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Exercise date Time Seminary room KAIM
Lecture PA
14.00 – 15.30h
3.11.2010
Wednesday
10.00-10.45h DM 4ab 29.10.2010Friday
KAIM
12.00- 12.45h Substitute date 3.12.2010
Friday
TEST
14.00- 14.45 h Substitute date
Substitute date is for students, who were not able to arrive for normal date.3.12.2010 14.00h TEST: 10 MCQ First aid ( Basic life support adults, Pediatric basic life support, Shock, Wounds, Heat Stroke, Burns , Emergency Rescue and Transfer – Removal from Automobile,…Literature: First Aid Manual, Latest Update, St John Ambulance Association, 2005, www.erc.com, Moule P., Albarran J., 2009: Practical resuscitation for healthcare professionalswww. books.google.com
First aid fundamentals (28th October 2010)1st part : education Department of anaesthesiology and inten. medicine, SNP 1 st.2nd part :education Department of Traumatology, Rastislavova 43 st.
Seminary room KAIM 2nd floor, SNP st. 1, we ask students to wait for teacher on the 2nd floor in front of University Department of Anaesthesiology & Intensive Care
Paediatric basic life support
Monika Grochová MD, PhDKlinika anestéziológie a intenzívnej
medicíny LF UPJŠ a UNLP Košice
• www.erc.eduwww.resus.org.uk
• Resuscitation (2005, 2010) 67 Supplement
• Resuscitation (2005, 2010) 67
Basic life support
Airway – airways opening
Breathing – arteficial ventilation
Circulation – recovery of circulation
CBA adults
Paediatric basic life support
• simplification based on the knowledge that many children receive no resuscitation at all because rescuers fear doing harmAge:
- An infant is a child under 1 year of age
- a child is between 1 year and puberty
25 kg, 8. years
CPR IN CHILDREN
• Adult CPR techniques can be used on children
• Compressions 1/3 of the depth of the chest
30
30
Approach safely
Check response
Shout for help
Open airway
BASIC LIFE SUPPORT (BLS)
head tilt and chin lift,
Cam
pbel
l
Approach safely
Check response
Shout for help
Open airway
Check breathing
BASIC LIFE SUPPORT (BLS)
Look, listen and feel for NORMAL breathing
Breathing• Take a breath and cover the mouth and nasal apertures of the infant with your mouth, makingsure you have a good seal • Blow steadily into the infant’s mouth and nose over 1—1.5 s, sufficient to make the chest visibly rise
• Take another breath and repeat this sequencefive times
BreathingNo effective breathing:- the airway may be obstructed
• Open the child’s mouth and remove any visible obstruction.
• Ensure that there is adequate head tilt and chin lift,try the jaw thrust method
• Make up to five attempts to achieve effective breaths; if still unsuccessful, move on to chestcompressions
Breathing, circulation
• look for signs of a circulation any movement, coughing normal breathing=circulation is
present (not agonal gasps, which are infrequent, irregular
breaths)
Basic life support
• Chest compressions– To 1. year 2 fingers (2 thumbs circular)– Over 1. yer one hand/two hands– Low part of sternum– Thumb over processus xiphoideus– Compression by 1/3 of antero-posterior
distance– AED– Children > 1 year– Smaller size of pads for children to 8 years– 50 – 75 J (4 J/kg)
Chest compression
Chest compressions
• to depress the sternum by approximately one third of the depth of the chest
• and repeat at a rate of about 100 min−1
Chest compressions : breaths
30:2
AED IN CHILDREN
• Age > 8 years• use adult AED
• Age 1-8 years• use paediatric
pads / settings if available (otherwise use adult mode)
• Age < 1 year• use only if
manufacturer instructions indicate it is safe
AED DEFIBRILLATION
ATTACH PADS TO CASUALTY’S BARE CHEST
ANALYSING RHYTHM - DO NOT TOUCH VICTIM
SHOCK INDICATED
• Stand clear• Deliver shock
SHOCK DELIVERED FOLLOW AED INSTRUCTIONS
30 2
Recovery position
Approach safely
5 rescue breaths
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest cmpressions
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
Attach AED
Follow voice prompts
Anatomical diferencies of airwais by children
Postresuscitation care
• Aproppriate tissue perfusion• Cooling – if unconsiousness after
CPR– 32 – 34°C of body core 12 – 24 hours– Warming 0,25 – 0,5°C / hour– AE- infection, koagulopathy, glykémia,
ións, circulation– Avoid hyperthermia - antipyretics
ETICS and CPR
• Start – not start• Parents´presens during CPR
• Decision to stp CPR- team leader, not parents
CPR of newborn
Newborn resuscitation• Lungs distension- ambu- bag with face mask,
in term newborn f: 30-60/minif bradycardia persists - increase oxygen concentration
• Mecónium – desuflation by weak newborns• Compressions- breathing ratio 3:1
90 compressionsií and 30 breaths• Adrenalín, if despite art. Vent.with O2 bradycardia
<60/mindose 0,01-0,03 mg/kg i.v., into ETT 5-7 x more
• Check HR every 30 sekúnd, STOP if HR > 60/min• Circulation support evective only by lungs
distension • Temperature of body core maintenance
Foreign body airway obstruction
– Combination of methods needed– 5 hits back blows– 5 chest compressions (till 1year) /
abdominal thrusts over 1 year– Horisontal rib´s position – abdominal organs
damage risk
ANY QUESTIONS?