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ADULT ADVANCED LIFE S UPPORT (ALS). RECOGNISING THE CRITICALLY ILL PATIENTS RESPONSE TO CRITICAL ILLNESS M edical emergency team (MET) APPROPRIATE PLACEMENT OF PATIENTS RESUSCITATION DECISIONS Many European countries have no formal policy for recording DNAR decisions
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ADULT ADVANCED LIFE SUPPORT (ALS)
RECOGNISING THE CRITICALLY ILL PATIENTS RESPONSE TO CRITICAL ILLNESS Medical emergency team (MET) APPROPRIATE PLACEMENT OF PATIENTS RESUSCITATION DECISIONS Many European countries have no formal policy for recording DNAR decisions Consider ‘do not attempt resuscitation’ (DNAR) when the patient: • does not wish to have CPR • will not survive cardiac arrest even if CPR isattempted GUIDELINES FOR PREVENTION OF IN-HOSPITAL CARDIAC ARREST
Head tilt and chin lift Jaw thrust BASIC AIRWAY MANAGEMENT
Oropharyngeal airways Bag-mask ventilation ADJUNCTS TO BASICAIRWAY TECHNIQUES
OTHER AIRWAY DEVICES Laryngeal Tube Tracheal Tube
- DRUGS Vasopressors Adrenaline Anti-arrhythmics Amiodarone Other drugs AtropineTheophylline - INTRAVENOUS FLUIDS Hartmann’s solution, Ringer’s solution Intravenous fluidto flush peripherally injected drugs into the central circulation DRUGS AND FLUIDS
DEFIBRILLATION Passage across the myocardium of an electrical current of sufficient magnitude to depolarise a critical mass of myocardium and restoration of coordinated electrical activity USE OF DEFIBRILLATORS: - Adults - Children older than 8 years - NO defibrillation in children less than 1 year ELECTRICAL THERAPIES
AUTOMATED EXTERNAL DEFIBRILLATOR (AED) CARDIOVERSION is used to convert atrial or ventricular tachyarrhythmias PACING Consider pacing in patients with symptomatic bradycardia ELECTRICAL THERAPIES
PAEDIATRIC BASIC LIFE SUPPORT (PBLS)
MANY CHILDREN RECEIVE NO RESUSCITATION AT ALL BECAUSE THE RESCUERS FEAR DOING HARM. APPLYING OF THE SAME GUIDANCE FOR ALL ADULTS AND CHILDREN ARE FEASIBLE ! ! ! ! ! ! ENHANCED TRAINING FOR HEALTHCARE PROFESSIONALS. PEADIATRIC BASIC LIFE SUPPORT(PBLS)
carotid pulse / CHILD brachial pulse / INFANT
Back blows,chest thrusts and abdominalthrusts all increaseintrathoracic pressureand can expel foreign bodiesfrom theairway FOREIGN BODY AIRWAY OBSTRUCTION (FBAO)
PAEDIATRIC ADVANCED LIFE SUPPORT (PALS)
1. Name 3 causes of airway obstruction. 2. Name 2 types of airway in-hospital devices. 3. Name 2 drugs commonly used in ALS. 4. What is the age limit 4 defibrillator usage? 5. What electrical therapies can be performed in the hospital? 6. What is the C:V ratio in an infant life support? 7. What is the major cause of cardio-pulmonary arrest in: - children? - adult? REPETITION