7. High Quality CPR:
It improves a victim chances of survival.
Characteristics:
1. Start compression within 10 seconds.
2. Push hard & push fast: Compress at a rate of 100 to 120/min
with a depth of –
• At least 5 cm adults
• At least one third the depth of the chest approx. 5 cm, for children
• At least one third the depth of the chest approx. 4 cm, for infants.
3. Allow complete chest recoil.
4. Minimize interruptions.
5. Give effective breaths.
6. Avoid excessive ventilation.
19. Primary Assessment:
The ABCDE’s of the Primary Assessment are:
(A) Airway: Maintain airway and use advanced airway if needed.
Ensure confirmation of placement of an advanced airway and secure
the advanced airway device.
(B) Breathing: Give bag-mask ventilation, provide supplemental
oxygen, and avoid excessive ventilation. Also, adequacy of
ventilation and oxygenation should be monitored during this step.
(C) Circulation: Obtain IV access, attach ECG leads, identify and
monitor arrhythmias, giving fluids if needed, and use defibrillation if
appropriate.
20. (D) Disability:
Perform a general neurological assessment which should
include assessment of responsiveness, level of consciousness,
and pupil reflex. AVPU acronym may help. (Alert, Voice,
Painful, Unresponsive)
(E)Exposure:
Ensure that clothing is removed so that a complete visual
assessment can be performed. This visual assessment should
include looking for signs of trauma, bleeding, burns, or
medical alert bracelets.
21. Secondary Assessment:
• The secondary assessment includes a search for underlying
causes for the emergency and if possible a focused medical
history.
• Performing the focused medical history can be simplified
using the SAMPLE.
(S)Signs and symptoms; (breathing difficulty, Tachypnoea,
tachycardia, fever, headache, abdominal pain, bleeding)
(A)Allergies; (medication, food, associated reaction)
22. (M)Medications; ( last dose, patients medication details)
(P)Past medical history; (current & previous illness,
family health history, past surgery)
(L)Last Oral Intake; ( time & nature of last intake of
liquid or food)
(E)Events: Leading Up To Present Illness or injury,
hazards at scene, time of onset
23. This search for underlying causes, also known as
differential diagnosis, requires a review of all of the H’s
and T’s of ACLS.
5 H’s :
• Hypovolemia
• Hypoxia
• Hydrogen ion (acidosis)
• Hypo-Hyper kalemia
• Hypothermia
5 T’s:
• Tension Pneumothorax
• Cardiac Temponade
• Toxins
• Pulmonary Thrombosis
• Coronary Thrombosis
29. Types of stroke:
•Ischemic stroke:
87% of all strokes is usually caused by an occlusion of
an artery to a region of the brain.
•Haemorrhagic stroke:
13% of all strokes occurs when a blood vessel in the
brain suddenly rupture into the surrounding tissue.
Fibrinolytic therapy is contraindicated. Avoid
anticoagulant.
30.
31.
32.
33. STROKE:
8 D’s of Stroke care:
Detection: rapid recognition of stroke signs & symptoms
Dispatch: early activation & dispatch of EMS by phone.
Delivery: rapid EMS stroke identification, management, triage,
transport, & prehospital notification.
Door: emergency ED & immediate assessment by the stroke team.
Data: rapid clinical evaluation.
Decision: establishing stroke diagnosis & therapy selection.
Drug/Device: administration of fibrinolytic.
Disposition: rapid admission to the stroke unit.
39. Effective High-Performance Team Dynamics
Understanding Team Roles
• Whether you are a team member or a team leader
during a resuscitation attempt, you
should understand not only your role but also the
roles of other members.
• How to communicate and work as a member or as a
leader of a high-performance team
40. Role of the
Team Leader
The role of the team leader is -
•Organizes the group
•Monitors individual performance of
team members
•Backs up team members
•Trains and coaches
•Facilitates understanding
•Focuses on comprehensive patient
care.
41. Role of the
Team Member
Team members must be proficient in
performing the skills. It is essential to the
success of the resuscitation attempt that
members of a high-performance team are
•Clear about role assignments
•Prepared to fulfill their role responsibilities
•Well practiced in resuscitation skills
•Knowledgeable about the algorithms
•Committed to success
42. Clear Roles and Responsibilities:
Every member of the team should know his or her role and
responsibilities.
43. When roles are unclear, team performance suffers.
Signs of unclear roles include -
• Performing the same task more than once.
• Missing essential tasks.
• Team members having multiple roles even if there are
enough providers.
• To avoid inefficiencies, the team leader must clearly delegate
tasks.
• Team members should communicate when and if they can
handle additional responsibilities.
• The team leader should encourage team members to
participate in leadership and not simply follow directions
blindly.
44. Knowing Your Limitations:
• Not only should everyone on the team know his or her own
limitations and capabilities, but the team leader should also
be aware of them. This allows the team leader to evaluate
team resources and call for backup of team members when
assistance is needed.
• During the stress of an attempted resuscitation, do not
practice or explore a new skill. If you need extra help,
request it early. It is not a sign of weakness or incompetence
to ask for help.
45. Constructive Interventions:
• During a resuscitation attempt, the leader or a member of a high-
performance team may need to intervene if an action that is
about to occur may be inappropriate at the time.
• Although constructive intervention is necessary, it should
be tactful. Team leaders should avoid confrontation with
team members. Instead, conduct a debriefing afterward if
constructive criticism is needed.
46. What to
Communicate
Knowledge Sharing
Sharing information is a critical component
of effective team performance.
When resuscitative efforts are ineffective,
talk as a team, like, “Well, we’ve observed
the following on the Primary Assessment
Have we missed something?”
Members of a high-performance team
should inform the team leader of any
changes in the patient’s condition to ensure
that decisions are made with all available
information.
47. How to
Communicate
Closed-Loop Communicate
The team leader should use closed-loop
communication:
1.The team leader gives a message, order, or
assignment to a team member.
2.By receiving a clear response and eye
contact, the team leader confirms that the team
member heard and understood the message.
3. The team leader listens for confirmation of
task performance from the team member before
assigning another task.
48. Clear Messages:
•Clear messages consist of concise communication
spoken with a controlled tone of voice.
•All healthcare providers should deliver messages
with a calm and direct manner without yelling or
shouting.
•Unclear communication can lead to unnecessary
delays in treatment or to medication errors.
• Only one person should talk at any time.
49. Mutual Respect:
• The best high-performance teams should share a mutual
respect for each other and work together in a team.
• To have a high-performance team, everyone must abandon
ego and respect each other during the resuscitation attempt,
regardless of any additional training or experience that the
team leader or specific team members may have.
https://www.youtube.com/watch?v=aMBugLXCPWY
