NCM121

• TRIAGE CATEGORIES

  1. Expectant
  2. Immediate
  3. Delayed
  4. Minor
• TRIAGE CATEGORIES

  Expectant- Victim unlikely to survive given severity of injuries, level of available care, or both
• TRIAGE CATEGORIES

  Expectant - Palliative care and pain relief should be provided
• TRIAGE CATEGORIES

  Immediate - Victim can be helped by immediate intervention and transport.
• TRIAGE CATEGORIES

  Immediate - Requires medical attention within minutes for survival (up to 60 mins)
• TRIAGE CATEGORIES

  Immediate - includes compromise to patient’s airway breathing and circulation.
• TRIAGE CATEGORIES

  Delayed - victims transport can be delayed.
• TRIAGE CATEGORIES

  Delayed - includes serious and potentially life-threatening injuries but status not expected to deteriorate significantly over several hours.
• TRIAGE CATEGORIES

  Minor - victim with a relatively minor injuries.
• TRIAGE CATEGORIES

  Minor - status unlikely to deteriorate over days.
• TRIAGE CATEGORIES

  Minor - may be able to assist in own care, “walking wounded”
• ADULT CHAIN OF SURVIVAL

  1. Activation of Emergency Response
  2. Perform early CPR
  3. Defibrillate with AED
  4. Advance Life Support
  5. Post Cardiac Arrest Care
  6. Recovery
• PEDIATRIC CHAIN OF SURVIVAL

  1. Prevent Arrest
  2. Activate EMS
  3. Perform early COR
  4. Advanced Life Support
  5. Post Cardiac Care
  6. Recovery
• Rescue breathing - is a type of first aid. That’s given to people who have stopped breathing during rescue breathing you blow air into a persons mouth to supply them with vital oxygen.
• One- Rescuer BLS for Adults

  1. Be Safe
  2. Check LOC
  3. Call EMS
  4. CPR
  5. Defibrillate
• What breathing is not considered breathing initiating CPR?

  Agonal - Occasional gasping and is ineffective
• How long is the maximum time when checking for pulse or breathing?

  10 seconds
• Adult CPR ratio is?

  30:2

  30 compressions, 2 breathing of 5 cycles
• Adult chest compressions’ depth should be 5-6cm only and at a rate of 100-120 compressions per minute.
• Allow chest recoil after every compression.
• Head-Tilt/Chin-Lift maneuver when delivering air.
• ADULT BLS ALGORITHM

  Criteria for high-quality CPR:

  1. Start chest compressions (hard and fast)
  2. Allow chest recoil
  3. Minimize interruptions
  4. Assure breaths make chest rise
  5. Do not over-ventilate
  6. Assess for shockable rhythm as soon as AED arrived
• ADULT BLS ALGORITHM:

  No normal breathing, Has pulse?

  Administer 1 breath every 5-6 seconds, Assess pulse every 2 minutes.
• ADULT BLS ALGORITHM:

  No breathing, Or only gasping, No pulse?

  Start cycles of 30 compressions and 2 breaths
• ADULT BLS ALGORITHM:

  Assess for Shockable Rhythm:

  Not Shockable: ?

  1. Resume CPR for 2 minutes
  2. Assess rhythm every 2 mins
  3. Continue until ACLS providers arrived or ROSC
• ADULT BLS ALGORITHM:

  Assess for Shockable Rhythm:

  Shockable?

  1. Administer 1 shock and resume CPR immediately for 2 minutes.
• One-rescuer CPR ratio for children?

  15:2
• Use pediatric pads for children under the age of 8 and less than 55 pounds (25 kg). Use pediatric pads for infants

  and place the pads in an anterior-posterior position if

  they would overlap on the front of the chest.
• PEDIATRIC BLS - Single Rescuer

  1. Check for responsiveness
  2. Look for signs of breathing (10 secs)
  3. No normal breathing, pulse felt?

  Provide rescue breathing of 1 breath every 2-3 seconds or about 20-30 breaths/min
• PEDIATRIC BLS - Single Rescuer

  1. Check responsiveness
  2. Look for signs of breathing
  3. Normal breathing, pulse felt?

  Monitor until EMS arrived
• PEDIATRIC BLS - Single Rescuer

  1. No normal breathing, pulse felt
  2. HR <60/min with signs of poor perfusion?

  1.Continue rescue breathing: check every 2 minutes

  2.If no pulse, start CPR
• PEDIATRIC BLS - Single Rescuer

  1 rescuer - perform cycles of 30 compressions and two breaths.
• 6 Reasons to STOP CPR

  1. The victim dies
  2. Too exhausted (rescuer)
  3. ROSC (victim)
  4. Scene is unsafe
  5. DNR ordered
  6. Person has LVAD
• ACLS - is a series of evidence-based responses simple enough to be committed to memory and recalled under moments of stress.
• This atrial contraction registers on an electrocardiogram (ECG) strip as the P wave.
• The time between the start of atrial contraction and the start of ventricular contraction registers on an ECG strip as the PR interval.
• The ventricular contraction registers on the ECG strip as the QRS complex.
• The ventricles rest and repolarize , which is registered on the ECG strip as the T wave.
• THE ACLS SURVEY

  1. Airway
  2. Breathing
  3. Circulation
  4. Differential Diagnosis
• THE ACLS SURVEY

  Airway - The provider must decide if the benefit of adding an advanced airway outweighs the risk of pausing CPR.