Algorithm Approach to ACLS Emergencies 高級心臟救命術聯合委員會 林口長庚醫院急診醫學科
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Transcript Algorithm Approach to ACLS Emergencies 高級心臟救命術聯合委員會 林口長庚醫院急診醫學科
Algorithm Approach to ACLS
Emergencies
高級心臟救命術聯合委員會
林口長庚醫院急診醫學科
陳日昌
Key Principles in the
Application of ACLS
The
Importance of Time
The "Periarrest" Period
Never Forget the Patient
Code Organization
Primary
and Secondary ABCD Surveys
Primary ABCD Survey
Airway:
with noninvasive techniques.
Breathing: with positive-pressure
ventilations
Circulation: CPR until an AED
Defibrillation: assessing the cardiac
rhythm for VF/VT and providing
defibrillatory shocks
Secondary ABCD Survey
Airway: Advanced
rescuers manage a
compromised airway by placing a
tracheal tube.
Secondary ABCD Survey
Breathing: Assess
adequacy of breathing
and ventilation by checking tube
placement and performance; correct all
problems detected. Manage breathing by
treating inadequate ventilation with
positive-pressure ventilations through the
tube
Secondary ABCD Survey
Circulation: Assess
and manage the
circulation of blood and delivery of
medications by —Starting a peripheral
IV line —Attaching ECG leads to
examine the ECG for the most frequent
cardiac arrest rhythms (VF, pulseless VT,
asystole, and PEA) —Administering
appropriate rhythm-based medications
Secondary ABCD Survey
Differential
Diagnosis: Assess and
manage the differential diagnoses that
you develop as you search for, find, and
treat reversible causes
Understanding the Algorithm
Approach to ACLS
Observation:
series of decision-making
points or "decision nodes."
Action: identify the problems present at
the decision node and then select the
proper action to take
The Structure of the Algorithms
Observational
boxes: curved corners
Action boxes: square corners
BLS algorithm
Check
responsiveness
Open the airway
Check breathing
Give 2 effective breaths
Assess circulation
Compress chest (no signs of circulation
detected)
All cardiac arrest victims
VF/VT
rhythms
Non-VF rhythms
asystole and PEA
All cardiac arrest victims
receive the same 4 treatments
CPR
Tracheal
intubation
Vasoconstrictors
Antiarrhythmics
International ACLS Algorithms
ILCOR
Universal/International ACLS
Algorithm
Comprehensive ECC Algorithm
VF/Pulseless VT Algorithm
Pulseless Electrical Activity Algorithm
Asystole: The Silent Heart Algorithm
Bradycardia Algorithm