Fm99topics.files.wordpress.com



ACLS

1. Keep up to date with ACLS recommendations

2. Promptly defibrillate a patient with V. fib or pulseless/symptomatic V. tach.

3. Diagnose serious arrhythmias (e.g. V. tach, V. fib, SVT, A. fib, or 2nd/3rd degree heart block), and treat according to ACLS protocol.

4. Suspect and promptly treat reversible causes of arrhythmias (e.g. hyperkalemia, digoxin toxicity, cocaine intoxication) before confirmation of the diagnosis.

5. Ensure adequate ventilation (i.e. with a bag valve mask) and secure the airway in a timely manner.

6. In patients requiring resuscitation, consider their circumstances (e.g. asystole, long code times, pre-code prognosis, living wills) to help you to decide when to stop (e.g. avoid inappropriate resuscitation)

7. In patients with serious medical problems or end stage disease, discuss code status and end of life decisions (e.g. resuscitation, feeding tubes, level of treatment) and readdress these issues periodically.

8. Attend to family members (e.g. with counseling, attendance in the code room) during and after resuscitating a patient.

9. In a pediatric resuscitation, use appropriate resources (e.g. Braeslow tape, the patient’s weight)to determine the correct drug doses and tube size.

Basic Approach

Pulseless Arrest

1. C-B-A-D-E does patient have a pulse? (dead or alive- less than 10 sec)

2010 guidelines recommend early CPR...therefore a change from ABCs to CBA...

2. Call for help/ code

3. No pulse, start Chest compressions

CPR Quality

• Push hard (≥2 inches [5 cm]) and fast (≥100/min) and allow complete chest recoil

• Minimize interruptions in compressions

• Avoid excessive ventilation

• Rotate compressor every 2 minutes

• If no advanced airway, 30:2 compression-ventilation ratio

• Quantitative waveform capnography

– If Petco2 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download