The document summarizes several key changes and recommendations from the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Specifically:
1) It recommends changing the basic life support sequence from "A-B-C" to "C-A-B" to prioritize chest compressions over rescue breathing.
2) It recommends increasing the depth of chest compressions for adults from 1.5 to 2 inches to at least 2 inches.
3) It emphasizes the importance of using capnography to confirm and continually monitor tracheal tube placement and quality of chest compressions during CPR.
The document summarizes several key changes and recommendations from the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Specifically:
1) It recommends changing the basic life support sequence from "A-B-C" to "C-A-B" to prioritize chest compressions over rescue breathing.
2) It recommends increasing the depth of chest compressions for adults from 1.5 to 2 inches to at least 2 inches.
3) It emphasizes the importance of using capnography to confirm and continually monitor tracheal tube placement and quality of chest compressions during CPR.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPTX, PDF, TXT or read online from Scribd
The document summarizes several key changes and recommendations from the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Specifically:
1) It recommends changing the basic life support sequence from "A-B-C" to "C-A-B" to prioritize chest compressions over rescue breathing.
2) It recommends increasing the depth of chest compressions for adults from 1.5 to 2 inches to at least 2 inches.
3) It emphasizes the importance of using capnography to confirm and continually monitor tracheal tube placement and quality of chest compressions during CPR.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPTX, PDF, TXT or read online from Scribd
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card|ac arrest arrest care and AC1IVA1ICN of the emergency response system 1he 8ulldlng 8locks of C8 |gh||ghts of the 2010 Gu|de||nes W 1he Change Irom "A8C" to "CA8" I IIaIIb III cbooqe lo tbe boslc llfe soppott (8l5) sepoeoce of sLeps from A8C" Lo CA8 for adulLs and pedlaLrlc paLlenLs (chlldren and lnfanLs excludlng newlyborns) 8 I 2010 4n4 6uide/ines for cPk ond cc recommend this change for the fo||ow|ng reasons W vasL ma[orlLy of cardlac arresLs occur ln adulLs W hlghesL survlval raLes from cardlac arresL are reporLed among paLlenLs of all ages wlLh wlLnessed arresL and a rhyLhm of vl or pulseless v1 W ln Lhese paLlenLs Lhe crlLlcal lnlLlal elemenLs of C8 are chesL compresslons and early deflbrlllaLlon 2010 4n4 6uide/ines for cPk ond cc recommend this change for the fo||ow|ng reasons W ln Lhe A8C sequence chesL compresslons are ofLen delayed whlle Lhe responder opens Lhe alrway W 8y changlng Lhe sequence Lo CA8 chesL compresslons wlll be lnlLlaLed sooner W flrsL cycle of chesL compresslons (30 compresslons should be accompllshed ln approxlmaLely 18 seconds) 2010 4n4 6uide/ines for cPk ond cc recommend this change for the fo||ow|ng reasons W lewer Lhan 30 of persons ln cardlac arresL recelve bysLander C8 W Cne lmpedlmenL rescuers flnd mosL dlfflculL openlng Lhe alrway and dellverlng rescue breaLhs W SLarLlng wlLh chesL compresslons mlghL ensure LhaL more vlcLlms recelve C8 W rescuers who are unable or unwllllng Lo provlde venLllaLlons wlll aL leasL perform chesL compresslons ey chonqes in the 2010 4n4 6uide/ines for cPk and LCC W Look LlsLen and leel" has been removed from Lhe algorlLhm W 5ttess lmmedlaLe acLlvaLlon of Lhe emergency response sysLem W SLarL chesL compresslons for any unresponslve adulL vlcLlm wlLh no breaLhlng or no normal breaLhlng (le only gasps) ey chonqes in the 2010 4n4 6uide/ines for cPk and LCC l llallblll 1he recommended depLh of compresslon for adulL vlcLlms has lncreased from a depLh of 1 12 Lo 2 lnches Lo a depLh of aL leasL 2 lnches 8 ey chonqes in the 2010 4n4 6uide/ines for cPk and LCC W lnlLlaLe chesL compresslons before glvlng rescue breaLhs 8escue breaLhlng all Lake Llme l lla llb lll 8eglnnlng C8 wlLh 30 compresslons raLher Lhan 2 venLllaLlons leads Lo a shorLer delay Lo flrsL compresslon 8 ,ost |mportant Deve|opments kecommendat|ons |n ALS s|nce the 200S ILCCk rev|ew 1he recognlLlon LhaL adulLs who progress Lo braln deaLh afLer resusclLaLlon from ouLofhosplLal cardlac arresL (CPCA) should be consldered for organ donat|on 1he recommendaLlon LhaL lmplemenLaLlon of a comprehenslve sLrucLured treatment protoco| may lmprove survlval afLer cardlac arresL AbouL use of capnography Ann Lmerg Med 2003 May43(3)497303 1he effect|veness of outofhosp|ta| use of cont|nuous endt|da| carbon d|ox|de mon|tor|ng on the rate of unrecogn|zed m|sp|aced |ntubat|on w|th|n a reg|ona| emergency med|ca| serv|ces system SllvesLrl S 8alls CA krauss 8 1hundlyll ! 8oLhrock SC Senn A CarLer L lalk ! ueparLmenL of Lmergency Medlclne Crlando 8eglonal Medlcal CenLer Crlando lL uSA emsmedlcaldlrecLor[ocflneL Abstract S1uu? C8!LC1lvL We evaluaLe Lhe assoclaLlon beLween ouLofhosplLal use of conLlnuous endLldal carbon dloxlde (L1CC2) monlLorlng and unrecognlzed mlsplaced lnLubaLlons wlLhln a reglonal emergency medlcal servlces (LMS) sysLem ML1PCuS 1hls was a prospecLlve observaLlonal sLudy conducLed durlng a 10monLh perlod on all paLlenLs arrlvlng aL a reglonal Level l Lrauma cenLer emergency deparLmenL who underwenL ouLofhosplLal endoLracheal lnLubaLlon 1he reglonal LMS sysLem LhaL serves Lhe Lrauma servlce area ls composed of mulLlple counLywlde sysLems conLalnlng numerous LMS agencles Some of Lhe LMS agencles had lndependenLly lmplemenLed conLlnuous L1CC2 monlLorlng before Lhe sLarL of Lhe sLudy 1he maln ouLcome measure was Lhe unrecognlzed mlsplaced lnLubaLlon raLe wlLh and wlLhouL use of conLlnuous L1CC2 monlLorlng 8LSuL1S 1wo hundred forLyelghL paLlenLs recelved ouLofhosplLal alrway managemenL of whom 133 recelved lnLubaLlon Cf Lhe 133 paLlenLs 93 (61) had conLlnuous L1CC2 monlLorlng and 60 (39) dld noL lorLynlne (32) were medlcal paLlenLs 104 (68) were Lrauma paLlenLs and 31 (33) were ln cardlac arresL 1he overall lncldence of unrecognlzed mlsplaced lnLubaLlons was 9 1he raLe of unrecognlzed mlsplaced lnLubaLlons ln Lhe group for whom conLlnuous L1CC2 monlLorlng was used was zero and Lhe raLe ln Lhe group for whom conLlnuous L1CC2 monlLorlng was noL used was 233 (93 confldence lnLerval 134 Lo 360) CCnCLuSlCn no unrecognlzed mlsplaced lnLubaLlons were found ln paLlenLs for whom paramedlcs used conLlnuous L1CC2 monlLorlng lallure Lo use conLlnuous L1CC2 monlLorlng was assoclaLed wlLh a 23 unrecognlzed mlsplaced lnLubaLlon raLe AbouL use of capnography AnaesLh lnLenslve Care 1993 CcL21(3)61720 1he Austra||an Inc|dent ,on|tor|ng Study rob|ems w|th vent||at|on an ana|ys|s of 2000 |nc|dent reports 8ussell W! Webb 8k van der WalL !P 8unclman W8 ueparLmenL of AnaesLhesla lnLenslve Care unlverslLy of Adelalde SA Abstract A revlew of Lhe flrsL 2000 lncldenLs reporLed Lo Lhe AusLrallan lncldenL MonlLorlng SLudy found 317 lncldenLs whlch lnvolved problems wlLh venLllaLlon 1he ma[or porLlon (47) were dlsconnecLlons 61 of Lhese were deLecLed by a monlLor MonlLor deLecLlon was by a low clrculL pressure alarm ln 37 buL Lhls alarm falled Lo warn of nonvenLllaLlon ln 12 lncldenLs (ln 6 because lL was noL swlLched on and ln 6 because of a fallure Lo deLecL Lhe dlsconnecLlon) lallure of deLecLlon was usually wlLh venLllaLor bellows descendlng ln explraLlon CompleLe fallure Lo venLllaLe occurred ln 143 lncldenLs mosL commonly because of a dlsconnecLlon ulsconnecLlon was assoclaLed ln oneLhlrd of Lhe cases wlLh lnLerference Lo Lhe anaesLheLlc clrculL by a Lhlrd parLy and ln nearly half wlLh surgery on Lhe head and neck Leaks affecLed venLllaLlon ln 129 lncldenLs buL ln only 19 was venLllaLlon LoLally losL leaks assoclaLed wlLh seal fallure of Lhe absorber were common MlsconnecLlons occurred ln 36 lncldenLs mosL commonly lnvolvlng Lhe scavenglng sysLem 1he frequency of a compleLe fallure Lo check an anaesLheLlc machlne was greaLer when an lnducLlon room was lnvolved Lhan when only Lhe operaLlng LheaLre was Lhe slLe of Lhe lncldenL 1hese lncldenLs suggesL LhaL meLlculous checklng and monlLorlng for fallure of venLllaLlon preferably uslng aL leasL Lwo separaLe selfacLlvaLlng sysLems ls hlghly deslrable 1he AusLrallan and new Zealand College of AnaesLheLlsLs pollcy on low clrculL pressure alarms oxlmeLry and capnography ls vlndlcaLed by Lhese reporLs Advanced Card|ovascu|ar L|fe Support atrop|ne ls no longer recommended for rouLlne use ln Lhe managemenLof LA/asysLole MonlLor C8 quallLy uslng mechanlcal parameLers or L1CC2 arLerlal pressure durlng Lhe relaxaLlon phase of chesL compresslons or cenLral venous oxygen saLuraLlon ScvC2 8 I IIa IIb III C I IIa IIb III Advanced Card|ovascu|ar L|fe Support I IIa IIb III adenos|ne can now be consldered for Lhe dlagnosls and LreaLmenL of sLable und|fferent|ated w|decomp|ex tachycard|a when Lhe rhyLhm ls regular and Lhe C8S waveform ls monomorphlc I IIa IIb III lor sympLomaLlc or unsLable bradycardla lv lnfuslon of chronotrop|c agents ls now recommended as an equally effect|ve a|ternat|ve to externa| pac|ng when atrop|ne |s |neffect|ve 8 8 Advanced Card|ovascu|ar L|fe Support l lla llb lll When quanLlLaLlve waveform capnography ls used for adulLs monlLor C8 quallLy and deLecLlng 8CSC based on L1CC2 values W Culdellnes for posL cardlac arresL managemenL have been slgnlflcanLly expanded and now lnclude a new Larly osLCardlac ArresL 1reaLmenL AlgorlLhm A I ,ost |mportant Deve|opments kecommendat|ons |n ALS s|nce the 200S ILCCk rev|ew 1he use of capnography Lo conflrm and conLlnually monlLor Lracheal Lube placemenL and quallLy of C8 8|ood g|ucose values 180 mg/dL (10 mmol/L) should be LreaLed and hypoglycemla avolded ,ost |mportant Deve|opments kecommendat|ons |n ALS s|nce the 200S ILCCk rev|ew therapeut|c hypotherm|a for comaLose survlvors of cardlac arresL lnlLlally assoclaLed wlLh nonshockable rhyLhms 8ecognlLlon LhaL many accepLed predlcLors of poor ouLcome ln comaLose survlvors of cardlac arresL are unrellable especlally lf Lhe paLlenL has been LreaLed wlLh LherapeuLlc hypoLhermla 1here ls lnadequaLe evldence Lo recommend a speclflc approach Lo predlcLlng poor ouLcome ln posLcardlac arresL paLlenLs LreaLed wlLh LherapeuLlc hypoLhermla 1hank you