Resus - ALS (adult) 2015

Question 1

Step 1

Answer 1

Unresponsive?

Question 2

Step 2 (after unresponsive)

Answer 2

Call for help

Question 3

Step 3 (after help)

Answer 3

CPR 30:2

Question 4

Step 4 (after starting CPR)

Answer 4

Assess rhythm

Question 5

Shockable rhythm

Answer 5

VF / pulseless VT

• Shock
• CPR for 2 min
• Oxygen
• Waveform capnography
• IV access
• Continuous compressions once advanced airway in place
• Adrenaline 1mg (1:10,000) IV every 3-5 min
• Amiodarone 300mg IV after 3 shocks

Question 6

Non-shockable rhythm

Answer 6

PEA / Asystole

• CPR 2 min
• Oxygen
• Waveform capnography
• IV access
• Continuous compressions once advanced airway in place
• Adrenaline 1mg (1:10,000) IV every 3-5 min

Question 7

ROSC (return of spontaneous circulation)

Answer 7

• ABCDE
• Aim SpO2 94-98%
• Aim for normal PaCO2
• 12 lead ECG
• Treat precipitating cause
• Targeted temperature management

Question 8

4Hs and 4Ts

Answer 8

• Hypoxia
• Hypovolaemia
• Hypo/hyperkalaemia / metabolic
• Hypothermia
• Thrombus
• Tension pneumothorax
• Tamponade - cardiac
• Toxins

Question 9

Consider

Answer 9

• Ultrasound
• Mechanical chest compressions
• Coronary angiography / percutanous coronary intervention
• Extracorporeal CPR