ilspresentation.ppt

Uncoordinated electrical activity Coarse/fine Exclude artefact Movement Electrical interference Shockable (VF) Shockable (VF) Bizarre irregular waveform No recognisable QRS complexes Random frequency and amplitude Shockable (VT) Shockable (VT) Polymorphic VT Torsade de pointes Monomorphic VT Broad complex rhythm Rapid rate Constant QRS morphology Automated External Defibrillation If not confident in rhythm recognition use an AED Start CPR whilst awaiting AED to arrive Switch on and follow AED prompts AED algorithm Manual defibrillation Plan all pauses in chest compressions Brief pause in compressions to check rhythm Do chest compressions when charging Ensure no-one touches patient during shock delivery Very brief pause in chest compressions for shock delivery Resume compressions immediately after the shock Shockable (VF / VT) RESTART CPR Assess rhythm Shockable (VF / VT) Shockable (VT) CHARGE DEFIBRILLATOR Assess rhythm Shockable (VF / VT) Shockable (VF / VT) DELIVER SHOCK Assess rhythm Shockable (VF / VT) Shockable (VF / VT) IMMEDIATELY RESTART CPR Assess rhythm Shockable (VF / VT) Shockable (VF / VT) MINIMISE INTERRUPTIONS IN CHEST COMPRESSIONS Assess rhythm Shockable (VF / VT) IMMEDIATELY RESTART CPR MINIMISE INTERRUPTIONS IN CHEST COMPRESSIONS Vary with manufacturer Check local equipment If unsure, deliver highest available energy DO NOT DELAY SHOCK Energy levels for manual defibrillators on this course Manual defibrillation energies If VF / VT persists CPR for 2 min CPR for 2 min During CPR Adrenaline 1 mg IV Amiodarone 300 mg IV Deliver 2nd shock Deliver 3rd shock Non-Shockable Assess rhythm Shockable (VF / Pulseless VT) Non-Shockable (PEA / Asystole) MINIMISE INTERRUPTIONS IN CHEST COMPRESSIONS Absent ventricular (QRS) activity Atrial activity (P waves) may persist Rarely a straight line trace Adrenaline 1 mg IV then every 3-5 min Non-shockable (Asystole) Non-Shockable (Asystole) Clinical features of cardiac arrest ECG normally associated with an outpu