acls bls 2
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CHAKRADHAR HOSPITALS
ICU NURSING PROVIDING HIGH QUALITY NURSING CARE
BLS – ACLSAHA GUIDELINES 2010
DR.CH PAVAN KUMAR MBBS
CHAKRADHAR HOSPITALS.
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ACLS BLS
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HIGH QUALITY CPR
• MONITORING OF HIGH QUALITY CPR– INTER ARTERIAL PULSE PRESSURE <
20mmhg– PULSE WAVE CAPNOGRAPHY WITH END
TIDAL CO2 < 10mmhg
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H AND T
• HYPOVOLEMIA• HYPOXIA
• HYDRROGEN ION ACIDOSIS
• HYPER OR HYPOKALEMIA
• HYPOTHERMIA• HYPOGLYCAEMIA
• TABLET• TAMPONADE• TENSION
PNEUMOTHORAX• THROMBOSIS
(PUL , CORONARY )• TRAUMA
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H
• HYPOXIA– CONFIRM B/L CHEST RAISE ,VBS– CHECK O2 SOURCE– ADVANCED AIRWAY
• HYPOVOLEMIA– SET IO IV ACCESS– GIVE FLUID BOLUSES– REASSESS
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H• HYDROGEN ION ACIDOSIS– RESPIRATORY ACIDOSIS DON’T
HYPERVENTILLATE–METABOLIC ACIDOSIS START SODA
BICARB• HYPER HYPOKALEMIA–HYPERKALEMIA• CALCIUM CHLORIDE 10 % 10ML IN 5 MINS
–HYPOKALEMIA • POTASSIUM CHLORIDE 20mmol• MAGNESIUM SULFATE 50 % SOLN 5 ML(10 MMOL IN 30 MINS)
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• Hyper/Hypothermia– If too hot, cool down– If too cold, warm up
• Hypo/Hyperglycemia– Accu-check and correct if needed.
H
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• Tablets (drug OD, accidents)– Support circulation while you find an antidote or rever
reverse drug. (poison control)
• Tamponade– (chest trauma, chest malignancy, recent central line insertion,
JVD, narrow pulse pressure, electrical alternans etc…)– Pericardial centesis
• Tension Pneumothorax– (chest asymmetry, tympani, diminished breath sounds, high
peak pressures, JVD, tracheal deviation, severe respiratory distress etc…)
– Vent tension in chest– Support ventilation and oxygenation with BVM and intubate as
necessary
T
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• Thrombosis (coronary or pulmonary)– Consider fibrinolysis for suspected coronary or
pulmonary embolus.– CPR is not a absolute contraindication for
fibrinolysis.
• Trauma– Inspect body completely. Remove all clothes.– Secure airway– Control external bleeding with tamponade while
concurrently delivering volume with isotonic crystalloids and blood products.
– Look for internal bleeding (tap the abdomen if suspicious for internal bleed)and take to
T
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PROVIDING BEST ICU CARE