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Cardiac Life Support

Dr.Dhananjaya Bulathwatta. Cardiac Life Support. BLS. ALS. BLS. Defined as “the preservation or restoration of life by the establishment and/or the maintenance of airway, breathing and circulation, and related emergency care. Importance. Importance. CPR TIME LINE

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Cardiac Life Support

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  1. Dr.Dhananjaya Bulathwatta Cardiac Life Support

  2. BLS ALS

  3. BLS Defined as “the preservation or restoration of life by the establishment and/or the maintenance of airway, breathing and circulation, and related emergency care.

  4. Importance

  5. Importance CPR TIME LINE • 0-4 mins. brain damage unlikely • 4-6 mins. brain damage possible • 6-10 mins. brain damage probable • >10 mins. probable brain death

  6. Urgency 60% 40% 20% 0%

  7. Background The best chance of long term neurologically intact survival occurs if: • The victim’s collapse is witnessed • CPR is commenced immediately • The cardiac rhythm is VF or pulse less VT

  8. Adult BLS sequence • Check for Response - “touch and talk” • Shout – “HELP” • Call Emergency No.[s] • Airway • Breathing • Circulation • Disability

  9. Airway • Head tilt- Chin lift

  10. Jaw Thrust with Support

  11. Breathing • LOOK • LISTEN • FEEL for rise and fall of the chest. for breath sounds. for the exhaled air Take at least 5 but not more than 10 seconds

  12. Breathing…. • 2 Resque breaths within 2-4 seconds • Make the chest rise

  13. Circulation Signs of Circulation • Carotid pulse • Cyanosis • Cold peripheries “There is reasonable evidence that rescuers are no more likely to be able to correctly determine if a pulse is present than simply tossing a coin” (ARC, 2006) Take at least 5 but not more than 10 seconds

  14. Circulation… Push down on the chest 11/2 to 2 inches 30 times right between the nipples.  Pump at the rate of 100/minute, faster than once per second. Minimize interruptions to 10 seconds or less.

  15. Disability prevention

  16. Adult Choking sequence

  17. Child CPR deferences • Pulse less than 60 bpm • 2 Rescuer CPR • Concider as poor perfusion • -15 : 2

  18. infant CPR differences • Brachial Pulse less than 60 bpm • Just below the nipple line on breast bone • 2 Rescuer CPR • Consider as poor perfusion • -2 fingers • -15 : 2

  19. ALS • Intubation • Cardiac Monitor • Precordial Thumb

  20. Als… • Pulseless VT • Asystole • VF • E.M.D.

  21. VT/VF • Defibrillation (one shock - 150-200 J biphasic or 360 J monophasic). • Immediately resume chest compressions (30:2) without reassessing the rhythm or feeling for a pulse. • Continue CPR for 2 min, then pause briefly to check the monitor. • If VF/VT persists give adrenaline 1 mg IV [every 3-5 min] followed immediately by a shock.

  22. Asystole • CPR 30:2 till pt. becomes shockable • Give adrenaline 1 mg IV as soon as intravascular access is achieved and every 3-5 min (alternate loops). • Give atropine 3 mg IV

  23. E.M.D. • CPR • Give further adrenaline 1 mg IV every 3-5 min (alternate loops)

  24. Ensure your skills areupdated each year Thank you

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