This document outlines the basics of advanced life support (ALS) and the steps involved in cardiac resuscitation. It describes the "chain of survival" which includes immediate recognition of cardiac arrest, beginning high-quality CPR, rapid defibrillation if needed, effective ALS, and integrated post-cardiac arrest care. The document then details the new CPR sequence, use of an automated external defibrillator, and interventions for post-resuscitation care including intubation, hemodynamic monitoring, inotrope infusion, and targeted temperature management.

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