This document provides information on cardiopulmonary resuscitation (CPR) including its history, current statistics on cardiac arrest, the goals and steps of CPR, and guidelines from the American Heart Association (AHA). It details the adult BLS sequence of assessing for responsiveness, activating emergency services, providing chest compressions, opening the airway, rescue breathing, and use of an automated external defibrillator. Advanced cardiac life support techniques like defibrillation, intubation, and use of resuscitation drugs are also summarized. New recommendations from the AHA on compression rate, ventilation volume, and capnography monitoring are highlighted.
Advanced cardiac life support or advanced cardiovascular life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.
Advanced Cardiovascular Life Support (ACLS) is the pre-eminent resuscitation course for the recognition and intervention of cardiopulmonary arrest or other cardiovascular emergencies.
Advanced cardiac life support or advanced cardiovascular life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.
Advanced Cardiovascular Life Support (ACLS) is the pre-eminent resuscitation course for the recognition and intervention of cardiopulmonary arrest or other cardiovascular emergencies.
CPR is a life saving emergency measure which includes BLS, ALS, prolonged life support
CPR with both compression & rescue breath is critical for victim in emergency situation
BLS includes recognition of signs of cardiac arrest, heart attack, strock, foreign body air way obstruction(FBAO) with activation of EMS
Performed by a medical professional or an ordinary citizen who trained on it
ALS includes BLS & use of defibrillation, drugs to stabilize the victim & done by specially trained medical person
In critical moments where every second counts, the knowledge and skills to perform Adult Cardio Pulmonary Resuscitation (CPR) can make the difference between life and irreversible damage. This comprehensive presentation, titled "Adult CPR Techniques: A Comprehensive Guide (BLS-ACLS-Post CPR)," available on SlideShare, delves into the intricacies of adult CPR, offering a well-rounded overview of Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), and the crucial post-CPR procedures.
The presentation is meticulously designed to cater to healthcare professionals, first responders, and individuals seeking a comprehensive understanding of adult CPR techniques. Starting with the fundamental principles of BLS, the slides explore step-by-step instructions for delivering effective chest compressions and rescue breaths. The integration of up-to-date guidelines ensures that viewers are equipped with the most accurate and evidence-based practices.
Transitioning into the realm of ACLS, the presentation delves into the advanced interventions necessary for managing cardiac arrest situations. Topics such as defibrillation, drug administration, and airway management are covered in depth, empowering viewers to make informed decisions and take appropriate actions during critical moments.
Furthermore, the post-CPR segment of the presentation highlights the essential steps to follow once successful resuscitation has occurred. From monitoring vital signs to providing appropriate care, this section addresses the critical period following CPR and emphasizes the significance of ongoing support and medical attention.
The presentation employs a blend of engaging visuals, explanatory diagrams, and succinct textual content to facilitate a holistic learning experience. Whether you're a medical professional aiming to refresh your skills, a student delving into life-saving techniques, or an individual concerned with being prepared for emergencies, this slide deck offers an invaluable resource for acquiring and reinforcing essential knowledge.
In summary, "Adult CPR Techniques: A Comprehensive Guide (BLS-ACLS-Post CPR)" is a comprehensive SlideShare presentation that meticulously covers the entire spectrum of adult CPR, ranging from Basic Life Support and Advanced Cardiovascular Life Support techniques to vital post-CPR considerations. By exploring this presentation, you'll be better equipped to respond effectively to cardiac emergencies and contribute to saving lives within your community.
GEMC- Advanced Cardiac Life Support- for ResidentsOpen.Michigan
This is a lecture by Rockefeller Oteng from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
CPR is a life saving emergency measure which includes BLS, ALS, prolonged life support
CPR with both compression & rescue breath is critical for victim in emergency situation
BLS includes recognition of signs of cardiac arrest, heart attack, strock, foreign body air way obstruction(FBAO) with activation of EMS
Performed by a medical professional or an ordinary citizen who trained on it
ALS includes BLS & use of defibrillation, drugs to stabilize the victim & done by specially trained medical person
In critical moments where every second counts, the knowledge and skills to perform Adult Cardio Pulmonary Resuscitation (CPR) can make the difference between life and irreversible damage. This comprehensive presentation, titled "Adult CPR Techniques: A Comprehensive Guide (BLS-ACLS-Post CPR)," available on SlideShare, delves into the intricacies of adult CPR, offering a well-rounded overview of Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), and the crucial post-CPR procedures.
The presentation is meticulously designed to cater to healthcare professionals, first responders, and individuals seeking a comprehensive understanding of adult CPR techniques. Starting with the fundamental principles of BLS, the slides explore step-by-step instructions for delivering effective chest compressions and rescue breaths. The integration of up-to-date guidelines ensures that viewers are equipped with the most accurate and evidence-based practices.
Transitioning into the realm of ACLS, the presentation delves into the advanced interventions necessary for managing cardiac arrest situations. Topics such as defibrillation, drug administration, and airway management are covered in depth, empowering viewers to make informed decisions and take appropriate actions during critical moments.
Furthermore, the post-CPR segment of the presentation highlights the essential steps to follow once successful resuscitation has occurred. From monitoring vital signs to providing appropriate care, this section addresses the critical period following CPR and emphasizes the significance of ongoing support and medical attention.
The presentation employs a blend of engaging visuals, explanatory diagrams, and succinct textual content to facilitate a holistic learning experience. Whether you're a medical professional aiming to refresh your skills, a student delving into life-saving techniques, or an individual concerned with being prepared for emergencies, this slide deck offers an invaluable resource for acquiring and reinforcing essential knowledge.
In summary, "Adult CPR Techniques: A Comprehensive Guide (BLS-ACLS-Post CPR)" is a comprehensive SlideShare presentation that meticulously covers the entire spectrum of adult CPR, ranging from Basic Life Support and Advanced Cardiovascular Life Support techniques to vital post-CPR considerations. By exploring this presentation, you'll be better equipped to respond effectively to cardiac emergencies and contribute to saving lives within your community.
GEMC- Advanced Cardiac Life Support- for ResidentsOpen.Michigan
This is a lecture by Rockefeller Oteng from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Advanced Cardiovascular Life Support (ACLS).pptxRebilHeiru2
discusses the basic and Advanced Life support according to the AHA guidelines.
ACLS, BLS, defibrillation and Advanced medications at Adama Hospital medical college ICU
Advanced cardiac life support, or advanced cardiovascular life support, often referred to by its acronym, "ACLS", refers to a set of clinical algorithms for the urgent treatment of cardiac arrest, stroke, myocardial infarction (also known as a heart attack), and other life-threatening cardiovascular emergencies.
Cardiac arrest, also known as cardiopulmonary arrest or circulatory arrest, is the end of normal circulation of the blood due to failure of the heart to contract effectively.
Also referred as a sudden cardiac arrest (SCA).
Cardiac arrest is a medical emergency that, in certain situations, is potentially reversible if treated early.
Unexpected cardiac arrest sometimes leads to death almost immediately; this is called sudden cardiac death (SCD).
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
2. “The most common reason many
people die is because no one near by
knew CPR, or if they did know it, they
did not actually do it .”
-Michael Sayre
3. Cardio Pulmonary Resuscitation
• 1960 CPR program was started by
American Heart Association (AHA)
• 1966, the first CPR guidelines were
developed by AHA.
4. Current Statistics
• 383,000 cardiac arrest in USA/year
• Major cause is Sudden Cardiac Arrest
(SCA)
VF/Pulseless VT most common initial
rhythms in SCA
Other causes are asphyxia, as in
drowning, choking or drug overdose
5. 1. Immediate recognition & activation
2. Early CPR
3. Rapid defibrillation
4. Effective advanced life support
5. Integrated post cardiac arrest care
BLS ACLS
Chain of Survival - Adults
8. Adult BLS sequence
• BLS algorithm is series of sequential
assessments & actions.
• Before approaching the victim, the
rescuer must ensure that the
scene is safe.
9. TAP ON THE SHOULDER & SHOUT “are you all right”
Assessing responsiveness
10. Unresponsive adult
If a lone rescuer finds an unresponsive adult
activate the EMS system, get an AED
return to the victim to provide CPR &
defibrillation
If 2 or more rescuers are present:
one rescuer should begin the steps of CPR
2nd rescuer activates the EMS system & gets
AED.
11. Unresponsive adult
If a lone healthcare provider sees an
adult suddenlycollapsing(Witness arrest)
should phone, get an AED, & start CPR
(Phone First)
Aids a drowning victim or victim of likely
asphyxial (primary respiratory arrest)give
5 cycles (about 2 mins) of CPR before leaving
the victim to activate the EMS system.
(Phone Fast)
12. Activate EMS
• Call EMS/ERS
• Centralised Accident & Trauma Services (CATS)
New Delhi 1099
• Medical Helpline, State (Andhra Pradesh,
Gujarat, Uttarakhand, Goa, Tamil Nadu,
Rajasthan, Karnataka, Assam, Meghalaya,
Madhya Pradesh and Uttar Pradesh )108
• Give the following information:
– Location of the emergency
– What happened
– Victims’ specification &Aid being given
13. C - Circulation
• Pulse Check
–Health Care Providers:
•check for carotids for 10 sec
•no definite pulse, begin
compressions
14. CHECKING FOR CAROTID PULSE
Gutter between
trachea and
sternocleidoma
stoid muscles
15. Chest Compression/Technique
• To maximize the
effectiveness of
compressions:
–Victim should lie supine on a
hard surface
–Rescuer kneeling beside the
victim’s thorax.
–Rescuer should compress
lower half of the sternum in
the center of the chest,
between Nipples
17. CORRECT POSITION FOR COMPRESSIONS:
ELBOWS STRAIGHT, SHOULDERS ABOVE THE VICTIM’S
CHEST
18. Chest Compression
–“Effective” chest compressions
essential for providing blood flow
during CPR
–“push hard and fast.” Compress @
about 100/min, with a
compression depth of 2 inches (5 cm)
–Allow complete chest recoil after each
compression
– Minimize interruptions in chest
compressions.
19. A - Airway
Tongue is the most common cause of
airway obstruction in unresponsive
patient
Victim should be lying flat (supine)
HEAD TILT - CHIN LIFT maneuver lifts the
tongue and relieves obstruction
JAW THRUST maneuver in cases of
suspected neck injuries
Quickly remove food particles, or loose
21. HEAD TILT - CHIN LIFT lifts the tongue & relieves obstruction
22. B - Breathing
• Provide 2 rescue breaths
• Each over 1 second
• Small TV, sufficient for a visible chest
rise
• Compression ventilation ratio of 30:2
• Prevents stomach distension
25. D - Defibrillation [BLS]
• In VF, early defibrillation is Class-1
intervention..
• Use of low energy biphasic current for
defibrillation improves outcome.
• 90% patients with primary VF revert to
normal rhythm with defibrillation, if done
within 1 minute.
• New Recommendation: D is now BLS.
26. Why early defibrillation is critical?
Survival rates after VF arrest decrease approx.
7% to 10% with every minute that defibrillation
is delayed
29. Automated External Defibrillator
1. Ease of use by untrained
rescuers
2. Automated detection of
defibrillatable rhythms
3. Advises shock & delivers
it
4. Portable
30. Automated External Defibrillator
AED ELECTRODE PLACEMENT
• Anterolateral
• Anteroposterior
• Antero left infrascapular
• Antero right infrascapular
SIZE: 8-12cm
TRANSTHORACIC IMPEDENCE
• 70-80 Ω.
• use conductive material like gel pads or
electrode paste or self adhesive pads
31. Steps of AED
1) Power on the AED
2) Attach Electrode Pads to pt’s bare
chest
3) Analyze rhythm (ALL CLEAR)
4) Deliver Shock if advisable
32. Resume CPR
• After shock is delivered,
resume CPR
• Start chest compression
• Give cycle of 30:2
• Do not perform pulse or rhythm check
• After 2 min of CPR, AED will prompt you
to repeat steps 3 and 4
33. AED in Special Situation
Hairy Chest
• If pad stick to the hair, press down
firmly on each pad
• Quickly pull of the pads
• If too much hair remains then shave
the area with razor
• Put on a new set of pads
34. AED in Special Situation
Implanted Pacemaker
• Hard lump beneath the skin of the
upper chest or abdomen with visible scar
mark.
• Place the AED electrode pads to either side
and not directly on top of the device.
• If implanted D. is delivering shock, wait for
30-60 sec before giving shock with AED
35. AED in Special Situation
Water
• Do not use AED in water (conduct)
• The patient chest is covered with water-
Wipe the chest quickly before attaching
the electrodes
• The patient is lying on snow or ice: you
can use AED
36. AED in Special Situation
Trans-dermal medical patch
• Do not place AED electrode pad directly on top
of trans-dermal patch( nitroglycerine, nicotine,
analgesic, hormone, anti HTN)
• Block energy transfer and cause skin burns
• Remove the patch and wipe the area clean
37. Unresponsive
No breathing or no normal breathing (gasping)
Get defibrillatorActivate emergency
response
Start CPR
Push hard
Push fast
Check rhythm/ shock if indicated
Repeat every 2 min
BASIC LIFE SUPPORT
38. ACLS CARDIAC ARREST ALGORITHM
Adult Cardiac
Arrest
VF/ VT Asystole / PEA
Rhythm shockable
Start CPR
• give O2
• monitor/
defibrillator
Call for help / EMS
noyes
40. Pulseless VT represents organized electric
activity of the ventricular myocardium.
Neither of these rhythms generates significant forward
blood flow
41. PEA absence of mechanical ventricular activity or
mechanical ventricular activity that is insufficient to
generate a clinically detectable pulse.
42. Asystole represents absence of detectable
ventricular electric activity with or without
atrial electric activity
Asystole
Flat line protocol
• Check lead attachment.
• Check lead selection
• Check the gain
• Check power on/off
43. VF/ VT
SHOCK
CPR x 2 min
• IV / IO access
Rhythm shockable ?
CPR x 2 min & epinephrine every 3 – 5 min
Consider advanced airway, capnography
yes
SHOCK
Rhythm shockable ?
yes
SHOCK
CPR x 2 min & amiodarone
treat reversible causes
no
no
• go to Asyst / PEA algorithm
• ROSC +, go to post-cardiac
arrest care
44. Asystole / PEA
CPR x 2 min
• IV / IO access
• epinephrine every 3 – 5 min
• Consider advanced airway, capnography
yes
no
Rhythm shockable ?
CPR x 2 min
• treat reversible causes
Rhythm shockable ?
yes
• go to VF / VT algorithm
• ROSC +, go to post-cardiac
arrest care
no
46. Drugs used in resuscitation
NAME DOSE MECH OF ACTION INDICATION
Adrenaline 1 mg IV/ IO
every 3-5 min
α adr receptor
stimulation
Confirmed adult
cardiac arrest
Vasopressin 40 units IV/ IO Non adrenergic
peripheral
vasoconstrictor
May replace 1st
or 2nd
dose of
adrenaline
Amiodarone Initial 300 mg
IV/ IO f/b 1 dose
of 150 mg IV /
IO
Affects Na, K & Ca
channels and has α &
β adrenergic blocking
properties
VF or pulseless
VT
unresponsive to
shock, CPR or
vasopressor
47. Drugs used in resuscitation
NAME DOSE MECH OF ACTION INDICATION
Lidocaine 1 to 1.5
mg/kg IV IO
every 3-5
min
Na channel blocker If amiodarone
is not available
Magnesium
Sulphate
1-2 gm
diluted in 10
ml 5 %
dextrose IV/
IO
Termination of torsades de pointes
(irregular/polymorphic VT associated
with prolonged QT interval)
49. New Recommendation:
Early institution of EtCO2 monitoring. It correlates well
with CO. EtCo2 > 20 mmHg indicates adequate CO & a
good outcome. Rise of EtCo2 > 40 mmHg is the earliest
sign of ROSC.
New Recommendation:
TV has been reduced to just that which causes the chest
to rise & fall (8-10 ml/kg, O2 – 6-7 ml/kg)
Initial Rescue breaths – 2 over 1 sec each.
Ratio of Compression: Ventilation be 30:2 in adults.
When the airway has been secured, compression rate is
kept 100/min independent of 8-10 ventilation
50. Reversible causes
H s T s
Hypoxia Toxins/tablets
Hypovolemia Tamponade (cardiac)
Hydrogen ion (acidosis) Tension pneumothorax
Hypo/ hyperkalemia Thrombosis,
pulmonary/coronary
Hypothermia/Hypoglycemia Trauma
54. LifeBand / Autopulse
• Conforming, load-distributing band
• Fully releases during relaxation
– Maximizes time for diastolic blood flow
– Allows visual confirmation of inhalation via chest
rise
• Single-use disposable
– Infection control
– Minimal clean-up between patients
55. Patient Specifications
• Chest circumference: 29.9 in / 80.0 cm to
51.2 in / 130.0 cm
• Chest width: 9.8 in / 24.9 cm to 15 in / 38 cm
• Maximum patient weight: 300 lbs / 136 kg
AHA gives LDB-CPR Class II b recommendation.
(Acceptable .Good evidence provides support)
56. • PocketCPR is placed on the chest and chest
compressions are started. The device notifies the
rescuer to “push harder” if the compressions are
less than 1.5 inches. If good compressions are
delivered, PocketCPR will respond “good
compressions”. Four LED lights on the device flash
for a good compression and one LED flashes if the
compression is less than 1.5 inches.
57. Extra-Corporeal Cardiopulmonary
Resuscitation (ECPR)
• Stage 1:
Placement of femoral artery and vein catheters
• Stage 2: Placement of ECLS Cannulas
• Stage 3: Going on Pump
The ECPR algorithm typically involves 2 physicians.
With the first physician supervising ACLS ( the “code
doc”), the second doctor is responsible for
percutaneous femoral venous and arterial access
( the “line doc”). On average, it takes 20 to 30
minutes to complete all 3 stages
58.
59. • ECMO in the Cardiac Arrest setting2011
• Guidelines for ECPR:ELSO ECPR Supplement to the
2013
• CHEER Trial 2014
60.
61.
62.
63. When to STOP CPR
• Spontaneous return of circulation/Scene
unsafe
• Turn to properly trained personnel(ACLS)
• Operator is exhausted
• Patient has signs of irreversile death
AHA is a non government ,non profitable organisation that fosters ppropriate cardiac care to reduce disability n death caused by cardiovascular ds n stroke.with its head quarters in dallas,texas.
Early recognition: of emergency --activation of emergency response system (ERS/EMS)
Early bystander CPR: can double or triple victim’s chance of survival from VF SCA
.
Early delivery of a shock with defibrillator: within 3 to 5 min - produce survival rates as high as 49% - 75%.
Early advanced life support
Post-resuscitation care delivered by healthcare providers.
Bystanders can perform 3 of the 5 links in the Chain
Sternocleidomastoid muscle
Ventilation- 3 means mouth to mouth
Mouth to mask and bag mask