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Life Support

Life Support

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Life Support

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  1. Life Support • Basic Life Support • Advanced Life Support • What is the difference?

  2. Emergency situations do not solely concern cardiac arrests. Patients with life threatening arrhythmias are said to be in a peri-arrest period. Peri-arrest rhythms include Bradycardia Broad complex tachycardia Narrow complex tachycardia Atrial Fibrillation Emergency situations

  3. Quick Electrophysiology Revision Label this diagram.

  4. Quick ECG Revision • What is…..? • The P wave • The QRS complex • The T wave

  5. Is the pulse fast or slow? Is the pulse regular or irregular? What is this arrhythmia?

  6. Is the pulse regular or irregular? Can you see P waves? What is this arrhythmia?

  7. Is the pulse fast or slow? Are the QRS complexes broad or narrow? What is this arrhythmia?

  8. Is the pulse fast or slow? Are the QRS complexes broad or narrow? What is this arrhythmia?

  9. Cardiac Arrest • Arrest arrhythmias are divided into non-shockable and shockable. • Ventricular fibrillation and pulseless ventricular tachycardia are both treatable by defibrillation • In other arrhythmias such as asystole and Pulseless Electrical Activity (PEA) defibrillation is not indicated, rather the underlying cause must be treated.

  10. Shockable arrhythmias • Ventricular Fibrillation • Pulseless Ventricular Tachycardia What is happening to these individual’s hearts?

  11. Defibrillators • Defibrillation is defined as the termination of fibrillation or, more precisely, the absence of VF/VT at 5 seconds after shock delivery (Resuscitation Council 2005). • The defibrillator passes an electrical current through the myocardium, depolarising a large amount of cardiac muscle simultaneously. • If successful the natural pacemaker tissue will resume control of the heart.

  12. Non-shockable Arrhythmias • Asystole • Pulseless Electrical Activity What is happening to these individual’s hearts?

  13. Hypoxia Hypovolaemia Hyperkalaemia, hypokalaemia, hypocalcaemia and other metabolic disorders Hypothermia Tension pneumothorax Tamponade Toxic substances Thromboembolism The 4 H’s and the 4 T’s Can you define these terms?

  14. Main ALS Drugs • Epinephrine (Adrenaline) • 1mg (1 in 10,000 or 1 in 1,000) every 3-5 mins • Produces vasoconstriction, thus increases cerebral and coronary perfusion. • Consider • Atropine • Blocks the effect of the vagus nerve thus parasympathetic control of both SA node and AV node is reduced, facilitating greater SA and AV node automaticity. • Amiodarone • Increases the duration of cardiac cell action potential, therefore increasing QT interval