Medication for pulseless electrical activity12/28/2023 There is no pattern to the frequency or amplitude giving the appearance of uncoordinated electrical activity. It is characterised by bizarre irregular waveform with no recognisable QRS complexes. Ventricular fibrillation is a shockable rhythm. Once you have determined if a shockable or non-shockable rhythm is present, re-start CPR.ĩ. Keep the time spent analysing the rhythm as short as possible and certainly avoid interruptions in CPR of greater than 10 seconds duration. Once the defibrillator is attached, briefly pause to assess the underlying rhythm. To avoid fatigue switch the CPR provider every 2 minutes.Ĩ. The quality of CPR declines as CPR providers become fatigued. Once the airway is secured switch to continuous chest compressions with asynchronous ventilation. Allow the chest to fully re-expand between compressions and avoid residual pressure on the chest between compressions.Įven brief interruptions in chest compressions are harmful and should be avoided. There is good evidence that the quality of chest compressions and ventilations is related to patient outcome.Īlternate 30 high quality chest compressions with 2 ventilations.Įnsure compressions are given in the centre of the chest, to a depth of 5-6 cm at a rate of approximately 100-120 min-1. Attach the defibrillator/monitor as soon as it is available.ħ. Start with 30 chest compressions followed by 2 ventilations. While the resuscitation team are being called, ensure CPR is commenced without delay. It is good practice for the switchboard operator to confirm the details before placing the emergency call.Ħ. For example a good call would state, There is a cardiac arrest on ward 4. Give clear concise instructions to the telephone operator ensuring that the location, nature of emergency and response required are clearly stated. In the UK, hospitals use a centralised emergency call number which is 2222. Imprecise instructions such as, Put the call out or ∼all the crash team can lead to confusion. Be explicit in your briefing to the person you send to make the emergency call ensuring the person knows the location, nature of emergency and response required. Send a member of staff to call the resuscitation team unless they are already in attendance. This can be done by activating the emergency alarm or calling for help. Once cardiac arrest is confirmed, alert other staff in the area. The diagnosis of cardiac arrest is based on the patient being unresponsive and either not breathing or only having occasional gasps. Use any monitoring attached to the patient to assist in the decision making process.ĥ. coughing or movement - this should include checking for the carotid pulse. Simultaneously with breathing assessment, check for other signs of life, e.g. It should not be confused with signs of life. This is slow, sighing respirations and is common in the early stages after cardiac arrest. Take care not to confuse normal breathing with agonal breathing. If they are unresponsive, open their airway and check for normal breathing. The first step in the assessment process is to test for the patients response. Over the course of the next few slides I am going to break this down into stages.Ĥ. It takes the ALS provider through the initial assessment of the unresponsive patient, commencement of CPR and management according to the initial rhythm, before outlining the key stages after achieving return of spontaneous circulation. This slide show the ALS treatment algorithm in its entirety. It provides focus on the task in hand and allows all members of the team to work from the same standard, allowing them to anticipate and plan for interventions. The strengths of this protocolised approach are its foundations from the 2010 International Liaison Committee for Resuscitation scientific evidence evaluation process and the fact that it provides a common standard from which resuscitation providers can make rapid treatment decisions in an emergency situation. It is a central element in the ALS course. The ALS treatment algorithm provides a standardised approach to the resuscitation of the adult patient in cardiac arrest. Consider the role of the resuscitation team.ģ.Outline the potentially reversible causes of cardiac arrest.Describe the role of drugs during cardiac arrest.Outline the treatment algorithms for shockable and non-shockable rhythms.Emphasise the importance of high quality chest compressions.
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