Transcript of "6. abc and maternal resusctation rev_19.5.10"
IN PARTNERSHIP WITHLiverpool School of Tropical MedicineLiverpool Associates in Tropical HealthAirway, Breathing andAirway, Breathing andCirculationCirculation
AimsAimsTo understand the ABC and D approachTo understand the ABC and D approachTo develop and practise the skills ofTo develop and practise the skills ofcardiopulmonary resuscitation using the ABCcardiopulmonary resuscitation using the ABCapproachapproachTo achieve competence in those skillsTo achieve competence in those skills
Airway, Breathing and CirculationAirway, Breathing and Circulation Assessment of any sick patient begins with ABCAssessment of any sick patient begins with ABC Done in this order because airway and/orDone in this order because airway and/orbreathing problem will kill before a circulationbreathing problem will kill before a circulationproblemproblem You assess airway and breathing,You assess airway and breathing, and treatand treat,,and then assess circulationand then assess circulation and treatand treat
Airway and BreathingAirway and Breathing‘‘Hello how are you MrsHello how are you MrsTilt?’Tilt?’If no response:If no response: Assess if patient isAssess if patient isbreathing or notbreathing or not
Airway and BreathingAirway and Breathing LookLook for breathing byfor breathing bylooking for movementlooking for movementof the chestof the chest ListenListen for breathingfor breathingor noisy breathingor noisy breathing FeelFeel for breathingfor breathing
Airway and BreathingAirway and BreathingIf not breathing orIf not breathing ordifficult breathing:difficult breathing: Open airway byOpen airway byhead tilthead tilt andand chinchinliftlift
Airway and BreathingAirway and Breathing Open airway byOpen airway byjaw thrustjaw thrust
Airway and BreathingAirway and Breathing Gentle suctionGentle suction if necessary under direct visionif necessary under direct vision
Airway and BreathingAirway and Breathing If still not breathing:If still not breathing: place oropharyngeal airwayplace oropharyngeal airway
Airway and BreathingAirway and BreathingIf still not breathing:If still not breathing: give rescue breathsgive rescue breaths
Airway and BreathingAirway and BreathingIf breathing:If breathing: givegive oxygenoxygen(if available)(if available) Sit patient upSit patient up (if alert)(if alert)or place inor place in recoveryrecoverypositionposition
CirculationCirculationHow do we assess circulation?How do we assess circulation?
CirculationCirculation Pregnant uterus compresses vena cavaPregnant uterus compresses vena cavacausing BP to dropcausing BP to drop ‘‘Hello Mrs Tilt’……..Hello Mrs Tilt’……..
CirculationCirculation Place iv lines, take bloods, start iv fluidsPlace iv lines, take bloods, start iv fluids Why is there a circulation problem?Why is there a circulation problem? Stop bleedingStop bleeding Treat infectionTreat infection
Cardiopulmonary resuscitationCardiopulmonary resuscitation(CPR)(CPR) This is the approach to an apparentlyThis is the approach to an apparentlylifeless patientlifeless patient It is a rapid assessment ofIt is a rapid assessment of AAirway andirway and BBreathing andreathing and CCirculationirculation starting treatment quicklystarting treatment quickly
Ensure you are not putting yourself atEnsure you are not putting yourself atrisk!risk! Is it safe to approach?Is it safe to approach?
Shake and shoutShake and shout Hello how are you?Hello how are you? If no response, callIf no response, callor send for helpor send for help Tilt to left lateralTilt to left lateralposition if greaterposition if greaterthan 20 weeksthan 20 weekspregnantpregnant
Open the AirwayOpen the Airway Turn onto back andTurn onto back andopen airwayopen airway Head tilt or chin lift orHead tilt or chin lift orjaw thrustjaw thrust Assess breathing andAssess breathing andfeel for a pulse for 10feel for a pulse for 10secondsseconds Look, listen, feel Palpate carotid pulsefor 10 seconds
No breathing, No pulseNo breathing, No pulse Start chestStart chestcompressionscompressions
Chest compressionsChest compressions place heel of firstplace heel of firsthand on lower part ofhand on lower part ofsternumsternum place heel of secondplace heel of secondhand on top of firsthand on top of first interlock fingersinterlock fingers
Chest compressionsChest compressions Keep arms straightKeep arms straightand depress sternumand depress sternum4-5 cm at a rate of4-5 cm at a rate of100 compressions per100 compressions perminuteminute Change the personChange the persondelivering thedelivering thecompressions tocompressions toavoid getting tiredavoid getting tired
Give 30 compressions:2 breathsGive 30 compressions:2 breaths Give 2 slow breathsGive 2 slow breathseach lasting about 1each lasting about 1secondsecond Watch for chest riseWatch for chest rise Give oxygen ifGive oxygen ifavailableavailable
If breathingIf breathingTurn into recovery positionTurn into recovery positionCheck pulse, BP and FHCheck pulse, BP and FHRegularly reassessRegularly reassessAssessAssess DD, DISABILITY (level of consciousness), DISABILITY (level of consciousness)AA-Alert,-Alert, VV-respond to voice,-respond to voice, PP-respond to pain,-respond to pain,UU - Unresponsive- Unresponsive
Think of Reversible CausesThink of Reversible Causes• 4 H’s, 4 T’s4 H’s, 4 T’sHypovoleamiaHypovoleamiaHypothermiaHypothermiaHypo/HyperkalaemiaHypo/HyperkalaemiaHypoxiaHypoxiaTension PneumothoraxTension PneumothoraxTamponadeTamponadeThromboembolismThromboembolismToxinsToxins
AAirway beforeirway before BBreathing beforereathing before CCirculationirculationOpenOpen AAirway and maintain, give oxygenirway and maintain, give oxygen Check forCheck for BBreathing, assist if necessaryreathing, assist if necessaryAssessAssess C and don’t forget left lateral tiltC and don’t forget left lateral tiltTreatTreat CC problemproblemRECAP-1RECAP-1
IN PARTNERSHIP WITHLiverpool School of Tropical MedicineLiverpool Associates in Tropical HealthRECAP-2RECAP-2The approach to an apparently lifelesspatientRemember: CALL FOR HELP!ABC approachCPR 30:2Left lateral tiltThink about causes - 4 H’s, 4 T’s4 H’s, 4 T’s
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