This document outlines emergency management protocols for various medical situations, including CPR techniques, trauma care for hemorrhage and burns, and management of sepsis. Key topics include high-quality CPR practices, assessment of circulation issues, types and degrees of burns, and the importance of early detection and intervention. It emphasizes the need for precise evaluation and timely transfer to hospitals to optimize patient outcomes.

1. BY
DR. AHMED ABDELTAWAB AZAB
Emergency Consultant
American Heart Association Instructor
Emergency lecturer

3. Cardiovascular system

4. Cardiovascular system
• Heart.
• Blood vessels.
• Bleeding – shock.
• Assessment by:
– Pulse.
– Blood pressure.
– Capillary refill time
– Urinary catheterization.

5. Arrested patient.
• CPR:
– Safety.
– Check Response.
– Pulse detection.
– Code blue – false code blue.
– High quality CPR.

6. Arrested patient.
• High quality CPR:
– Hand position – finger position.
– Depth – 1/3 antero posterior diameter.
– Rate: 100 – 120 / minute.
– Alone: adult – child – infant.
– Two rescue: adult – child – infant.
– After advanced airway: compression – breathing.
– Adequate chest recoil.
– Minimize interruption: 10 second max.
– Shockable VS non – shockable rhythms.

7. Heart Trauma
Cardiac tamponade.
Most critical – reversible cause during CPR

9. Chest pain.
• Acute coronary syndrome:
– Stable angina.
– Unstable angina.
– MI – myocardial infarction.
• Early management:
– Rest – comfortable.
– M – O – N – A.
• Early transfer.

10. Circulation problems:
• Trauma – hemorrhage.
• Burn.
• Sepsis.

11. Trauma – hemorrhage.
• Minimal trauma
– Compression over bleeding site.
• Moderate trauma:
– Stitching.
– Limb tourniquet:
• Upper limb: 1 – 1.5 hours
• Lower limb: 1.5 – 2 hours.

12. Trauma – hemorrhage.
• Massive hemorrhage:
– Internal – external.
– Shock.
– Need rapid surgical intervention

14. Burn.
• Types of burn:
– Dry - flammable
– Wet.
– Electrical.
– Chemical.
– Others: radiation – frostbite.
• Degrees of burn:
– 1st. – superficial.
– 2nd. – deep with papules and pustules
– 3rd. – all skin layers – nerve ending - painless
– 4th. – bone – muscles deep tissues.

15. Burn
• Pre hospital management:
– Safety.
– Stop burning process.
– Assessment.
– Cooling – 10 – 60 minutes + analgesics
– Dressing.
– Transportation.
• Inform receiving hospital – give O2 elevate the head –
elevate the limb – vascular access (once) – ORS.

16. Burn
• Hospital care:
– Admit the patient
– Airway control – early intubation
– Breathing and ventilation – CO poisoning
– Circulation – IV line – CRT – ur. catherization
– Disability – neurological - metabolic
– Exposure with environment control
– Fluid resuscitation – role of 9
– Assess the %, age, degree and type of burn
– Keep the patient in clean environment
– Sedation and proper analgesia.
– Escharotomy.

18. Bone fractures
• Closed fractures:
– pain
– Nerve injury.
– Vascular injury.
– Compartmental syndrome.
• Open fractures:
– The same complications like closed but more
sever.

19. Bone fractures
• Assessment:
– Airway – C- spine.
– Breathing.
– Circulation – shock.
• Limb examination.
• Peripheral pulse.
• Peripheral CRT.
– Disability.
– Exposure – missed fractures.

23. Bone fractures
• Reduction.
• Fixation.

27. Sepsis

28. Sepsis

29. Sepsis
• Management at home:
– Early detection.
– Safety – for me and pt.
– ABC maintenance.
– Early transfer to hospital.

30. Sepsis
• Hospital management:
– 1st 3 hours
• ABC.
• Blood culture and sensetivity.
• Lactate level.
• Broad spectrum antibiotics.
• Fluid resuscitation.
– 2nd 3 hours
• Reassess lactate level – ICU admission – inotropes

31. Capillary refill
time

32. CALL FOR HELP