ALS In Perspective Flashcards
How common is IHD in cause of death in UK?
Second most common behind dementia
What is the most common presenting rhythm in out of hospital cardiac arrest? Percentages of shockable vs non shockable?
Non shockable 75% most common
- 50% asystole
- 25% PEA
Shockable (VT/VF) 25%
Outcomes of out of hospital cardiac arrest - ROSC and discharge from hospital?
ROSC 30%
Discharge from hospital 9.7%
Outcomes of in hospital cardiac arrest to discharge?
23.9%
Presenting rhythm in in-hospital cardiac arrest?
Non shockable 73%
Shockable 17%
Key chain of survival 4 points?
Early recognition and call for help
Early CPR
Early defibrillation
Post resuscitation care
ALS Algorithm - Step 1 - Unresponsive or not breathing normally?
Call for resuscitation team/ambluance
Commence CPR 30:2
Attach defibrillator pads
ALS Algorithm - Step 2
Assess Rhythm
ALS Algorithm - Non Shockable Rhythm Management
PEA/Asystole
Immediately resume CPR for 2 minutes
Give oxygen
Use waveform capnography
If advance airway then continuous compressions
IV/IO Access
Minimise interruptions of CPR
Adrenaline 1mg 1:10000 when IV access achieved and every 3-5 minutes
ALS Algorithm - Shockable Rhythm Management
VF/Pulseless VT
1 shock
Immediately resume CPE for 2 mins
Give oxygen
Use waveform capnography
If advance airway then continuous compressions
IV/IO Access
Minimise interruptions of CPR
Adrenaline 1mg 1:10000 every 3-5 minutes
Give amiodarone after 3 shocks
What are the 4H’s and 4T’s
Hypoxia
Hypovolaemia
Hypothermia
Hypo/Hyperkalaemia/Metabolic
Thrombosis - Coronary /Pulmonary
Tampondade
Tension Pneumothorax
Toxins
ALS Algorithm - ROSC Steps
Use ABCDE Approach
Aim for SpO2 94-98% and normal paCO2
12 Lead ECG
Identify and treat cause
Temperature control
