ALS

1. Demonstration of Advanced Life
Support
Department of Cardiology
Yangon General Hospital

3.  Basic life support
 Can be provided by trained medical personnel,
including emergency medical technicians, paramedics
and by trained bystanders.
 BLS does not include the use of drugs or invasive
skills.
 It includes cardiac arrest, respiratory arrest, drowning
and choking.
 Advanced life support

5. These actions are termed the links in the
"Chain of Survival." For adults they include
 Immediate recognition of cardiac arrest and activation of
the emergency response system
 Immediate High-Quality CPR
 Rapid defibrillation if indicated
 Effective advanced life support
 Integrated post–cardiac arrest care

7. New CPR Sequence

8. Compressions

9. Open the Airway

10.  Rate 100-120/min
 Compression depth at least 2 inches (5 cm) but not greater
than 6cm
 Allow complete chest recoil after each compression
 Minimize interruptions in chest compressions
 Avoid excessive ventilation

13. BLS
By
Health
Care
Providers
Adult Cardiac Arrest

14. BLS
By
Health
Care
Providers
Single
rescuer
Paediatric Cardiac
Arrest

15. BLS
By
Health
Care
Providers
2 or more
rescuers
Paediatric Cardiac
Arrest

21. Use an AED
 If you start CPR and then use
an AED within a few minutes,
you will have the best chance of
saving a life
 AEDs are safe, accurate, and
easy to use

22. DEFIBRILLATION

23. AUTOMATED EXTERNAL
DEFIBRILLATOR (AED)
 Some AEDs will
automatically
switch themselves
on when the lid is
opened

24. ATTACH PADS TO
CASUALTY’S BARE
CHEST

25. ANALYSING RHYTHM
DO NOT TOUCH VICTIM

26. SHOCK
INDICATED
 Stand clear
 Deliver shock

27. SHOCK DELIVERED
FOLLOW AED
INSTRUCTIONS
30 2

28. NO SHOCK ADVISED
FOLLOW AED
INSTRUCTIONS
30 2

29. IF VICTIM STARTS TO
BREATHE NORMALLY
PLACE IN RECOVERY
POSITION

31. CONTINUE RESUSCITATION UNTIL
 Qualified help arrives and takes over
 The victim starts breathing normally
 Rescuer becomes exhausted

32. Ventricular Tachycardia

33. Ventricular Fibrillation

38. Continuous waveform capnography

39. Continuous waveform capnography

40. Intra-arterial blood pressure

41. Post-resuscitation care
 Interventions in the post-resuscitation period influence the final
outcome significantly. Once stabilized, the patient should be
transferred to the most appropriate high-care area (e.g. ICU or
CCU) for continued monitoring and treatment.
 Airway and breathing
 Tracheal intubation
 Sedation
 Controlled ventilation (Adjust ventilation to achieve
normocarbia and adjust inspired Oxygen saturation)
 Gastric tube to decompress the stomach

42. Post-resuscitation care
 Circulation
 Arterial line for continuous BP monitoring
 Infusion of inotrope to maintain normal blood pressure and
urine output
 Serum potassium between 4-4.5 mmol/L
 Revascularization by thrombolytic therapy or PCI
 Disability (optimizing neurological recovery)
 Sedation
 Control of seizure
 Temperature control
 Blood glucose control

55. The End