1 / 27

CDR VASILIS BEKOS, HN ANAESTHESIOLOGIST-INTENSIVIST ATHENS NAVAL HOSPITAL ICU DIRECTOR

MEDICAL EMERGENCIES ON BOARD ΙΑΤΡΙΚΗ ΣΤΗ ΘΑΛΑΣΣΑ 3 ο ΣΥΝΕΔΡΙΟ ΝΑΥΤΙΚΗΣ - ΤΑΞΙΔΙΩΤΙΚΗΣ ΙΑΤΡΙΚΗΣ ΙΔΡΥΜΑ Α ΛΑΣΚΑΡΙΔΗ 2-3 ΔΕΚ 2011. CDR VASILIS BEKOS, HN ANAESTHESIOLOGIST-INTENSIVIST ATHENS NAVAL HOSPITAL ICU DIRECTOR. MEDICAL EMERGENCIES. Vasovagal syncope Cardiac emergencies

shellie-fisher
Download Presentation

CDR VASILIS BEKOS, HN ANAESTHESIOLOGIST-INTENSIVIST ATHENS NAVAL HOSPITAL ICU DIRECTOR

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MEDICAL EMERGENCIES ON BOARDΙΑΤΡΙΚΗ ΣΤΗ ΘΑΛΑΣΣΑ3οΣΥΝΕΔΡΙΟΝΑΥΤΙΚΗΣ-ΤΑΞΙΔΙΩΤΙΚΗΣΙΑΤΡΙΚΗΣΙΔΡΥΜΑ Α ΛΑΣΚΑΡΙΔΗ 2-3 ΔΕΚ 2011 CDR VASILIS BEKOS, HN ANAESTHESIOLOGIST-INTENSIVIST ATHENS NAVAL HOSPITAL ICU DIRECTOR

  2. MEDICAL EMERGENCIES • Vasovagal syncope • Cardiac emergencies • Neurological emergencies • Respiratory emergencies • Gastrointestinal emergencies • Dizziness-Nausea-Vertigo-Seizures

  3. MEDICAL EMERGENCIES • Vasovagal syncope • Cardiac emergencies • Neurological emergencies • Respiratory emergencies • Gastrointestinal emergencies • Dizziness-Nausea-Vertigo-Seizures MOST EVENTS ARE NOT SERIOUS MEDICAL EVACUATION < 7-14%

  4. MEDICAL INTERVENTIONS • Medical staff (physician-nurse) • Environment (special) • Emergency facilities • Triage

  5. MEDICAL INTERVENTIONS • A - airway • B - breathing • C - circulation

  6. Cardiac events on board… • Ischemic heart disease…on earth • Increasing number of travelers • Elderly passengers • Longer distances • Acute environmental conditions

  7. …. to confirm cardiac arrest Open Airway Look for signs of life • Pulse check if trained to do so • Take no more than 10 seconds for assessment

  8. A-airwayMEDICAL INTERVENTIONS • Supraglotic devices • Trachea intubation • Emergency cricothyroidotomy

  9. A-airwayMEDICAL INTERVENTIONS

  10. A-airwayCricothyroidotomy • Only as a last chance to achieve airway • For an upper airway obstruction…above the larynx • Safer and quicker that tracheostomy • Cricothyroidotomy emergency kit

  11. B- breathingMEDICAL INTERVENTIONS • Mechanical ventilation • Needle thoracentesis • Chest tube placement

  12. B- breathingMechanical ventilation • Ventilator (mechanical) – bag valve vent • Secure airway (LMA-intubation) • Sedation • Mechanical ventilation parameters: frequency-oxygen inspiration fraction-inspiration pressure / tidal volume-PEEP

  13. B- breathingChest tube placement • Hemothorax-pneumothorax • Needle thoracentesis (hypotension-decreased or absent breath sounds to one side) • Emergency kit (Heimlich valve)

  14. C- circulationMEDICAL INTERVENTIONS • CPR • Defibrillation / Cardioversion • Temporary cardiac pacing • Central vein cannulation • Vein cutdown

  15. Chest compression • 30:2 • Compressions • “Centre of chest” • 4-5 cm depth • 100 min-1 • Uninterrupted compressions when airway secured • Avoid • Provider fatigue • Interruptions

  16. Self-adhesive electrodes • Hands-free • Remove excess chest hair • Dry chest if necessary • Continue CPR whilst applying

  17. Shockable (VF) • Bizarre irregular waveform • No recognisable QRS complexes • Random frequency and amplitude • Uncoordinated electrical activity • Coarse / fine • Exclude artefact • movement • electrical interference

  18. Shockable (VT) • Monomorphic VT • broad complex rhythm • rapid rate • constant QRS morphology

  19. Non-shockable Asystole • Absent ventricular (QRS) activity • Atrial activity (P waves) may persist • Rarely a straight line trace

  20. Non-shockable (PEA) • Clinical features of cardiac arrest • ECG normally associated with an output

  21. CPR… to buy time!!! • BLS keep brain alive.... • Until an AED used

  22. …moreMEDICAL INTERVENTIONS • Urinary catheter • Nasogastric tube • Anti Epileptic • Bronchodilations • Analgesia- Sedation

  23. SUMMARY • Ischemic heart disease is a leading cause of death • Importance of clinical signs early recognition and prevention of a cardiac arrest event • Following the ALS algorithm • Early air-evacuation • Post Resuscitation Care • Similar with the intervention on land

More Related