Advanced Life Support
1. Principles of high
quality CPR
2. Ways to ensure the - Allow the chest to recoil fully
delivery of high - Compress to a depth of at least 2 in but not more than 2.4 in
quality CPR - Minimize interruptions to chest compressions
- Provide compressions at the proper rate (100 to 120/minute)
3. How to insert an
oropharyngeal air-
way.
4. how to insert na-
sopharyngeal air-
way
5. Considerations
when an advanced
airway is in place
6. Proper placement
of electrodes for
monitoring of HR,
rhythm, and ob-
taining 12 and
15-lead ECG
7. Procedure for de-
fibrillation
8. Procedure for syn-
chronized car-
dioversion
, Advanced Life Support
9. Procedure for tran-
scutaneous pacing
10. Procedure for
obtaining in-
traosseous (IO) ac-
cess
11. How to interpret 30-45 what it is normally
EtCO2 during re- 15-20 during a resuscitation
suscitation ventila- Below 10 could be a problem with rate or quality of compressions
tion? Spike is often the first sign of ROSC
12. Four components Sender, message, receiver, feedback (closed loop communication)
of communication
13. Debriefing Review, Analyze, Reflect, Summarize
14. Team leader re- - Assigns team roles
sponsibilities - Sets expectations
- Prioritizes, directs, acts decisively
- Encourages and allows team input and interaction
- Focuses on big picture
- Monitors performance while providing support
- Acts as a role model
- Coaches the team
- Re-evaluates and summarizes progress
- Leads a debriefing session
15. Team member re- - Have the knowledge and skills to perform their assigned role
sponsibilities - Communicate with the team leader if they feel they are lacking the above,
identify something the team leader may have overlooked, recognize a dan-
gerous situation or need for urgent action
, Advanced Life Support
- Stay in their assigned role but assist others as needed, as long as they are
able to maintain their own responsibilities
16. Six-Person Includes three CPR/defibrillator roles, and three leadership/supportive roles
High-Performance
Resuscitation Team 1) Airway manager and ventilator
2) Compressor
3) AED/Defibrillator operator (also relieves for compressions)
4) Establishing vascular access and administering medication
5) Team leader prioritizing/directing others' actions
6) Data Manager - communicates and records key data (i.e. med admin or
interruptions to chest compressions)
17. Example of a de- A 15-year-old patient who had been brought to the emergency department
brief review for evaluation of an earlier episode of syncope went into witnessed ventricular
fibrillation. Compressions were started, defibrillator pads were applied and
an initial shock of 120 J was delivered. An OPA was inserted and high-flow
oxygen was initiated. After 2 minutes of CPR and a rhythm check, the patient
was observed to still be in ventricular fibrillation; a second shock of 150 J
was delivered, CPR was resumed, 1 mg of epinephrine was administered and
capnography monitoring was established. After approximately 1 more minute
of CPR, the patient achieved ROSC.
18. What should be pri- Defibrillation is the most effective therapy for the treatment of vfib
oritized during ven-
tricular fibrillation
- defibrillation or
ventilations?
19. A systematic ap- Rapid, primary, secondary
proach to assess-
ment includes a
, Advanced Life Support
____, ____, and ____
assessment.
20. - Initial impression Rapid
- Responsiveness
- Breathing
- Pulse
Are components of
a _____ assessmetn
21. - Airway Primary
- Breathing
- Circulation
- Disability
- Exposure
are components of
a _____ assessment
22. A broader assess- secondary (focused history, physical examination, diagnostic testing)
ment to narrow
the list of differen-
tial diagnoses and
discover underly-
ing causes is a _____
assessment
23. An OPA can only unconscious
be used on a(n)
________ patient
24.
1. Principles of high
quality CPR
2. Ways to ensure the - Allow the chest to recoil fully
delivery of high - Compress to a depth of at least 2 in but not more than 2.4 in
quality CPR - Minimize interruptions to chest compressions
- Provide compressions at the proper rate (100 to 120/minute)
3. How to insert an
oropharyngeal air-
way.
4. how to insert na-
sopharyngeal air-
way
5. Considerations
when an advanced
airway is in place
6. Proper placement
of electrodes for
monitoring of HR,
rhythm, and ob-
taining 12 and
15-lead ECG
7. Procedure for de-
fibrillation
8. Procedure for syn-
chronized car-
dioversion
, Advanced Life Support
9. Procedure for tran-
scutaneous pacing
10. Procedure for
obtaining in-
traosseous (IO) ac-
cess
11. How to interpret 30-45 what it is normally
EtCO2 during re- 15-20 during a resuscitation
suscitation ventila- Below 10 could be a problem with rate or quality of compressions
tion? Spike is often the first sign of ROSC
12. Four components Sender, message, receiver, feedback (closed loop communication)
of communication
13. Debriefing Review, Analyze, Reflect, Summarize
14. Team leader re- - Assigns team roles
sponsibilities - Sets expectations
- Prioritizes, directs, acts decisively
- Encourages and allows team input and interaction
- Focuses on big picture
- Monitors performance while providing support
- Acts as a role model
- Coaches the team
- Re-evaluates and summarizes progress
- Leads a debriefing session
15. Team member re- - Have the knowledge and skills to perform their assigned role
sponsibilities - Communicate with the team leader if they feel they are lacking the above,
identify something the team leader may have overlooked, recognize a dan-
gerous situation or need for urgent action
, Advanced Life Support
- Stay in their assigned role but assist others as needed, as long as they are
able to maintain their own responsibilities
16. Six-Person Includes three CPR/defibrillator roles, and three leadership/supportive roles
High-Performance
Resuscitation Team 1) Airway manager and ventilator
2) Compressor
3) AED/Defibrillator operator (also relieves for compressions)
4) Establishing vascular access and administering medication
5) Team leader prioritizing/directing others' actions
6) Data Manager - communicates and records key data (i.e. med admin or
interruptions to chest compressions)
17. Example of a de- A 15-year-old patient who had been brought to the emergency department
brief review for evaluation of an earlier episode of syncope went into witnessed ventricular
fibrillation. Compressions were started, defibrillator pads were applied and
an initial shock of 120 J was delivered. An OPA was inserted and high-flow
oxygen was initiated. After 2 minutes of CPR and a rhythm check, the patient
was observed to still be in ventricular fibrillation; a second shock of 150 J
was delivered, CPR was resumed, 1 mg of epinephrine was administered and
capnography monitoring was established. After approximately 1 more minute
of CPR, the patient achieved ROSC.
18. What should be pri- Defibrillation is the most effective therapy for the treatment of vfib
oritized during ven-
tricular fibrillation
- defibrillation or
ventilations?
19. A systematic ap- Rapid, primary, secondary
proach to assess-
ment includes a
, Advanced Life Support
____, ____, and ____
assessment.
20. - Initial impression Rapid
- Responsiveness
- Breathing
- Pulse
Are components of
a _____ assessmetn
21. - Airway Primary
- Breathing
- Circulation
- Disability
- Exposure
are components of
a _____ assessment
22. A broader assess- secondary (focused history, physical examination, diagnostic testing)
ment to narrow
the list of differen-
tial diagnoses and
discover underly-
ing causes is a _____
assessment
23. An OPA can only unconscious
be used on a(n)
________ patient
24.
