In study session III you have learnt
- While resuscitating a patient Aim to achieve the 5Ps
- Give focus for patients with ABCD instability
- Team mobilization and team work is key in emergency pts management,
- CPR- Is a skill which includes artificial respiration to provide oxygen to the lungs and artificial circulation to maintain blood flow through the body enough to give a person a chance for survival.
- Components: BLS- can be done any were, any time, by anyone who is trained to do so, and most of time it doesn't need special equipments. ALS - needs trained medical workers, special equipments,
- Goal- CPR- is given for those patients who have stopped breathing and heart beat due to multiple reasons. The goal of resuscitation interventions for a patient in respiratory or cardiac arrest is to: Restore effective oxygenation & ventilation, Restore circulation, Return of intact neurological functions
- Chain of survival- For effective result of resuscitation there should be: Early access to the patient or victim, Early CPR initiation, Early defibrillation, Early & effective post resuscitation care
- Causes of cardiac arrest- Cardiac origin: due to myocardial ischemia cardiac patients are at higher risk to develop: ventricular fibrillation and pulseles tachyarrhythmias. respiratory origin: airway obstruction, drowning, carbon monoxide poisoning and narcotic and sedative overdose
- To open the air way push backward on the forehead and lift the chin if the possibility of cervical spine injury is less
- During the initial phase of cardiac arrest when the pulmonary vessels and heart likely contain sufficient oxygenated blood to meet markedly reduced demands, the importance of compressions supersedes ventilations
- Assume cardiac arrest if patient is unresponsive and apneaic or has an abnormal (agonal) breathing pattern.
- 2 rescue breaths 30 chest compressions for 5 cycles and check for pulse in the carotid artery for 5sec don't waste time searching for pulse. If no pulse continue 30:2 compressions and ventilation until EMS arrive for advanced cardiac support(ACLS),or sign of life appear ,or you are alone and tire
- After every 5 cycle/2min. check for spontaneous breathing and circulation for 5 sec. avoid frequent interruptions
- The initial shock for all biphasic defibrillators is 150J with subsequent shocks at 200J. The initial and subsequent shocks for monophonic defibrillators are 360J.
- Complications of CPR: Gastric distention and regurgitation, Rib and sternal fracture, Pneumothorax, Lung contusion, Over ventilation-→ intra-thoracic pressure → ↓coronary perfusion, ↓CO ↓Perfusion of vital organs Hemopneumothorax
- Close monitoring on the progress, AND when there is deterioration restart from ABCD
- Aim immediate definitive management after successful resuscitation
Last modified: Monday, 21 November 2016, 8:46 AM