Beruflich Dokumente
Kultur Dokumente
Life Support
Christian Gallardo, MD
CPR Milestones
• 1966 1st conference on CPR
• 1973 AHA Guidelines for ACLS
• 1979 3rd conference
• 1985 4th conference
• 1992 5th conference. ILCOR
• 2000 Guidelines 2000 for CPR and ECC
International Consensus on Science
Essentials of ACLS
• CORE of ACLS Concepts
– Cerebral Resuscitation is the
most important goal!
• Returning the patient to the pre-
arrested level of neurological
functioning
• Cardio-Pulmonary-Cerebral
resuscitation (CPCR) – had been
proposed to replace CPR
– Focuses on Airway and
Ventilation, Basic CPR,
Defibrillation of Ventricular
fibrillation and Drugs
Essentials of ACLS
– The probability of survival
declines with each passing minute
of cardiopulmonary compromise
– Medical conditions that lead to
cardiac arrest must be identified
as quickly as possible (e.g. AMI)
– The chain of survival applies in all
settings.
– Good ACLS requires a careful
thought about when to start and
when to stop resuscitative efforts.
The Chain of Survival
Acute Coronary Syndrome (ACS)
• 52% deaths of AMI
occurs out of the
hospital within the 1st
hour after the onset of
symptoms (chest
discomfort, nausea,
SOB etc)
Stroke
• Number 3 killer and
leading cause of severe,
long term disability
• EMS provider should be
trained to suspect
stroke, rapid dispatch of
EMS and rapid delivery
to a hospital capable of
providing acute stroke
care
Adult BLS Algorithm
Adult BLS Algorithm
Adult BLS Algorithm
Torsade de Pointes
Emergency Case 3
Torsade de Pointes
• Do synchronize cardioversion 360J (for
unstable patients).
• Do it for 3 to 4x. If still not converted,
consider Magnesium.
– How to give: 1-2 g diluted in 50 - 100 ml D5W
administer over 5 to 60 minutes followed by an
infusion of 0.5 – 1.0 g (4 to 8 mEq) per hour.
Emergency Case 4
• Patient comes in due to chest heaviness of about 1 week.
BP= 100/60, RR= 18. Oxygen was given. ECG revealed:
Acute
Coronary
Syndrome
Algorithms
Acute Coronary Syndrome Algorithm
Acute Coronary Syndrome Algorithm
Acute Coronary Syndrome Algorithm
Acute Coronary Syndrome Algorithm
Fibrinolytic Checklist
Fibrinolytic Therapy
Acute Coronary Syndrome
Acute Coronary Syndrome
Acute Coronary Syndrome
Acute Coronary Syndrome Algorithm
Acute Coronary Syndrome Algorithm
Acute Coronary Syndrome Algorithm
Acute Coronary Syndrome Algorithm