ACLS 2015* - ?· แนวทางการปฏิบัติการกู้ชีวิต 2015…

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  • ACLS 2015*K.Lohaborisuth

  • 2015

    International Liaison Committee On Resuscitation (ILCOR)

    American Heart association (AHA)

    European Resuscitation Council (ERC)

  • Adult Basic Life Support

    2-4 ACLS 2015 3

    - Bystander CPR- Tel. Assisted CPR- Public or onsite AED

  • Chain of Survival

    1.Early recognition and call for help -To prevent cardiac arrest

    2.Early CPR-To buy time

    3.Early defibrillation-To restart the heart

    4.Post Resuscitation care-To restore quality of life

  • Early recognition and call for help

    (unresponsiveness) (Not breathing normally or Gasping)

    Call for help

  • Early Bystander CPR

    - Chest compression only CPR

    - 30:2

  • Chest compression*

    5 . 2 6 . 2.4 100-120

    2

    (head tilt and chin lift) 1

    30:2

  • Early defibrillation

    shock

  • Advanced Cardiac Life Support

    Algorithm Start CPR ( BLS) Attach monitor or defibrillator rhythm

    shockable 2-3 cardiac arrest

    advance airway chest compression defibrillation

  • VF or pulseless VT

    Defibrillation 120-200 J 1 CPR IV/IO access blood chemistry,

    glucose 2 EKG + check pulse VF or pulseless VT Defibrillation 2

    adrenaline 1 mg diluted to 10 mL IV q 3-5 min advanced airway 1 6 2 VF or pulseless VT Defibrillation

    3 Amiodarone 300 mg IV 150 mg IV

  • Asystole or PEA

    IV/IO access adrenaline 1 mg IV q 3-5 min advanced airway CPR 2 reversible cause 4H 4T

  • Reversible causes

    4H Hypoxia: advance airway Hypovolemia: blood/fluid

    loss, PR LGIH, NG UGIH, FAST peritoneal fluid

    Hypo/Hyperkalemia/Metabolic: dialysis Ca, NaHCO3, RI, glucose

    Hypothermia: warm blanket warm IV

    4T Toxins: TCA NaHCO3 Tamponade

    cardiac: bedside US, pericardiocenthesis

    Tension pneumothorax: breath sound ETT ; needle decompression

    Thrombosis coronary/pulmonary:

  • ROSC*Return of spontaneous circulation and comatose

  • Tachycardia-Bradycardia

    algorithm

  • EKG

  • Non shockable rhythms

    Asystole

    Pulseless Electrical activity :PEA

  • Shockable rhythms

    VF

    VT

  • Tachycardia

    SVT

    -Stable: adenosine-Unstable: Synchronized cardioversion 50-100J

  • Tachycardia

    AF

    Atrial flutter

  • Bradycardia

    First degree AV block: the PR interval is >0.20

  • Bradycardia

    2nd Degree AV block

    Wenckebach (Mobitz I)

    Mobitz II

  • Bradycardia

    3rd degree AV block

  • EKG-STEMI

  • Localization of Infarction

    Inf. wall

    Lat.wall

    Lat.wall

    Lat.wall

    Septal.wall

    Ant.wall

    Ant.wall

  • STEMI

  • 1

  • 2

  • 3

  • LBBB

    A new LBBB in a patient with symptoms consistent with MI should be treated like a STEMI

  • ACLS 2015** CMU

    https://www.youtube.com/watch?v=gb-boQWhmhU

  • References

    -American Heart association (AHA)-European Resuscitation Council (ERC)

  • EN:D