ACLS Teori
ACLS Teori
ACLS Teori
Introduction
Cardiopulmonary arrest results in a rapid decline in oxygen delivery to the brain Permanent disability or death results if the period of cerebral hypoxia lasts longer than 3 minutes
Introduction
Cardiopulmonary resuscitation (CPR) is the term used to describe the maintenance of adequate breathing and circulation in a patient who cannot do so for him- or herself The aim of CPR is to restore respiration and adequate cardiac output as soon as possible to prevent death or permanent disability
Chain of Survival
1. Immediate recognition of cardiac arrest and activation of the emergency response system 2. Early CPR with an emphasis on chest compressions 3. Rapid defibrillation 4. Effective advanced life support 5. Integrated post-cardiac arrest care Basic Life Support
2. Early CPR
Chest compression (forceful rhythmic applications of pressure over the lower half of sternum) Place heel of the hand in lower half of sternum Adult sternum should be depressed at least 2 inches/5cm Allow chest recoil after every compression Minimizing interruptions in compression Avoiding excessive ventilation Give at least 100 compression/minute Deliver each rescue breath over 1 second (mouth to mouth or mouth to mask) Compression : ventilation = 30:2
Survival and neurological outcome can be improved with integrated post cardiac arrest care
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Drugs Therapy
Epinephrine (1:10,000) - (drug class= Vasopressor) 1 mg Rapid IV/IO push 1st for all pulseless arrests Vasopressin (drug class= Vasopressor) 40 Units IV/IO- can replace 1st or 2nd Epi Amiodarone Used with ventricular rhythms (V-Fib / V-Tach) Pulseless= 300 mg IV push or drip over 10 min With pulse= 150 mg in 100 ml D5W drip over 10 min Amiodarone Maintenance Drip= 450mg in 250 glass bottle of D5w Drip infusion @ 1mg/min
Drugs Therapy
Atropine 0.5mg IV/IOfor sinus bradycardia may repeat every 5 minutes for Max of 3 mg Adenosine Used for SVT or stable monomorphic VT 6mg rapidlymay repeat with a 12mg x 2- always follow with NS bolus & give closest to heart Warn patient and family about drug related symptoms: Chest pressure, feeling faint, EKG pause
Drugs Therapy
Dopamine Drip Chronotropic drug- given for Symptomatic Bradycardia refractory to Atropine 2-10 mcg/kg/min Epinephrine Drip 2-10 mcg/min For symptomatic bradycardia refractory to Atropine
Advanced Airway