Vision
This presentation is the property of its rightful owner.
Sponsored Links
1 / 28

VISION PowerPoint PPT Presentation


  • 153 Views
  • Uploaded on
  • Presentation posted in: General

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

Download Presentation

VISION

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


Vision

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


Vision

Emergency Drugs in Dogs


Vision

Emergency Drugs in Cats


Vision

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_________________)


Vision

CPR

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


Cardiopulmonary resuscitation intubation

Cardiopulmonary Resuscitation Intubation


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


Vision

CPR


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 resuscitation11

Cardiopulmonary Resuscitation

FISH

DEFIBRILLATORS


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%


Vision

CPR


  • Login