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FLS. ABCDE ,causes and Prevention Cardiac Arrest. FLS. The causes of cardiorespiratory arrest Identify and managing patients at risk using the ABCDE approach. Objectives. FLS. Early recognition of the critically ill patient. 3. 2. 1. 0. 1. 2. 3. Pulse. < 40. 41-50. 51-100.

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Presentation Transcript
objectives

FLS

  • The causes of cardiorespiratoryarrest
  • Identify and managing patients at risk using the ABCDEapproach
Objectives
slide3

FLS

Early recognition of the critically ill patient

recognition of critically ill patients

3

2

1

0

1

2

3

Pulse

< 40

41-50

51-100

101-110

111-130

> 130

Systolic BP mmHg

< 70

71-80

81-100

101-199

> 200

Respiratory

Rate

< 8

9 -14

15-20

21-29

> 30

Temp °C

< 35

35.1-36.5

36.6-37.4

> 37.5

CNS

A

V

P

U

FLS

Recognition of critically ill patients

Track score - a score of > 4 triggers a review by doctor

causes of cardiorespiratory arrest

FLS

  • Airway
  • Breathing
  • Circulation
Causes of cardiorespiratory arrest
causes of cardiorespiratory arrest airway problems

FLS

Obstruction caused by:

  • CNS depression
  • Blood
  • Vomit
  • Foreign body
  • Trauma
  • Infection
  • Inflammation
  • Laryngospasm
Causes of cardiorespiratory arrest Airway problems
causes of cardiorespiratory arrest breathing problems

FLS

  • Decreased respiratory drive
    • CNS depression
  • Decreased respiratory effort
    • muscle weakness
    • nerve damage
    • restrictive chest defect
    • pain from fractured ribs
  • Lung disorders
    • pneumothorax
    • haemothorax
    • infection
    • acute exacerbation COPD
    • asthma
    • pulmonary embolus
    • ARDS
Causes of cardiorespiratory arrest Breathing problems
causes of cardiorespiratory arrest circulatory problems

FLS

Primary

  • Acute coronary syndromes
  • Dysrhythmias
  • Hypertensive heart disease
  • Valve disease
  • Drugs
  • Electrolyte / acid base abnormalities

Secondary

  • Hypoxaemia
  • Blood loss
  • Hypothermia
  • Septic shock
Causes of cardiorespiratory arrestCirculatory problems
slide11

FLS

The ABCDE approach to the critically ill patient

A…

B…

C…

D…

E…

abcde approach rules

FLS

  • Call for help early
  • Priority of treatment
  • Complete initial assessment
  • Reassessment
  • safety
  • Patient responsiveness to treatment
ABCDE approachRules
abcde approach airway

FLS

Recognition of airway obstruction

  • Talking
  • Difficulty breathing, distressed, choking
  • Shortness of breath
  • Noisy breathing
    • stridor, wheeze, gurgling
  • See-saw respiratory pattern,

accessory muscles

ABCDE approachAirway
abcde approach airway14

FLS

Treatment of airway obstruction

  • Oxygen
  • Airway opening

- i.e. head tilt, chin lift, jaw thrust

  • Simple adjuncts
  • Advanced techniques

- e.g. LMA, tracheal tube

ABCDE ApproachAirway
abcde approach breathing

FLS

Recognition of breathing problems

  • Look
    • Inspect respiratory distress, accessory muscles, cyanosis, respiratory rate, chest deformity, conscious level
  • Listen
    • Auscultate breath sounds, noisy breathing
  • Feel
    • palpat expansion, percussion, tracheal position
  • Pulse oxymetry
ABCDE approachBreathing
abcde approach breathing16

FLS

Treatment of breathing problems

  • Airway
  • Oxygen
  • Treat underlying cause

- e.g. drain pneumothorax

- e.g . Nebulizers

  • Support breathing if inadequate

- e.g. ventilate with bag valve mask

ABCDE approachBreathing
abcde approach circulation

FLS

  • Look at the patient
  • Pulse – central pulse (carotid)

peripheral pulse

  • Peripheral perfusion

capillary refill time

( normally <2 sec)

  • Blood pressure
  • Monitor
ABCDE approachCirculation
abcde approach circulation18

FLS

  • Airway, Breathing
  • Oxygen
  • IV access, take blood sample and lab investigations
  • Treat cause
  • Give fluids
  • Haemodynamic monitoring
  • MONA if acute coronary syndrome

Treatment

ABCDE approachCirculation
slide20

Disability

Glasgow

Coma

Score

Global Injury Solutions

abcde approach disability

FLS

  • AVPU or GCS, and pupils
  • Treatment - ABC
  • Treat underlying cause
  • Blood glucose
    • if < 3 mmol l-1 give glucose
ABCDE approachDisability
abcde approach exposure

FLS

  • Remove clothes to enable examination

- e.g. injuries, bleeding, rashes

  • Avoid heat loss
  • Maintain dignity
ABCDE approachExposure
slide23

FLS

Anyquestions

summary

FLS

  • Early recognition of patients at risk may prevent cardiorespiratory arrest
  • Airway, breathing or circulation problems can cause cardiorespiratory arrest
  • ABCDE approach to recognise and treat patients at risk of cardiorespiratory arrest
Summary