advance life support (als).ppt
TRANSCRIPT
What is advance life support (ALS) ?What is advance life support (ALS) ?
It is the continuation of Basic Life support to help support the patient and ensure return of spontaneus circulation
BLS provides cardiac output of BLS provides cardiac output of only 25% normal & delivers 10% only 25% normal & delivers 10% oxygenoxygen
Produces limited circulation not Produces limited circulation not enough to support brain & heart for enough to support brain & heart for long long
2 lines of steps or therapies 2 lines of steps or therapies in ALSin ALS
1. early & continued attempts at defibrillation
2. attemps to improve myocardial performance
Defibrilation (or defib) is an attempt to stop ventricle fibrilation (VF) or pulseless ventricle tachycardia (VT)
Defib uses direct current counter shock that produces simultaneous depalarization of the mass of myocardial cells and enables the resumption of organized electrical activity
The majority of heart arrest due to coronary artery disease have VF or pulseless VT & defib. Is the effective therapy
The benchmarks for timing of early defib.: Within 5 minutes of call for out-of
hospital arrest : Within 3 minutes of call in-hospital
arrest
If the rhythm is undetermined, or a delay in diagnosis , a blind shock should be delivered
1. The paddles should be given gel.or lubricant as not to burn the skin
Place one paddle on the right parasternal & the other paddle on the apex of heart.
Initial energy charges to 200 J, that nobody has a contact with the patient or bed & then press tha charge
Check the rhythm,if VT/VF persist another 200 J or 300 J, if persit give a third shock of 360 J
After 3 shock, no response After 3 shock, no response than pharmacology therapy than pharmacology therapy necessarynecessary
Precaution in defib.Precaution in defib.
Charging the paddles in the airDefib over ECG electrodes,
nitrate patches or pace makersPhysical contact with patient
on bed