CPR 2010CPR 2010

ADULTADULTA A dvanceddvanced

C C ardiacardiac L L ifeife

S S upportupport

Rule #1:Rule #1:

Always start with BLS.Always start with BLS.

PPush Hard, ush Hard, PPush Fastush Fast

FFull Chest ull Chest RRecoilecoil

MMinimizeinimizeInterruptionInterruption

30 : 230 : 2until intubateduntil intubated

100%100% Oxygen Oxygen

When intubated:

Do not HyperventilationAmbu every 6 – 8 seconds

Rule #2:Rule #2:

Always Always PulsePulse + + EKGEKGq q 22 minutesminutes

Rule #2:Rule #2:

PulsePulse + + EKGEKG== ==

CPR?CPR? SHOCK?SHOCK?

q q 22 minutesminutes

VFVFVT VT (pulseless)

AsystoleAsystolePEAPEA

Rule #3:Rule #3:

Drug.Drug.

Adrenaline1 mg IV q 3-5 min

Amiodarone300 mg IV push

Atropine0.5 mg IV q 3-5 min0.5 mg IV q 3-5 min

Rule #4:Rule #4:

Advanced AirwayAdvanced AirwayAfter CPR & ShockAfter CPR & Shock

CombitubeCombitube

Rule #5:Rule #5:

Find theFind the Cause Cause TreatTreat it. it.andand

55HHTT

H y p o t h e r m i aH y p o v o l e m i aH y p o x i aH y p e r   /   H y p o   K a l e m i aH +   i o n   ( a c i d o s i s )

T e n s i o n   P n e u m o t h o r a xC a r d i a c   Ta m p o n a d eT o x i nT h r o m b o s i s   –   H e a r tT h r o m b o s i s   ­   L u n g

PULSELESS ARRESTPULSELESS ARREST

BradycardiaBradycardia

TachycardiaTachycardiawithwith Pulse Pulse

< 60/min< 60/min

> 100/min> 100/min

Cause or Effect?

55HHTT

H y p o t h e r m i aH y p o v o l e m i aH y p o x i aH y p e r   /   H y p o   K a l e m i aH +   i o n   ( a c i d o s i s )

T e n s i o n   P n e u m o t h o r a xC a r d i a c   Ta m p o n a d eT o x i nT h r o m b o s i s   –   H e a r tT h r o m b o s i s   ­   L u n g

Poor Tissue Perfusion?Poor Tissue Perfusion?

Hypotension?

Altered mental status?

Signs of shock?

Ischemic chest pain?

Acute heart failure?

Atropine0.5 mg IV q 3-5 min0.5 mg IV q 3-5 min

max. 3 mgmax. 3 mg

DopamineIV drip 2-10 mcg/kg/minIV drip 2-10 mcg/kg/min

AdrenalineIV IV dripdrip 2-10 mcg/kg/min 2-10 mcg/kg/min

Transcutaneous PacingTranscutaneous Pacing

Poor Tissue Perfusion?Poor Tissue Perfusion?

Hypotension?

Altered mental status?

Signs of shock?

Ischemic chest pain?

Acute heart failure?

Poor Tissue PerfusionPoor Tissue Perfusion

SynchronizedSynchronizedCardioversionCardioversion

Tachyarrhythmia withTachyarrhythmia with

Why Cardioversion?Why Cardioversion?

Prevent “R on T”

PULSELESS ARRESTPULSELESS ARREST

BradycardiaBradycardia““with Pulse”with Pulse”

TachycardiaTachycardia““with Pulse”with Pulse”