BY

ISLAM GHANEMASSISTANT LECTURER OF CARDIOLOGY

ZAGAZIG UNIVERSITYEGYPT2014

CARDIAC ARREST(ALS MANAGEMENT)

INTRODUCTION

Cardiac arrest also known as cardiopulmonary arrest or circulatory arrest is the end of normal circulation of the blood due to failure of the heart to contract effectively

Also referred as a sudden cardiac arrest (SCA) Cardiac arrest is a medical emergency that in

certain situations is potentially reversible if treated early

Unexpected cardiac arrest sometimes leads to death almost immediately this is called sudden cardiac death (SCD)

CLASSIFICATION

Based upon the ECG rhythm

1 SHOCKABLE

The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia

2 NON-SHOCKABLE

The two nonndashshockable rhythms are asystole and pulseless electrical activity

CAUSES

Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome

Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as

gastrointestinal bleeding aortic rupture and intracranial hemorrhage)

Overdose Drowning

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

INTRODUCTION

Cardiac arrest also known as cardiopulmonary arrest or circulatory arrest is the end of normal circulation of the blood due to failure of the heart to contract effectively

Also referred as a sudden cardiac arrest (SCA) Cardiac arrest is a medical emergency that in

certain situations is potentially reversible if treated early

Unexpected cardiac arrest sometimes leads to death almost immediately this is called sudden cardiac death (SCD)

CLASSIFICATION

Based upon the ECG rhythm

1 SHOCKABLE

The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia

2 NON-SHOCKABLE

The two nonndashshockable rhythms are asystole and pulseless electrical activity

CAUSES

Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome

Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as

gastrointestinal bleeding aortic rupture and intracranial hemorrhage)

Overdose Drowning

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Cardiac arrest also known as cardiopulmonary arrest or circulatory arrest is the end of normal circulation of the blood due to failure of the heart to contract effectively

Also referred as a sudden cardiac arrest (SCA) Cardiac arrest is a medical emergency that in

certain situations is potentially reversible if treated early

Unexpected cardiac arrest sometimes leads to death almost immediately this is called sudden cardiac death (SCD)

CLASSIFICATION

Based upon the ECG rhythm

1 SHOCKABLE

The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia

2 NON-SHOCKABLE

The two nonndashshockable rhythms are asystole and pulseless electrical activity

CAUSES

Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome

Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as

gastrointestinal bleeding aortic rupture and intracranial hemorrhage)

Overdose Drowning

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CLASSIFICATION

Based upon the ECG rhythm

1 SHOCKABLE

The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia

2 NON-SHOCKABLE

The two nonndashshockable rhythms are asystole and pulseless electrical activity

CAUSES

Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome

Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as

gastrointestinal bleeding aortic rupture and intracranial hemorrhage)

Overdose Drowning

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Based upon the ECG rhythm

1 SHOCKABLE

The two shockable rhythms are ventricular fibrillation and pulseless ventricular tachycardia

2 NON-SHOCKABLE

The two nonndashshockable rhythms are asystole and pulseless electrical activity

CAUSES

Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome

Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as

gastrointestinal bleeding aortic rupture and intracranial hemorrhage)

Overdose Drowning

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CAUSES

Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome

Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as

gastrointestinal bleeding aortic rupture and intracranial hemorrhage)

Overdose Drowning

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Cardiac Coronary heart disease Non-ischemic heart disease Cardiomyopathy Cardiac rhythm disturbances Hypertensive heart disease Congestive heart failure Coronary artery abnormalities Myocarditis pulmonary embolism Hypertrophic cardiomyopathy Long QT syndrome

Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as

gastrointestinal bleeding aortic rupture and intracranial hemorrhage)

Overdose Drowning

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Non-cardiac The most common non-cardiac causes Trauma non-trauma related bleeding (such as

gastrointestinal bleeding aortic rupture and intracranial hemorrhage)

Overdose Drowning

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Reversible causes

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

DIAGNOSIS

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Absence of palpable pulse(The main diagnostic criterion to diagnose a cardiac arrest is lack of circulation Lack of carotid pulse is the gold standard for diagnosing cardiac arrest)

Lack of consciousness Abnormal or absent breathing ldquosilent chestrdquo

Death

NB Misdiagnosis may lead tohelliphelliphelliphelliphelliphellip

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

MANAGEMENT

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Delay Can Be Deadly

Patient delay is the biggest cause of not getting care fast

Do not wait more than a few minutesmdash5 at the most

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Golden minutes

12042023 drdgm 17

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CPR CENTURIES amp DECADES AGO

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CPR NOW A DAYShellip

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

VFPulseless VT

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Ventricular Fibrillation

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Ventricular Tachycardia

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Ventricular Fibrillation (VF)

What VF looks like on an EKG

Shock ldquoconvertsrdquo VF to better rhythm

Defibrillation (electrical shock) is the primary solution (cannot be used in other lethal heart rhythms)

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Immediate AED

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

AsystolePEA

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Asystole

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

PEA Pulseless electrical activity (PEA)

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Advanced Airway

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

delayed endotracheal intubation combined with passive oxygen delivery and minimally interrupted chest compressions was associated with improved neurologically intact survival after out-of-hospital cardiac arrest in patients with witnessed VFVT

When an advanced airway (eg endotracheal tube or supraglottic airway) is placed 2 providers no longer deliver cycles of compressions interrupted with pauses for ventilation

1 breath every 6-8 seconds (8-10 breaths per minute)

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

ARTICLES USED IN CPR

1ENDOTRACHEAL TUBE 2 AMBU BAG WITH MASK

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

3SUCTION TUBE OR CATHETER

4NASAL AIRWAYORAL AIRWAY

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

5LUBRICATING JELLY

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CPR KIT

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Defibrillation

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Automated External Defibrillator

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

DEFIBRILLATION GENERAL CONCEPT

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Manual Defibrillator

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

1 OXYGEN ADMINISTRATION SET2 LARYNGOSCOPE WITH DIFFERENT

SIZE3 IV INFUSION SET CUT DOWN SETS

AND IV FLUIDS4 CARDIAC MONITOR WITH

DEFIBRILLATOR5 MECHANICAL VENTILATOR6 TRACHEOSTOMY SET7 GAUZE COTTON ETC8 STERILE SYRINGES AND NEEDLES

OTHERhellip

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CARDIO-PULMONARY RESUSCITATION(CPR)

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CPR Wins (Whats Important Now)

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

New CPR sequenceC-A-B

not

A-B-C

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Elbows should be locked and arms are straight

Rescuerrsquos shoulders position directly over hands

Begin compression

Pressure should come from the shoulders

Compression should depress victimrsquos sternum approximately 15- 2 inches

Donrsquot allow the fingers to touch the chest wall

Allow chest to rebound to normal position after each compression

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Approach safely

Check response

Shout for helpOpen airway

Check breathing

30 chest compressions

2 rescue breaths

SHOUT FOR HELP

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Approach safely

Check response

Shout for help

Open airwayCheck breathing

30 chest compressions

2 rescue breaths

OPEN AIRWAY

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Head tilt chin lift + jaw thrust- healthcare professionals

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Approach safely

Check response

Shout for help

Open airway

Check breathing30 chest compressions

2 rescue breaths

CHECK BREATHING

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Look listen and feel for NORMAL breathing

Do not confuse agonal breathing with NORMAL breathing

CHECK BREATHING

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Occurs shortly after the heart stops in up to 40 of cardiac arrests

Described as barely heavy noisy or gasping breathing

Recognise as a sign of cardiac arrestErroneous information can result in

withholding CPR from cardiac arrest victim

AGONAL BREATHING

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Approach safely

Check response

Shout for help

Open airway

Check breathing

30 chest compressions2 rescue breaths

30 CHEST COMPRESSIONS

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

bull Place the heel of one hand in the centre of the chest

bull Place other hand on top

bull Interlock fingersbull Compress the chest

ndash Rate 100 min-1

ndash Depth 4-5 cmndash Equal compression

relaxationbull When possible change

CPR operator every 2 min

CHEST COMPRESSIONS

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CONTINUE C P R

30

2

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

SPONTANEOUS signs of circulation are restoredTURNED over to medical services or properly trained and authorized personnel

OPERATOR is already exhausted amp cannot continue CPR

PHYSICIAN assumes responsibility (declares death take over etc)----------(DNAR)

WHEN TO STOP CPR

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

ChildInfant Compression

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Neonatal Resuscitation The etiology of neonatal arrests is nearly

always asphyxia

Therefore the A-B-C sequence has been retained for resuscitation of neonates unless there is a known cardiac etiology

Rate(302) to be changed to (152) if 2 rescuers

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

The following steps should be implemented helliphelliphellip

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Resuscitation team(Code Blue)

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Resuscitation room

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

AIRWAY BREATHING 1048577 Appropriate sized ventilation bag on bed 1048577 Oxygen ready humidified oxygen for pediatric

patients 1048577 Suction on and ready 1048577 Appropriate size suction catheters available 1048577 Airway equipment checked and at bedside ndash

estimate ETT size for children 1048577 Rapid sequence intubation tray at bedside 1048577 End tidal CO2 assessment equipment at

bedside 1048577 Pulse oximeter at bedside and ready

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

CIRCULATION 1048577 Manual and automatic BP cuffs at bedside 1048577 CPR backboard ndash available as needed 1048577 Heat lamps ndash available as needed 1048577 Intravenous lines stripped 1048577 ACLS drugs ndash available as needed 1048577 Appropriate size infusion catheters ndash available as

needed 1048577 Cardiac monitor on and event recording ready 1048577 Defibrillator on appropriate size paddles [peds

adult internal] ndash external pacer pads 1048577 Call for blood if needed

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

MISCELLANEOUS 1048577 Bedside hematocrit and glucose

monitors 1048577 Appropriate size foley catheter ndash

available as needed 1048577 Appropriate size NG tube ndash available

as needed

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Drugs used commonly during resuscitation

Epinephrine (Adrenaline) Amiodarone Lidocaine (Lignocaine) Magnesium Sulphate

(No role Atropine Ca++ Na bicarbonate)

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

HOME MESSAGE

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Donrsquot Forgetbull Push hard (at least 2 inches)bull Push fast (at least 100min)bull Minimize interruptions in compressionsbull Compress to ventilation 302bull Defibrillate as soon as possiblebull ETT (8 ndash 10 breathmin)bull Encourage team resuscitationbull New 5th link in the chain of survival (post

cardiac arrest care)

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Donrsquot Forget Epinephrine Amiodarone

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Forget Look Listen and Feel victims before

starting CPR Atropine in ACLS Routine use of calcium Routine use of sodium bicarbonate

(Except in cases of cardiac arrest due to hyperkalemia or TCA poisoning)

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

+ Demo cases(Shockable non)

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

Questions

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91

• Slide 1
• By Islam Ghanem Assistant lecturer of Cardiology Zagazig univer
• INTRODUCTION
• Slide 4
• CLASSIFICATION
• Slide 6
• CAUSES
• Slide 8
• Slide 9
• Reversible causes
• DIAGNOSIS
• Slide 12
• Slide 13
• MANAGEMENT
• Delay Can Be Deadly
• Slide 16
• Golden minutes
• Slide 18
• Slide 19
• Slide 20
• Slide 21
• Slide 22
• Slide 23
• VFPulseless VT
• Ventricular Fibrillation
• Ventricular Tachycardia
• Slide 27
• Slide 28
• Immediate AED
• Slide 30
• Slide 31
• Slide 32
• AsystolePEA
• Asystole
• PEA
• Slide 36
• Slide 37
• Slide 39
• Advanced Airway
• Slide 41
• Slide 42
• Slide 43
• Slide 44
• Slide 45
• Defibrillation
• Automated External Defibrillator
• DEFIBRILLATION GENERAL CONCEPT
• Manual Defibrillator
• Slide 50
• CARDIO-PULMONARY RESUSCITATION(CPR)
• CPR Wins (Whats Important Now)
• New CPR sequence
• Slide 54
• Slide 55
• Slide 56
• Slide 57
• Slide 58
• Slide 59
• Slide 60
• Slide 61
• Slide 62
• Slide 63
• Slide 64
• Slide 65
• Slide 66
• ChildInfant Compression
• Neonatal Resuscitation
• Slide 69
• Slide 70
• Slide 71
• Slide 72
• Slide 73
• Slide 74
• Resuscitation team (Code Blue)
• Slide 76
• Slide 77
• Resuscitation room
• Slide 79
• Slide 80
• Slide 81
• Drugs used commonly during resuscitation
• HOME MESSAGE
• Donrsquot Forget
• Donrsquot Forget (2)
• Forget
• Slide 87
• Slide 88
• Slide 89
• Questions
• Slide 91