Research

• In Europe, more than 350,000 patients are get

cardiac arrest every year outside the hospital. And
100.000 patient could be saved if lay resuscitation
giving chest compression immediately.
 Adult Basic Life Support Adult Advance Life Guidelines For Post Intial Management Of
And Automated Support. Resuscitation care. Acute Coronary
External Defibrillation. Syndrome
Learning
Objectives

Pediatric Life Support. Resuscitation And First Aid. The Ethics Of

Support Of Transition Resuscitation And End-
Of Babies At Birth. of-Life Descisions.
 Approach Safely
Check Response
Shout For Help
Open Airway
Components Call 112
Of Adult Basic 30 chest compression
Life Support 2 Rescue Breaths
Attach AED
Follow voice Prompts
 Prevention of
Science of Prehospital
cardiac arrest
resuscitation. resuscitation.
Adult in hospital.
Advance Life
Support Interavanous Shockable and
In hospital
access and non-shockable
resuscitation.
drugs. rhytms.
 Common Reversible Causes

Four Hs Four Ts
• Hypovolemia • Thrombosis Coronary
• Hypoxia • Thrombosis Pulmonary
• Hypo-/hyperkalemia • Tension Pneumothorax
• Hypothermia • Tamponade cardiac
 Maintain SpO2 94-98%
Airway and breathing Insert advanced airway

12-lead ECG
Blood sample
Circulation Aim for SBP >100mmHg
Post Restore Fluid

Resuscitation
Care
Diagnosis 12-lead ECG ST elevation?

Control Temprature Constant temprature 32*C –36*C

Continuity Treatment
12 Lead ECG ST Consider Coronary
Yes/No PCI If Needed
Elevation? Angiography

Optimise
Temprature Cantroll
Haemodynamics (Cardic Admit to Intesive Care Causes Of Cardiac Arrest
32*C-36*C For First 24
output, BP, intravascular Unit Identified?
Hour
volume, urine output)

Secondary Prevention
Delay Prognostication e.g. screen for inherited Follow-up And
For At Least 72 Hour disorder and risk factor Rehablitaion
management
 The term acute coronary syndrome (ACS)
encompasses three different entities of the acute
manifestation of coronary heart disease. ST
elevation myocardial infarction (STEMI), non-ST
Acute elevation myocardial infarction and unstable
angina pectoris (UAP). Non-ST elevation
Coronary myocardial infarction and UAP are usually
Syndrome combined in the term non-STEMI-ACS.
 The incidence of acute ST-elevation
myocardial infarction (AMI) is decreasing
Background in many European countries however,
the incidence of non-STEMI acute
coronary syndrome (non-STEMI ACS) is
increasing.
 ECG, Pain Relief: Antiplatlet
Treatment 150-300 mg Chewed
Tablet or IV, NTG If BP
>90mmHg/ Morphine (Repeated
doses) After 3-5 mg until pain free

STEMI Non-STEMI ACS

PCI preffred if: timely available in Fibrinolysis preferred if: Conservative or Delayed invasive
Adjunctive treatment: Give Antiplatelets: Ticagrelor or Early Ivasive Strategy: Adjunctive
24/7 high volume Centre Inappropriate delay to PCI and no strategy: Adjuctive treatment and
enoxaparine, heparin, bivalirudin clopidogrel treatment and Antiplatelets
Contraindication for fibrinolysis contraindications Antiplatelets
 Approach Safely
Unresponsive
Shout For Help
Open Airway
Pediatric Life Not Breathing Normally?

Support 5 Rescue Breaths

No Sign Of Life?
15 Chest Compressions
2 Rescue Breaths
Call EMS Team After 1 min of CPR
Resuscitation And Support Of Transition Of
Babies At Birth
 If Gasping Or Not Breathing,
Dry The Baby, Maintain Assess The Breathing And
Antenatal Counselling Open The Airway And Give 5
Normal Temperature Heart Rate
Rescue Breath

If Not Moving, Recheck For

Reassess The Baby, If No Head Position, Consider 2
If No Increase In Heart Rate,
Increases In Heart Rate Look Person Airway Control With Look For Response
Look For Chest movement
For Chest Movment Other Airway Maneuvers
Repeat 5 Inflation Breaths.

Reassess Heart Rate Every

If The Chest Is Moving But
30 Seconds If Heart Rate Is
Heart Rate Is Not Detectable Discusse With Parent And
Not Detectable Or Very Slow
Or Very Slow (<60 Min) Start Debrief Team
(<60 Min) Consider Venous
Chest Compression 3:1
Access And Drugs
 First Aid

First Aid is defined as the helping Recognise, assess and prioritise the Provide care using appropriate Recognise limitations and seek
behaviours and initial care provided need for first aid. competencies. additional care when needed.
for an acute illness or injury. First
Aid can be initiated by anyone in
any situation. A First Aid Provider is
defined as someone trained in First
Aid who should:
 Medical Emergencies
• Oxygen administration for first aid • Hypoglycaemia treatment
• Stroke recognition • Exertion-related dehydration and
• Aspirin administration for chest pain rehydration therapy
• Second dose of adrenaline • Eye injury from chemical exposure
for anaphylaxis • Optimal position for a shock victim
 Trauma Emergencies
• Haemostatic dressings • Spinal motion restriction
• Use of a tourniquet • Cooling of burns
• Straightening an angulated fracture • Burn dressings
• Treatment for an open chest wound • Dental avulsion
Aspects Of Ethics For Resuscitation And End-
Of-Life Decisions

The principle of The principle of The principle of non-

patient autonomy. beneficence. maleficence.

The principle of
justice and equitable Medical futility. Advance directives
access.
 REFRENCES...
• https://cprguidelines.eu/sites/573c777f5e61585a053d7ba5/content_entry573c7
7e35e61585a053d7baf/573c781e5e61585a053d7bd1/files/S0300-
9572_15_00327-5_main.pdf?
• https://cprguidelines.eu/sites/573c777f5e61585a053d7ba5/content_entry573c7
7e35e61585a053d7baf/573c78145e61585a083d7bcf/files/S0300-
9572_15_00328-7_main.pdf?
• https://cprguidelines.eu/sites/573c777f5e61585a053d7ba5/content_entry573c7
7e35e61585a053d7baf/573c780e5e61585a083d7bcc/files/S0300-
9572_15_00330-5_main.pdf?
• https://cprguidelines.eu/sites/573c777f5e61585a053d7ba5/content_entry573c7
7e35e61585a053d7baf/573c78075e61585a083d7bc6/files/S0300-
9572_15_00342-1_main.pdf?
• https://cprguidelines.eu/sites/573c777f5e61585a053d7ba5/content_entry573c7
7e35e61585a053d7baf/573c78055e61585a053d7bc8/files/S0300
Thank You