2 NON-SHOCKABLE
The two nonndashshockable rhythms are asystole and pulseless electrical activity
CAUSES
Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome
Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as
gastrointestinal bleeding aortic rupture and intracranial hemorrhage)
Overdose Drowning
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
INTRODUCTION
Cardiac arrest also known as cardiopulmonary arrest or circulatory arrest is the end of normal circulation of the blood due to failure of the heart to contract effectively
Also referred as a sudden cardiac arrest (SCA) Cardiac arrest is a medical emergency that in
certain situations is potentially reversible if treated early
Unexpected cardiac arrest sometimes leads to death almost immediately this is called sudden cardiac death (SCD)
CLASSIFICATION
Based upon the ECG rhythm
1 SHOCKABLE
The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia
2 NON-SHOCKABLE
The two nonndashshockable rhythms are asystole and pulseless electrical activity
CAUSES
Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome
Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as
gastrointestinal bleeding aortic rupture and intracranial hemorrhage)
Overdose Drowning
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Cardiac arrest also known as cardiopulmonary arrest or circulatory arrest is the end of normal circulation of the blood due to failure of the heart to contract effectively
Also referred as a sudden cardiac arrest (SCA) Cardiac arrest is a medical emergency that in
certain situations is potentially reversible if treated early
Unexpected cardiac arrest sometimes leads to death almost immediately this is called sudden cardiac death (SCD)
CLASSIFICATION
Based upon the ECG rhythm
1 SHOCKABLE
The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia
2 NON-SHOCKABLE
The two nonndashshockable rhythms are asystole and pulseless electrical activity
CAUSES
Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome
Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as
gastrointestinal bleeding aortic rupture and intracranial hemorrhage)
Overdose Drowning
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CLASSIFICATION
Based upon the ECG rhythm
1 SHOCKABLE
The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia
2 NON-SHOCKABLE
The two nonndashshockable rhythms are asystole and pulseless electrical activity
CAUSES
Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome
Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as
gastrointestinal bleeding aortic rupture and intracranial hemorrhage)
Overdose Drowning
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Based upon the ECG rhythm
1 SHOCKABLE
The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia
2 NON-SHOCKABLE
The two nonndashshockable rhythms are asystole and pulseless electrical activity
CAUSES
Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome
Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as
gastrointestinal bleeding aortic rupture and intracranial hemorrhage)
Overdose Drowning
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CAUSES
Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome
Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as
gastrointestinal bleeding aortic rupture and intracranial hemorrhage)
Overdose Drowning
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome
Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as
gastrointestinal bleeding aortic rupture and intracranial hemorrhage)
Overdose Drowning
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as
gastrointestinal bleeding aortic rupture and intracranial hemorrhage)
Overdose Drowning
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Reversible causes
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
DIAGNOSIS
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)
Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo
Death
NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
MANAGEMENT
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Delay Can Be Deadly
Patient delay is the biggest cause of not getting care fast
Do not wait more than a few minutesmdash5 at the most
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Golden minutes
12042023 drdgm 17
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CPR CENTURIES amp DECADES AGO
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CPR NOW A DAYShellip
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
VFPulseless VT
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Ventricular Fibrillation
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Ventricular Tachycardia
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Ventricular Fibrillation (VF)
What VF looks like on an EKG
Shock ldquoconvertsrdquo VF to better rhythm
Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Immediate AED
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
AsystolePEA
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Asystole
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
PEA Pulseless electrical activity (PEA)
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Advanced Airway
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT
When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation
1 breath every 6-8 seconds (8-10 breaths per minute)
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
ARTICLES USED IN CPR
1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
3SUCTION TUBE OR CATHETER
4NASAL AIRWAYORAL AIRWAY
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
5LUBRICATING JELLY
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CPR KIT
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Defibrillation
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Automated External Defibrillator
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
DEFIBRILLATION GENERAL CONCEPT
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Manual Defibrillator
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT
SIZE3 IV INFUSION SET CUT DOWN SETS
AND IV FLUIDS4 CARDIAC MONITOR WITH
DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES
OTHERhellip
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CARDIO-PULMONARY RESUSCITATION(CPR)
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CPR Wins (Whats Important Now)
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
New CPR sequenceC-A-B
not
A-B-C
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Elbows should be locked and arms are straight
Rescuerrsquos shoulders position directly over hands
Begin compression
Pressure should come from the shoulders
Compression should depress victimrsquos sternum approximately 15- 2 inches
Donrsquot allow the fingers to touch the chest wall
Allow chest to rebound to normal position after each compression
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Approach safely
Check response
Shout for helpOpen airway
Check breathing
30 chest compressions
2 rescue breaths
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Approach safely
Check response
Shout for help
Open airwayCheck breathing
30 chest compressions
2 rescue breaths
OPEN AIRWAY
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Head tilt chin lift + jaw thrust- healthcare professionals
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Approach safely
Check response
Shout for help
Open airway
Check breathing30 chest compressions
2 rescue breaths
CHECK BREATHING
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Look listen and feel for NORMAL breathing
Do not confuse agonal breathing with 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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
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 arrestErroneous information can result in
withholding CPR from cardiac arrest victim
AGONAL BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Approach safely
Check response
Shout for help
Open airway
Check breathing
30 chest compressions2 rescue breaths
30 CHEST COMPRESSIONS
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
bull Place the heel of one hand in the centre of the chest
bull Place other hand on top
bull Interlock fingersbull Compress the chest
ndash Rate 100 min-1
ndash Depth 4-5 cmndash Equal compression
relaxationbull When possible change
CPR operator every 2 min
CHEST COMPRESSIONS
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CONTINUE C P R
30
2
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel
OPERATOR is already exhausted amp cannot continue CPR
PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)
WHEN TO STOP CPR
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
ChildInfant Compression
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Neonatal Resuscitation The etiology of neonatal arrests is nearly
always asphyxia
Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology
Rate(302) to be changed to (152) if 2 rescuers
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
The following steps should be implemented helliphelliphellip
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Resuscitation team(Code Blue)
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Resuscitation room
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric
patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash
estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at
bedside 1048577 Pulse oximeter at bedside and ready
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as
needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds
adult internal] ndash external pacer pads 1048577 Call for blood if needed
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
MISCELLANEOUS 1048577 Bedside hematocrit and glucose
monitors 1048577 Appropriate size foley catheter ndash
available as needed 1048577 Appropriate size NG tube ndash available
as needed
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Drugs used commonly during resuscitation
Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate
(No role Atropine Ca++ Na bicarbonate)
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
HOME MESSAGE
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post
cardiac arrest care)
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Donrsquot Forget Epinephrine Amiodarone
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
Forget Look Listen and Feel victims before
starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate
(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)
+ Demo cases(Shockable non)
Questions
+ Demo cases(Shockable non)
Questions
Questions
Top Related