European Resuscitation Council ADULT ADVANCED LIFE SUPPORT ALS

European Resuscitation Council ADULT ADVANCED LIFE SUPPORT (ALS)

European Resuscitation Council GUIDELINES FOR PREVENTION OF IN-HOSPITAL CARDIAC ARREST RECOGNISING THE CRITICALLY ILL PATIENTS RESPONSE TO CRITICAL ILLNESS Medical emergency team (MET) APPROPRIATE PLACEMENT OF PATIENTS RESUSCITATION DECISIONS Many European countries have no formal policy for recording DNAR decisions Consider ‘do not attempt resuscitation’ (DNAR) when the patient: • does not wish to have CPR • will not survive cardiac arrest even if CPR is attempted

European Resuscitation Council IN-HOSPITAL RESUSCITATION

European Resuscitation Council ALS TREATMENT ALGORITHM

European Resuscitation Council AIRWAY MANAGEMENT AND VENTILATION

European Resuscitation Council BASIC AIRWAY MANAGEMENT Head tilt and chin lift Jaw thrust

ADJUNCTS TO BASIC AIRWAY TECHNIQUES European Resuscitation Council Oropharyngeal airways Bag-mask ventilation

OTHER AIRWAY DEVICES European Resuscitation Council Laryngeal Tube Tracheal Tube

DRUGS AND FLUIDS European Resuscitation Council - DRUGS Vasopressors Adrenaline Anti-arrhythmics Amiodarone Other drugs Atropine Theophylline - INTRAVENOUS FLUIDS Hartmann’s solution, Ringer’s solution Intravenous fluid to flush peripherally injected drugs into the central circulation

ELECTRICAL THERAPIES European Resuscitation Council DEFIBRILLATION Passage across the myocardium of an electrical current of sufficient magnitude to depolarise a critical mass of myocardium and restoration of coordinated electrical activity USE OF DEFIBRILLATORS: - Adults - Children older than 8 years - NO defibrillation in children less than 1 year

ELECTRICAL THERAPIES European Resuscitation Council AUTOMATED EXTERNAL DEFIBRILLATOR (AED) CARDIOVERSION is used to convert atrial or ventricular tachyarrhythmias PACING Consider pacing in patients with symptomatic bradycardia

European Resuscitation Council PAEDIATRIC BASIC LIFE SUPPORT (PBLS)

European Resuscitation Council PEADIATRIC BASIC LIFE SUPPORT(PBLS) MANY CHILDREN RECEIVE NO RESUSCITATION AT ALL BECAUSE THE RESCUERS FEAR DOING HARM. APPLYING OF THE SAME GUIDANCE FOR ALL ADULTS AND CHILDREN ARE FEASIBLE ! ! ! ENHANCED TRAINING FOR HEALTHCARE PROFESSIONALS.

European Resuscitation Council PBLS

European Resuscitation Council RESCUE BREATHS

European Resuscitation Council carotid pulse / CHILD brachial pulse / INFANT

PBLS European Resuscitation Council AGE Infant < 1 year of age Child 1 year to puberty C : V RATIO /RATE 15: 2 / 100 min 30: 2 / 100 min lone rescuer POSITION RESCUE BREATHS AED Tips of 2 fingers on the lower third of the sternum Mouth-to NO mouth and nose ventilation The heel of one hand over the lower third of the sternum, lift the fingers Mouth-to mouth ventilation YES paediatric pads /programmes

European Resuscitation Council CHEST COMPRESSION RESCUE BREATHS

FOREIGN BODY AIRWAY OBSTRUCTION (FBAO) European Resuscitation Council Back blows, chest thrusts and abdominal thrusts all increase intrathoracic pressure and can expel foreign bodies from the airway

European Resuscitation Council PAEDIATRIC ADVANCED LIFE SUPPORT (PALS)

European Resuscitation Council PALS

European Resuscitation Council REPETITION 1. Name 3 causes of airway obstruction. 2. Name 2 types of airway in-hospital devices. 3. Name 2 drugs commonly used in ALS. 4. What is the age limit 4 defibrillator usage? 5. What electrical therapies can be performed in the hospital? 6. What is the C: V ratio in an infant life support? 7. What is the major cause of cardio-pulmonary arrest in: - children? - adult?