vision
Download
Skip this Video
Download Presentation
VISION

Loading in 2 Seconds...

play fullscreen
1 / 28

VISION - PowerPoint PPT Presentation


  • 208 Views
  • Uploaded on

VISION. “It is a terrible thing to see and have no vision.” -Helen Keller. CPCR. CARDIOPULMONARY CEREBROVASCULAR RESUSCITATION. Cardiopulmonary Arrest and Resuscitation (CPR). Cardiopulmonary Arrest (CPA)— sudden ________ of effective __________ and circulation. Causes Anesthesia

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' VISION' - fuller


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
vision

VISION

“It is a terrible thing to see and have no vision.”

-Helen Keller

slide2

CPCR

CARDIOPULMONARY CEREBROVASCULAR RESUSCITATION

cardiopulmonary arrest and resuscitation cpr
Cardiopulmonary Arrest and Resuscitation (CPR)

Cardiopulmonary Arrest (CPA)— sudden ________ of effective __________ and circulation.

  • Causes
      • Anesthesia
      • ______________
      • Infections (e.g. pneumonia)
      • Heart disease
      • Autoimmune disease
      • Malignancy
cardiopulmonary resuscitation
Cardiopulmonary Resuscitation
  • Resuscitation Team Members
    • Should be _____________ members
      • Team leader—Veterinarian or RVT with most experience
      • All members have several responsibilities
        • Provide ventilation
        • Chest compression
        • Establish _______________
        • Administer drugs
        • Attach monitoring equipment
        • ____________ resuscitation efforts
        • Monitor team’s effectiveness
      • Teams should practice on a regular basis to stay sharp
cardiopulmonary resuscitation1
Cardiopulmonary Resuscitation
  • Facilities
    • Adequate room for entire team and equipment
    • ____________ source
    • Good lighting
    • ______________ with all needed Rx

(should be checked at beginning of each shift)

      • Defibrillators
      • Electrocardiogram
      • Suction
    • Table to perform chest compression
      • Grated surgery prep table _________________ enough for chest compression
        • Use board underneath patient
  • Recognition
    • RVT should ID patients at risk and observe any deterioration
    • Preventing an arrest is easier than __________________
cardiopulmonary resuscitation2
Cardiopulmonary Resuscitation
  • Standard Emergency Supplies (on crash cart)
    • Pharmaceuticals --Venous access supplies
      • __________________ ● Butterfly cath
      • Epinephrine ● IV caths
      • Vasopressin ● IV drip sets
      • 2% lidocaine (w/o epi) ● ________________________________________
      • Na+bicarb● Syringes
      • Ca++ chloride or gluconate● Hypodermic needles (var sizes)
      • Lactated Ringer’s, hypertonic saline, ● Adhesive tape

dextran 70, hetastarch● Tourniquet

    • Airway access supplies --Miscellaneous supplies
      • Laryngoscope ● Gauze pads (3 x 3)
      • Endotracheal tubes (variety of sizes) ● Stethoscope
      • Lubricating jelly ● Minor surgery pack
      • Roll gauze ● Suture material

● Scalpel blades

● Surgeon’s gloves

slide9
CPR
  • Basic Life Support:
    • A -- Establishment of an Airway.
    • B-- Breathing support.
    • C -- Circulation support.
  • Advanced Life Support:
    • D -- Diagnosis and Drugs.
    • E -- Electrocardiography.
    • F -- Fibrillation control.
  • Prolonged Life Support:
    • G -- Gauging a patient\'s response.
    • H -- Hopeful measures for the brain
    • I -- Intensive care.
cardiopulmonary resuscitation3
Cardiopulmonary Resuscitation
  • Basic Life Support (_____________)
    • Remember the priorities (ABC; Airway, Breathing, Circulation)
      • Establish _______________ Airway
        • Endotracheal tube
        • Tracheostomy tube for upper airway obstruction
        • Suction to remove blood, mucus, pulmonary edema fluid, vomit
      • Artificial ventilation (Breathing)
          • _____________________
          • Anesthetic machine
          • Ventilate once every 3-5 sec
        • Chest compressions in between breaths if working alone
          • 1 to 2 times per second (____________ times per minute for a large dog and _______________ times for a small dog or cat)
          • 10 compression for every 2 breaths (or_________________)
slide14
CPR

http://www.youtube.com/watch?v=VJGlsYHI9cU

cardiopulmonary resuscitation4
Basic Life Support (Phase I)

Circulation

External cardiac compression

____________________ recumbency—one/both hands on thorax over heart (4th-5th intercostal space)

In larger patients, arms extended, elbows locked

In small patients, thumb and first 2 fingers to compress chest

Rate of compression: ___________________ /min

Cardiopulmonary Resuscitation
cardiopulmonary resuscitation5
Cardiopulmonary Resuscitation
  • Basic Life Support (Phase I)
    • Circulation
      • Internal cardiac compression
        • ___________________ than external compression
          • ↑CO, ↑BP, higher survival rate
        • Indications
          • Rib fractures
          • Pleural effusion
          • Pneumothorax
          • If not responsive after ________________ of external cardiac compression
        • Preparation
          • Clip hair ASAP, no surgical scrub
          • Incision at __________________ intercostal space
          • With a gloved hand, compress heart between fingers and palm (Do not puncture heart with finger tips or twist heart)
          • After spontaneous beating returns, flush chest cavity with saline, perform sterile scrub of skin and close
cardiopulmonary resuscitation6
Cardiopulmonary Resuscitation
  • Basic Life Support (Phase I)
    • Assessing effectiveness (must be done frequently)
      • Improved color of mm
      • Palpable pulse during cardiopulmonary resuscitation (difficult)
      • If efforts are not effective, do something differently
        • Use different hand
        • __________________ person performing compression
        • Ventilate with every 2nd or 3rd chest compression
        • Compress chest where it is widest in lg breed dogs
        • Apply ____________________ to abdomen (hand, sandbag)
          • Prevents posterior displacement of diaphragm and increases intrathoracic pressure
cardiopulmonary resuscitation7
Cardiopulmonary Resuscitation
  • Advanced Life Support (Phase II)

Add 2 priorities to ABC--D E (administer

Drugs, Electrical—defibrillate)

    • Drugs
      • Fluids
        • Lactated Ringer’s is standard (do not use Dextrose)
          • Initial dose: Dogs—_________ /kg

(rapidly IV) Cats—____________/kg

      • Atropine—parasympatholytic effects

(blocks parasympathetic effects)

        • 0.02-0.04 mg/kg
        • ↑HR
        • ↓secretions
      • Epinephrine—adrenergic effects
        • 0.02-0.2 mg/kg
        • Arterial and venous _______________ → ↑BP
cardiopulmonary resuscitation8
Cardiopulmonary Resuscitation
  • Advanced Life Support (Phase II)

Add 2 priorities to ABC--D E (administer Drugs, Electrical—defibrillate)

    • Drugs(continued)
      • 2% Lidocaine (Used to treat____________________)
        • Dogs: 1-2 mg/kg

Cats: 0.5-1.0 mg/kg

      • Sodium bicarb (For metabolic acidosis)
        • 0.5 mEq/kg per 5 min or cardiac arrest
      • Vasopressin (ADH)
        • 0.8 U/kg
cardiopulmonary resuscitation9
Cardiopulmonary Resuscitation
  • Advanced Life Support (Phase II)

Add 2 priorities to ABC--D E (administer Drugs, Electrical—defibrillate)

    • Drugs (continued)
      • Route of drug administration
        • Jugular vein—close to heart; drugs will get to heart quicker
        • Cephalic, saphenous—follow drugs with ________________ saline flush
        • Intraosseous—intramedullarycannula into femur, humerus, wing of ilium, tibial crest
        • Intratracheal—for limited # of drugs: atropine, lidocaine, epinephrine
        • Intracardiac—last resort; several complications can occur
      • Depends on
        • Speed of access
        • Technical ability
        • Difficulties encountered
        • Rate of drug delivery
cardiopulmonary resuscitation10
Cardiopulmonary Resuscitation
  • Advanced Life Support (Phase II)

Add 2 priorities to ABC--D E (administer Drugs, Electrical—defibrillate)

    • Electrical—Defibrillate
      • Purpose—eliminate asynchronous electrical activity in heart muscles by __________________________ all cardiac muscle fibers; hopefully, the fibers will repolarize uniformly and start beating with coordinated contractions
      • Paddles (with electrical gel) placed on each side of chest
      • Yell “CLEAR” before discharging electrical current
      • Start with low charge and increase as needed
        • External: 3-5 J/kg
        • Internal: 0.2-0.4 J/kg
cardiopulmonary resuscitation12
Cardiopulmonary Resuscitation

VENTRICULAR FIBRILLATION

NORMAL EKG

cardiopulmonary resuscitation13
Cardiopulmonary Resuscitation
  • Prolonged Life Support (Phase III)
    • Once heart is beating on its own, monitor the following:
      • HR and rhythm
        • Antiarrhythmic drugs
        • Correct electrolyte abnormalities
    • ____________________
      • Peripheral perfusion
        • Color of mm
        • Cap refill time
        • urine output
      • RR and character of breathing
        • Adequate breathing
        • Auscultory sounds
      • Mental status
      • Improving or deteriorating

UC Davis study: survival rate at 1 wk for cardiac resuscitation patients

Dogs: 3.8%

Cats: 2.3%

ad