Advanced Cardiac Life Support (ACLS) | Mackenzie Thompson | Skillshare
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48 Lessons (1h 55m)
    • 1. Introduction to ACLS

      3:50
    • 2. Initial Assessment

      0:59
    • 3. Basic Life Support

      1:12
    • 4. Initiating the Chain of Survival

      1:52
    • 5. 2015 BLS Guideline Changes

      5:26
    • 6. 2010 BLS Guideline Changes

      2:35
    • 7. One Rescuer BLS and CPR for Adults

      2:39
    • 8. Two Rescuer BLS and CPR for Adults

      2:27
    • 9. Adult Mouth to Mask Ventilation

      1:24
    • 10. Adult Bag Mask Ventilation in Two Rescuer CPR

      1:08
    • 11. Normal Heart Anatomy for ACLS

      2:11
    • 12. Normal Heart Physiology for ACLS

      2:13
    • 13. The ACLS Survey

      2:32
    • 14. Airway Management

      1:49
    • 15. Basic Airway Adjuncts

      3:07
    • 16. Basic Airway Techniques

      2:50
    • 17. Advanced Airway Adjuncts

      2:18
    • 18. Routes of Access

      2:22
    • 19. Pharmacological Tools

      0:58
    • 20. Principles of Early Defibrilation

      2:47
    • 21. Keys to Using an AED

      2:01
    • 22. Criteria to Apply AED and Basic AED Operation

      2:08
    • 23. Systems of Care

      1:23
    • 24. Cardiopulmonary Resuscitation

      1:54
    • 25. Post Cardiac Arrest Care

      2:29
    • 26. Acute Coronary Syndrome

      2:33
    • 27. Acute Stroke

      2:36
    • 28. The Resuscitation Team

      2:09
    • 29. Education, Implementation, Teams

      2:24
    • 30. Respiratory Arrest

      3:46
    • 31. Ventricular Fibrillation and Pulseless Ventricular Tachycardia

      3:42
    • 32. Pulseless Electrical Activity and Asystole

      3:49
    • 33. Adult Cardiac Arrest Algorithm

      2:49
    • 34. Post Cardiac Arrest Care

      2:30
    • 35. Symptomatic Bradycardia

      5:23
    • 36. Tachycardia

      1:15
    • 37. Symptomatic Tachycardia

      3:19
    • 38. Stable and Unstable Tachycardia

      2:45
    • 39. Acute Coronary Syndrome

      2:45
    • 40. Acute Stroke

      5:05
    • 41. Adult 1 Person BLS

      1:39
    • 42. Adult 2 Person BLS

      1:41
    • 43. Adult Airway

      0:29
    • 44. Infant 1 Person BLS

      1:33
    • 45. Infant 2 Person BLS

      1:41
    • 46. Infant Airway

      0:21
    • 47. Airway Management

      2:52
    • 48. Who is NHCPS?

      1:08

About This Class

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Advanced Cardiac Life Support (ACLS) will prepare you to respond to life-threatening emergencies in the adult population with advanced interventions. This ACLS course is based on the latest guidelines which focus on doing several tasks simultaneously with a group process that enables efficiency and minimization of error.

This course will teach participants how to perform advanced emergency interventions as well as review foundation theories including Basic Life Support, Anatomy and Physiology of the Heart, the Resuscitation Team, a Systematic Approach, Life-Threatening Issues, Medical Devices, Bradycardia, Tachycardia, and much more.

The course package includes:

  • ACLS PDF handbook
  • ACLS Self-Assessments and Review Questions
  • ACLS Lectures and Video Presentations
  • Optional FREE Certification Available: This course is for training in Advanced Cardiac Life Support (ACLS). If you would like to be certified please visit https://nhcps.com/mooc-life-saving-course/.

If you want to stay up to date on my newest classes, be sure to click “Follow” below. I also share resources, and my followers are the first to hear about these opportunities!

Transcripts

1. Introduction to ACLS: Chapter one introduction to a C. L s. Welcome to a C. L s. The Advanced Cardiovascular Life Support, or a C. L s is a Siris of evidence based responses simple enough to be committed to memory and recalled under moments of stress. The's A. C. L s protocols have been developed through research, patient case studies, clinical studies and opinions of experts in the field. The gold standard in the United States and other countries is the course curriculum published by the American Heart Association, or H A. Previously the A H A released periodic updates to their cardiopulmonary resuscitation, or CPR, and emergency cardiovascular Care, or E. C. C. Guidelines on a five year cycle, with the most recent update published in 2015. Moving forward the A H A will no longer wait five years between updates. Instead, it will maintain the most up to date recommendations online at e. C. C. Guidelines dot heart dot org's Health care providers. Air recommended to supplement the materials presented in this video, Siri's and the corresponding manuals, with the guidelines published by the A. H. A and refer to the most current interventions and rationales throughout their study, of a C L s. While a CLS providers should always be mindful of timeliness, it is important to provide the intervention that most appropriately fits the needs of the individual. Proper utilization of a CLS requires rapid and accurate assessment of the individuals condition. This not only applies to the providers initial assessment oven individual in distress, but also to the reassessment throughout the course of treatment with a C l s a. C. L s protocols. Assume that the provider may not have all of the information needed from the individual or all of the resource is needed to properly use a C. L s. In all cases. For example, if a provider is utilizing a C. L s on the side of the road, they will not have access to sophisticated devices to measure breathing or arterial blood pressure. Nevertheless, in such situations, a CLS providers have the framework to provide the best possible care in the given circumstances. A. C. L s algorithms are based on past performances and result in similar life threatening cases , and are intended to achieve the best possible outcome for the individual during emergencies . The foundation of all algorithms involves the systematic approach of the BLS survey and the A. C. L s survey using steps A B C D that you will find later in this video. Siri's please refer to the Basic Life Support Provider Handbook and corresponding videos. Also presented by the Save A Life Initiative for a more comprehensive review of the BLS survey. This video, Siri's and its corresponding manual specifically covers a CLS algorithms and only briefly describes BLS. All A. C. L s providers are presumed capable of performing BLS correctly. This concludes introduction to a C. L s. Next, we will review a C. L s initial assessment. 2. Initial Assessment : Chapter two. The initial assessment. Welcome to the lesson on a CPL s initial assessment. In this video, we'll discuss determining the consciousness and unconsciousness of an individual. Determining whether an individual is conscious or unconscious can be done very quickly. If he noticed someone in distress lying down in a public place or possibly injured, call out to them. Make sure the seem to safe before approaching the individual and conducting the BLS for a C . L s survey when encountering an individual who is down. The first assessment to make is whether they're conscious or unconscious. If the individual is unconscious, then start with the BLS survey and move on to the A C. L s survey. If they're conscious and start the A c. L s survey, this concludes our lesson on a C. L s initial assessment. Next, we'll review basic life support 3. Basic Life Support: Chapter three Basic Life Support. Welcome to the overview on basic Life support. In this video, we'll briefly discuss the general concept of basic life support. The A J has updated the Basic Life Support, or BLS course over the years, as new research and cardiac care has become available, cardiac arrest continues to be a leading cause of death in the United States. BLS guidelines have changed dramatically, and the elements of BLS continue to be some of the most important steps in initial treatment. General concepts of BLS include the chain of survival, high quality chest compressions for adults, Children and infants. E d use rescue, breathing, treating, choking and teamwork for adult BLS algorithms. Please refer to figures three and seven in your corresponding manual. This concludes our overview on basic life support. Next will review initiating the chain of survival. 4. Initiating the Chain of Survival: welcome to the lesson on initiating the chain of survival in this video. We'll we'll learn about the BLS adult and pediatric chains of survival. Early initiation of BLS has been shown to increase the probability of survival for an individual dealing with cardiac arrest. To increase the odds of surviving a cardiac event, you should follow the steps in the adult chain of survival. The first step in the adult chain of survival is to recognize symptoms and activate E. M s next perform earliest DPR, then defibrillate with a D. Once the M S team arrives, they'll provide advanced life support to the individual. When the individual becomes stable and is taken to the hospital, they'll receive post cardiac arrest care. Now let's review the pediatric chain of survival. Emergencies in Children and infants are not usually caused by the heart. Children and infants most often have breathing problems that triggered cardiac arrest. The first and most important step of the pediatric chain of survival is prevention. This means if you come across a child or infant who's experiencing breathing problems, take immediate action. In the case of the heart does stop perform high quality CPR. They're still in responsible for performing CPR, Then activate E m s. Then the E. M s team will perform advanced life support after their stable and taken to the hospital. They will receive post cardiac arrest care. This concludes our Lisbon on initiating the chain of survival. Next will review the 2015 BLS guideline changes. 5. 2015 BLS Guideline Changes: Welcome to the lesson on 2015 BLS guideline changes In this video, we will discuss the recent BLS guideline changes that were made in 2015 by the American Heart Association, or A H A, which updates its guidelines every five years on cardiopulmonary resuscitation, more CPR and emergency cardiovascular Care or E. C. C. In 2015 the A H A update on its E. C. C. Guidelines strengthened some of the recommendations made in 2010. Here is a summary of the changes made to 2015 BLS guidelines. The 2010 sequence change from airway breathing compressions were ABC two compressions airway breathing were C A B remains in the 2015 update. The early initiation of chest compressions resulted in improved outcomes. Previously, as a rescuer or a provider, you may have been faced with the choice of leaving the individual to activate E. M s. Nowadays, you are more likely to have a cell phone, often with speakerphone capabilities. The 2015 BLS guidelines encourage you to use a speakerphone or other hands free device, allowing yourself to continue rendering aid while communicating with the E M s dispatcher. The 2015 update also suggests that if you are on untrained rescuer or provider, you should initiate hands only CPR under the direction of E. M. F's dispatcher as soon as the individual is identified as unresponsive. Meanwhile, if you are a trained rescuer or provider, you should continue to provide CPR with rescue breaths in situations where unresponsiveness is thought to be from narcotic overdose. As a trained BLS rescuer, you may administer naloxone via the intra nasal or intra muscular route. If the drug is available for individuals without a pulse, administer the drug after CPR is initiated in cardiac arrest. Use the defibrillator as soon responsible and resume chest compressions as soon as the shock is delivered by phasing defibrillators air more effective in terminating life threatening rhythms and their preferred to older mono facing defibrillators. Energy settings of defibrillators vary by manufacturer, so you should follow the device. Specific guidelines for cardiac arrests that is suspected to be caused by coronary artery blockage perform angiography. Emergent lee. Standard dose of epinephrine that is one milligram every 3 to 5 minutes is the preferred phase oppressor, high dose, separate, different and vasopressin have not been shown to be more effective and therefore are not recommended. Maintain constant target temperature between 32 to 36 degrees Celsius for at least 24 hours in the hospital environment. Routine cooling of individuals in the pre hospital environment is not recommended. The 2015 guidelines also emphasize on the importance of high quality chest compressions with enhanced recommendations for maximum rates and depths. To perform high quality chest compressions, keep the following in mind. Chest compressions should be 100 to 120 per minute because compressions faster than 120 per minute may not allow for cardiac refill and reduce profusion. Additionally, you should deliver compressions to adults at a depth between two and 2.4 inches. That is 5 to 6 centimeters because compressions at a greater depth may result in injury to vital organs without increasing odds of survival. For Children, that is less than one year old. Deliver at a depth between 1.5 to 3 inches that is 4 to 5 centimeters. Be sure to allow for full chest recoil between compressions to promote cardiac filling because it is difficult to accurately judge quality of chest Compressions on audio visual feedback device may be used to optimize delivery of CPR during resuscitation. Interruptions of chest compressions, including pre and post E D shocks, should be a short, responsible compression to ventilation ratio remains 32 2 for individuals without on advanced airway in place for individuals with an advanced airway in place, you should provide uninterrupted chest compressions with ventilation is at a rate of one every six seconds. For further details or an in depth review of 2015 guideline changes, please refer to the HHS Executive summary document. This concludes our lesson on 2015. BLS guideline changes. Next, we will review 2010 BLS guideline changes. 6. 2010 BLS Guideline Changes: Welcome to the lesson on 2010 BLS guideline changes In this video, we will summarise the A H. A change is to be a less guidelines in 2010. Previously, the initial steps were airway breathing compressions or ABC. The literature indicates that starting compressions early in the process will increase survival rates. Therefore, the steps were changed to compressions, airway breathing or C A B. This encourages early CPR and avoids bystanders, interpreting agonal breathing as signs of life and withholding CPR. Look, listen and feel for breathing was no longer recommended. Instead of assessing the individuals, breathing begins CPR. If they are not breathing or only gasping for breath, have no pulse or, if you are unsure or are unresponsive, do not perform on initial assessment of respirations. The goal is early delivery of chest compressions to cardiac arrest. Individuals cry quid. Pressure was no longer routinely performed. Pulse checks were shorter. I feel for a pulse for 10 seconds. If a pulse is absent or if you are not sure you feel a pulse, then begin compressions For infants. Use a manual defibrillator if available. If not, then use an E. D with pediatric dose attenuate er for infants. If anay e d with those attenuate er is not available, then use an adult e d, even for an infant. High quality CPR consists of the following compression rates of 100 to 120 beats per minute for all individuals. Compression depth between 2 to 2.4 inches for adults and Children and about 1.5 inches for infants. Allowing complete chest recoil after each compression, minimizing interruptions and CPR, except to use an A E d or to change rescuer positions. Do not over ventilate. Provide CPR as a team when possible. This concludes our lesson on 2010. BLS guideline changes. Next, we will review one rescuer, BLS and CPR for adults. 7. One Rescuer BLS and CPR for Adults: Chapter two Bill s for adults. Welcome to the one Rescuer Bill s CPR for adults. In this video, we will discuss the one rescuer BLS process in CPR steps. The general adult BLS process is to ensure safety of the scene, assess the injured or ill individual, activate PMS by calling 911 Performed CPR and defibrillator. Now let's review the CPR steps. Start CPR by checking for corroded polls on the side of the neck. Fuel for the pools for no more than 10 seconds. If you are not sure that you feel a pools to begin CPR with a cycle of 30 chest compressions and two breaths. Next, place the heel of one hand on the lower half the sternum in the middle of the chest. Then put your other hand on top of the first hand, then straighten your arms. Impressed straight down. Remember that compression should be at least two inches into the chest, but no more than 2.4 inches at a rate of 100 to 120 compressions a minute. Make sure that between each compression, you completely stop pressing on the chest and allow the chest wall to retain to its natural position. Do not lean or rest on the chest between compressions that can keep the heart from refilling blood between each compression. Stop after 30 compressions. Open the airway by using the head tilt chin lift maneuver. Put your hand on their forehead until the head back, then use your index and middle fingers on the lower jaw toe. Lift up the job. Do not do the head tilt chin lift maneuver. If you think the individual may have a neck injury in this case, use the jaw thrust maneuver. Use your index and middle fingers to lift up on both sides of the lower jaw. Next, give a breath while watching their chest rise up. Repeat while giving the second breath. The's breaths should be delivered for one second each. Resumed chest compressions. This concludes our lesson on one rescuer, BLS and CPR for adults. Next, we will review to rescue a BLS and CPR for adults 8. Two Rescuer BLS and CPR for Adults: welcome to the to rescue a BLS and CPR for adults. In this video, we'll discuss the to rescue Reveal S process and CPR steps. Many times there'll be a second person available who can act as a rescuer. The H A emphasizes that cell phones are available everywhere now, and most have a built in speaker. Phone directly second rescuer to call 911 without leaving the person while you begin CPR. This second rescuer can also find in a D while you stay with the individual. When the second rescuer returns, the CPR tasks could be shared. The steps for CPR are similar between one rescuer and to rescuer BLS. However, there are some slight differences. Let's review the to rescue her CPR steps for the first step, Have the second rescuer retrieve the A D and prepared for use next delivered chest compressions, counting out loud, Then have the second rescuer apply the A D pants After the first rescuer delivers 30 chest compressions. Have the second rescuer open the individuals airway and give to rescue breaths. Continue the CPR cycles of 30 compressions, followed by two breaths. Switch positions every five cycles. One cycle consists of 30 compressions and two breaths. Be sure that between each compression, you completely stop pressing on the chest and allow the chest wall to return to its natural position. Leaning or resting on the chest between compressions can keep the heart from refilling in between each compression. Make CPR less effective. Rescuers become tired. May tend to lean on the chest more during compressions. Switching roles helps rescuers perform high quality compressions. Try to minimize interruptions in CPR by switching positions while the E. D analyzes the heart rhythm. If a shock is indicated, minimize interruptions in CPR. Resume CPR as soon as possible. This concludes our lesson on to rescuer BLS and CPR for adults. Next, we'll review the adult mouth to mask ventilation. 9. Adult Mouth to Mask Ventilation: welcome to the adult mouth to mask ventilation. In this video, we will discuss the use of a mask to deliver breaths in one rescuer. CPR breaths should be supplied using a pocket mask. If it's available. First, give 30 high quality chest compressions. Next, Seal the mask against the individual's face by placing four fingers of one hand across the top of the mask and placed the thumb of the other hand along the bottom edge of the mask. Using the fingers of your hand on the bottom of the mask, open the airway using the head tilt chin lift maneuver unless you suspect that the individual may have a spine injury. If there's a chance the individual has a spine injury, then use the jaw thrust maneuver to open the airway. Press firmly around the edges of the mask and ventilate by delivering a breath for over one second. As you watch the individuals chest rise. Practice using the bag valve mask as it is essential to forming a tight seal and delivering effective breaths. This concludes our lesson on adult mouth to mask ventilation. Next, we will review adult bag mask ventilation 10. Adult Bag Mask Ventilation in Two Rescuer CPR: welcome to the adult bag mask ventilation. In this video, we'll discuss the use use of a bag mask to deliver breaths in to rescue her CPR. If to providers or rescuers are present and a bag mask devices available, the second rescuer is positioned at the individual's head, while the other rescuer performs high quality chest compressions. Begin by delivering 30 high quality chest compressions, counting them out loud. The second rescuer holds the bag mask with one hand, using the thumb and index finger in the shape of a sea on one side of the mask. This forms a tight seal between the mask and the individual's face using the other pan. The second rescuer opens the airway by lifting the jaw. Finally, the second rescuer gives two breaths for one second each. This concludes our lesson on adult bag mask ventilation in to rescue CPR. Next will review normal heart anatomy 11. Normal Heart Anatomy for ACLS: Chapter four Advanced Cardiac Life support. Welcome to the less S and on normal heart Anatomy for a C. L s. In this video, we'll discuss the normal cardiac anatomy, which will help understand physiology in the next video. The heart is a hollow muscle, comprised of four chambers that are all surrounded by thick walls of tissue called septum. The two upper chambers are the atria, and the two lower chambers are the ventricles. The right and the left halves of the heart work together to pump blood throughout the body . The right atrium receives blood from the body and sends it to the right ventricle to be sent to the lungs for oxygenation. The left atrium received the newly oxygenated blood and sends it to the left ventricle to be sent throughout the rest of the body. Balance between each chamber prevent reverse blood flow. Blood leaves the heart for a large vessel called the aorta. The two atria contract simultaneously, as do the metric ALS, making the contractions of the heart go from top to bottom. Each beat begins in the right atrium. The left ventricle is the largest and has the thickest wall as it's responsible for pumping the newly oxygenated blood to the rest of the body. The electrical pathways of the heart begin in the Sino atrial, or s a note in the right atrium. Together they created the electrical activity that acts is the heart's natural pacemaker. This electrical impulse then travels to the atrial ventricular, or a V node, which lies between the atria and the ventricles. After pausing briefly, theological impulse moves to the his per Kinji system, which acts as wiring to conduct the electrical signal into the left and the right ventricles. This electrical signal causes the heart muscle to contract and pump blood. This concludes the normal heart anatomy for a C. L s. Next, we'll review the normal heart physiology for a C. L s. 12. Normal Heart Physiology for ACLS: welcome to the lesson on normal heart physiology for a C. L s. In this video, we will discuss the normal electrical pathways of the heart. Understanding the normal electrical function of the heart helps understand the abnormal functions. When blood enters the atria of the heart on electrical impulse that is sent from the S, a node conducts through the atria, resulting in atrial contraction which registers as the P wave on an electro cardiograms or E c G strip. This impulse then travels to the A V node, which in turn conducts the electrical imposed through the bundle of hiss bundle branches and the Perkin gee fibers of ventricles, causing ventricular contraction. The time between the start of the atrial contraction and the start of ventricular contraction registers as the P R interval on an E. C G strip. The ventricular contraction registers as the Q. R s complex. Following ventricular contraction, the ventricles rest and re polarize, which registers as the T wave. The atria also re polarise, but this coincides with the QRS complex. Therefore it cannot be observed on the E C G Strip P Wave Q R s complex and the T wave together at proper intervals are indicative of normal Sinus rhythm or NSR, abnormalities. That air in the conduction system can cause delays in the transmission of the electrical impulse and are detected on the E C G. These deviations from normal conduction can result in dysrhythmia as such as heart books, applauses, Tackett, Guardia's and bradycardia as blocks and dropped beats. This concludes our lesson on normal heart physiology for a C l s. Next, we will review the A C. L s survey. 13. The ACLS Survey: Welcome to the lesson on the A. C. L s survey. In this video, we'll review you the A C L s survey, which follows the A B C D Pattern a stands for airway, which you should monitor and maintain open at all times. As a provider, you must decide if the benefit of adding an advanced airway outweighs the risk of pausing CPR. If the individuals chest is rising without using an advanced airway, continue giving CPR without pausing. However, if you're in a hospital or near trained professionals who can efficiently insert and use the airway, consider pausing CPR B stands for breathing in cardiac arrest. Administer 100% oxygen. Keep blood oxygen saturation or sets greater than or equal to 94% as measured by a pulse oximeter. Use quantitative way form Cap na graffiti when possible. Normal partial pressure of carbon dioxide is between 35 to 40 millimeters of mercury. High quality CPR should produce carbon dioxide between 10 to 20 millimeters of mercury. If the e. T. C 02 reading is less than 10 millimeters of mercury after 20 minutes of CPR for an intubated individual, then you may consider stopping resuscitation attempts. C stands for circulation obtained intravenous or ivy access when possible. Interoffice access or i O is also acceptable. Monitor blood pressure with a blood pressure cuff or intra arterial line. If available, monitor the heart rhythm using pads and a cardiac monitor. What using an e. D. Follow the directions that is Shaka Shaka were them. Give fluids when appropriate. Use cardiovascular medications. When indicated Last is D, which stands for differential diagnosis. Start with the most likely cause of the arrest and then assess for less likely conscious treat reversible causes and continue CPR As you create a differential diagnosis. Stop Onley briefly to confirm a diagnosis or treatment. Versatile causes. Minimizing interruptions in profusion is key. This concludes our lesson on the A. C. L s survey. Next, we'll review airway management. 14. Airway Management: Welcome to the lesson on airway management. In this video, we will briefly introduce you to basic and advanced airway equipment. If bag mask ventilation is adequate as a provider, you may differ Insertion of an advanced airway. You should make the decision as to the appropriateness of placing an advanced airway during the A. C. L s survey. The value of securing the airway must be balanced against the need to minimize the interruption in profusion that results in halting CPR during airway placement. Basic airway equipment includes the oral Pharyngeal Airway, where O. P. A. And the nasal Pharyngeal Airway, or M P A. The primary difference between an O. P. A and an M p A. Is that a no p A is placed in the mouth while on N. P. A. Is inserted through the nose. Both airway equipment terminate in the pharynx. The main advantage of an N P A. Over in O. P. A. Is that it can be used in either conscious or unconscious individuals because the device does not stimulate the gag reflex. Advanced airway equipment includes the Larrin Geo Mask, airway Lauren GL to Asafa GL, tracheal tube and endotracheal two different styles of these super GLAAD IQ airways are available. If it is within your scope of practice, you may use advanced airway equipment when appropriate and available. This concludes our lesson on airway management. Next, we will review basic airway add junks. 15. Basic Airway Adjuncts: Welcome to the lesson on basic airway. Add junks In this video, we will discuss when to use the three basic airway adjuncts or offering Geul airway nasal pharyngeal airway and sectioning. The oral pharyngeal airway, or O. P. A. Is a J shaped device that fits over the tongue toe. Hold the soft Hypo Fair NGO structures and the tongue away from the posterior wall of the pharynx. O P. A. Is used in individuals who are at risk for developing airway obstruction from the tongue or from relaxed upper airway muscle. Ah, properly sized and inserted Opie. A. Results in proper alignment with the Gladys opening if efforts to open the airway failed to provide and maintain a clear, unobstructed airway, then used the O. P. A. In unconscious individuals, you should not use an O P. A. In conscious or semi conscious individuals because it can stimulate gagging and vomiting and possibly aspiration. The key assessment is to check whether the individual has an intact cough and gag reflex. If so, then do not use in o p. A. The nasal pharyngeal airway or N P. A. Is a soft rubber or plastic uncuffed tube that provides a conduit for air flow between the Neary's and the pharynx. The MP A is used as an alternative to on O P. A in individuals who need a basic airway adjunct. Unlike the aural airway, NPS may be used unconscious or semi conscious individuals with intact cough and gag reflex . Use NPH when insertion of an O. P. A is technically difficult or dangerous, and p a placement can be facilitated by the use of a lubricant. Never force placement of the N P A as severe nosebleeds may occur. If it does not fit in one there, try the other side. Use caution or avoid placing MPs in individuals with obvious facial fractures. Sectioning is an essential component of maintaining a patent. Airway Providers should suction the airway immediately if there are copious secretions, blood or vomit Attempts that sectioning should not exceed 10 seconds. To avoid high poxy MIA. Follow sectioning attempts with a short period of 100% oxygen administration monitor the individual's heart rate, pulse, oxygen saturation and clinical appearance during sectioning. If you see a change in monitoring parameters than interrupt, sectioning and administer oxygen until the heart rate returns to normal and until clinical condition approves assist ventilation as warranted. This concludes our lesson on basic airway. Eh, Juckes? Next, we will review basic airway techniques. 16. Basic Airway Techniques: welcome to the lesson on basic airway techniques. In this video, we will discuss how to use the three basic airways, Oro, pharyngeal airway, nasal pharyngeal, airway and sectioning. When selecting an airway device. Keep in mind that too large oven airway device can damage the throat and too small of an airway device. Compress the tongue into the airway to insert an aural fair in GL Airway or O. P. A. First, clear the mouth of blood and secretions with suction. If possible, place the device at the side of the individual's face. Make sure to choose a device that extends from the corner of the mouth to the air lobe. Insert the device into the mouth so the point is toward the roof of the mouth or parallel to the teeth. Do not press the tongue back into the throat. Once the device is almost fully inserted, turn it until the tongue is cupped by the interior curve of the device. To insert a nasal pharyngeal airway or np a place the device at the side of the individual's face. Make sure to choose a device that extends from the tip of the nose to the air low use the largest diameter device that will fit. Lubricate the airway with a water soluble lubricant or anaesthetic jelly. Insert the device slowly into a nostril, moving straight into the face, not toward the brain. It should feel snug. Do not force the device into the nostril. If it feels stuck, then remove it and try the other nostril. Here are some tips on sectioning When sectioning the oral pharynx Do not insert the catheter too deeply. Extend the catheter to the maximum safe depth and section as you withdraw. When sectioning an E T tube. Remember, the tube is within the trachea and you may be sectioning near the bronc I or lung. Therefore, sterile techniques should be used. Each section attempt should be for no longer than 10 seconds. Remember, the individual will not get oxygen during sectioning. Monitor vital signs during sectioning and stop suctioning immediately. If the individual experiences high poxy mia, that is oxygen SATs. Less than 94% has a new arrhythmia or become cyanotic. This concludes our lesson on basic airway techniques. Next, we will review Advanced Airway, a Juckes 17. Advanced Airway Adjuncts: Welcome to the lesson on Advanced Airway. Add junks In this video, we will discuss advanced airway at junks and when to use them. Please keep in mind that when any advanced airway is placed, do not interrupt chest compressions. For breaths, give one breath every 6 to 8 seconds. The endotracheal, or E T. Tube, is an advanced airway alternative. It is a specific type of trachea tube that is inserted through the mouth or nose. It is the most technically difficult airway to place. However, it is the most secure airway available. Onley. Experienced providers should perform E T. Intubation. This technique requires the use of a LAURINDA Scope fiber optic, portable or endoscopes, have a video screen, improve success and are gaining popularity for field use. The Larrin Geo Mask Airway or L. M. A. Is an advanced airway alternative T E t intubation and provides comparable ventilation. It is acceptable to use the L. M. A as an alternative to an esophageal trachea tube for airway management. In cardiac arrest, experience will allow rapid placement of the Elem, A device by an A C. L s provider. The lettering GL tube advantages air similar to those of the esophageal trey kill two. However, the layering GL tube is more compact and less complicated to insert. This tube has only one larger balloon to inflate and can be inserted blindly. The if Soffa GL Trachea tube, which is sometimes referred to as a combat tube, is an advanced airway alternative to E. T. Intubation. This device provides adequate ventilation comparable to an E. T. To the Kamba tube has two separate balloons that must be inflated and two separate ports. As a provider, you must correctly determine which port to ventilate through to provide adequate oxygenation. This concludes our lesson on Advanced Airway at junks. Next, we will review routes of access. 18. Routes of Access: welcome to the lesson on routes of access. In this video, we will discuss the intravenous and intra Rossi s routes of access. Historically, in a CLS, providers have administered drugs via the intravenous or ivy or the endotracheal or E T route. E. T. Absorption of drugs is poor and optimal. Drug dose ing is unknown. Therefore, the Inter Ossetia's or Iot route is now preferred. When Ivy access is not available. Let's review the priorities for each route of access. The peripheral ivy is preferred for drug and fluid administration unless central line access is already available. Central line access is not necessary during most resuscitation attempts, as it may cause interruptions in CPR and complications during insertion. Placing a peripheral line does not require CPR interruption. If a drug is given via peripheral route of administration, then you should intravenously push Bullis injection unless otherwise indicated. Flush with 20 milliliters of fluid or saline and or raise extremity for 10 to 20 seconds to enhance delivery of drug to circulation. When using peripheral i v Route of administration drugs can take up to two minutes. Were more to reach central circulation. The effect of medications given May not be seen until even longer. High quality CPR help circulate thes drugs and is an important part of resuscitation. The I O route is used to deliver drugs and fluid safely and effectively during resuscitation. When I v access is not available, I o access can be used for all age. Groups can be placed in less than one minute and has more predictable absorption than the ET route. Keep in mind that any A C l s drug or fluid that can be administered intravenously can also be given Inter. Obviously, this concludes our lesson on routes of access. Next, we will review pharmacological tools. 19. Pharmacological Tools: Welcome to the lesson on pharmacological tools. In this video, we will briefly discuss pharmacological tools Table one in your corresponding A C. L s manual details, doses and routes and uses of common drugs. The use of any of these A C. L s medications should be done within your scope of practice and after thorough study of the actions and side effects. Table one only provides a brief reminder for those who are already knowledgeable in the use of these medications. Moreover, it contains only adult doses indication and routes of administration for the most common a CLS drugs. This concludes our lesson on pharmacological tools. Next, we will review principles of early defibrillation. 20. Principles of Early Defibrilation: Chapter five Principles of Early Defibrillation. Welcome to the overview on principles of early defibrillation. In this video, we will briefly discuss principles of early defibrillation. Earlier. The defibrillation occurs, the higher the survival rate when a fatal arrhythmia is present. CPR can provide a small amount of blood flow to the heart and the brain, but it cannot directly restore unorganized rhythm. The likelihood of restoring up refusing rhythm is optimized with immediate CPR and defibrillation. The purpose of defibrillation is to disrupt a chaotic rhythm and allow the heart's normal pacemakers to resume effective electrical activity. The appropriate energy dose is determined by the design of the defibrillator, mono physic or by face IQ. If you are using a mono physic defibrillator, give a single 360 tool shock, used the same energy dose on subsequent shocks by facing defibrillators, have a variety of wave forms and have been shown to be more effective for terminating a fatal arrhythmia. When using by phasing defibrillators, providers should use the manufacturer's recommended energy dose. Many by facing defibrillator manufacturers display the effective energy dose range on the face of the device. If the first shock does not terminate the arrhythmia. It may be reasonable to escalate the energy delivered if the defibrillator allows it to minimize interruptions and chest compressions during CPR. Continue CPR while the defibrillator is charging, Be sure to clear the individual by ensuring that oxygen is removed and that no one is touching the individual. Prior to delivering the shock immediately after the shock, resume CPR, beginning with chest compressions. Give CPR for two minutes. That is approximately five cycles. A cycle consists of 30 compressions, followed by two breaths for an individual without an advanced airway. Those individuals with an advanced airway device in place can be ventilated at a rate of one breath every 5 to 6 seconds, or 10 to 12 breaths per minute. This concludes our overview on principles of early defibrillation. Next, we will review keys to using an A E. D. 21. Keys to Using an AED: Welcome to the lesson on keys to using an E. D. In this video, we will review some key points for using an E. D. You're likely to find an automated external defibrillator or a D in the public spaces you visit. And E. D is both sophisticated and easy to use, providing life saving power in a user friendly device, which makes it useful for people who have never operated one. And for anyone in stressful scenarios. However, proper use of an A D is very important. Attach the pads to the upper right side and lower left side of the individuals chest. Once the pads are attached correctly, the device will read the heart rhythm. If the pads air not attached correctly, device will indicate so with prompts. Once the rhythm is analyzed, the device will direct you to shock the individual. If a shock is indicated, a shock deep polarizes all heart muscle cells at once attempting to organize its electrical activity. In other words, the shock is intended to reset the hearts abnormal electrical activity into a normal rhythm When using an e. D. Keep these key points in mind ashore. Oxygen is not flowing across the individuals chest when delivering shock, do not stop chest compressions for more than 10 seconds. When assessing the rhythm, stay clear of patient when delivering shock. Assess pulse after 1st 2 minutes of CPR. If the end tidal carbon dioxide is less than 10 millimeters of mercury during CPR, consider adding a vassal presser and improve chest compressions. Things concludes our lesson on keys to using an a d. Next, we'll review criteria to apply i e. D and basic e d operation. 22. Criteria to Apply AED and Basic AED Operation: welcome to the lesson on criteria to apply i e. D and basic A E d operation. In this video, we will review when you should use an A, E D and basic steps for using an A E. D. You should use an A e d. If the individual does not respond to shaking of shoulders or shouting at them. The individual is not breathing. Were breathing ineffectively. The corroded artery post cannot be detected. Now let's review the basic steps of using an eight he d first power on the e d. Choose adult or pediatric pads. Attach the pads to bare chest and make sure cables are connected. Be sure not to attach the pads over any medication patches and dried the chest if necessary . Place one pad on the upper right side and the other on the chest a few inches below the left arm. Clear the area to allow a E. D to read rhythm, which may take up to 15 seconds. If there is no rhythm in 15 seconds, restart CPR. If the A E. D indicates a shock is needed, clear the individual making sure no one is touching them and that the oxygen has been removed. Ensure visually that the individual is clear and shout clear. Press the shock button on the a e d. Immediately resume CPR starting with chest compressions. After two minutes of CPR analyzed the rhythm with a d D Continue to follow the e D prompts . This concludes our lesson on criteria to apply i e. D and basic a E d operations. Next, we will review systems of care. 23. Systems of Care: Chapter six Systems of Care. Welcome to the Overview on System Systems of Care in this video will briefly review what systems of care consists of the H. A guidelines describes systems of care as a separate, an important part of a C. L S provider training The's systems of care Describe the organization of professionals necessary to achieve the best possible result for a given individual circumstances. They include an overview of the ways life saving interventions should be organized to ensure their delivered efficiently and effectively. Hospitals, E. M s staff and communities that follow comprehensive systems of care demonstrate better outcomes for their patients than those who do not. Management of life threatening emergencies requires the integration of a multi disciplinary team that could involve rapid response teams or rt's cardiac arrest teams and intensive care specialists to increase survival rates. In fact, the 2015 guidelines update reflects research that shows that our Artie's improved outcomes . This concludes our overview on systems of care. Next, we'll review cardiopulmonary resuscitation 24. Cardiopulmonary Resuscitation: Welcome to the lesson on cardiopulmonary resuscitation. In this video video, we'll discuss performing CPR using the chain of survival. Successful cardiopulmonary resuscitation, or CPR, requires the use of it as a part of systems of care called the chain of survival. As with any chain, it's only as strong as its weakest link does. Everyone must strive to make sure each link is strong. For instance, community leaders can work to increase awareness of the signs and symptoms of cardiac arrest and make AIDS available in public places. E. M s crews must stay abreast of updates and innovations in resuscitation and home the skills required to deliver CPR quickly and effectively. Hospitals should be ready to receive patients in cardiac arrest and provide excellent care . Critical care and repre fusion centers should be staffed by experts and equipped with the latest technology. Early initiation of BLS has been shown to increase the probability of survival for an individual dealing with cardiac arrest. To increase the odds of surviving a cardiac event as a rescuer, you should follow the steps in the adult chain of survival. The first step in the adult chain of survival is to recognize symptoms and activate PMS. Next perform early. CBR then defibrillate with a D. Once the EMAs team arrives, they'll provide advanced life support to the individual in the individual, becomes stable and is taken to the hospital. They'll receive post cardiac arrest care. This concludes our lesson on cardiopulmonary resuscitation. Next, we'll review post cardiac arrest care. 25. Post Cardiac Arrest Care: Welcome to the lesson on post cardiac arrest care. In this video, we'll discuss the into the interventions that increase likelihood of survival. Integrated post cardiac arrest care is the last link in the adult chain of survival. The quality of this care is critical to providing resuscitated individuals with the best possible results. When the interventions below are provided, there is an increased likelihood of survival. In fact, the 2015 Guidelines Update recommends a focused debriefing of rescuers and or providers for the purpose of performance improvement. Now let's take a look at the post cardiac arrest care interventions. Therapeutic hypothermia is recommended for comatose individuals with return of spontaneous circulation. After a cardiac arrest event, you should cool the individual to 89.6 to 93.2 degrees Fahrenheit. That is 32 to 36 degrees Celsius for at least 24 hours. To optimize chemo dynamics and ventilation, 100% oxygen is acceptable for early intervention, but not for extended periods of time. Oxygen should be tight traded so that the individuals Paul socks symmetry is greater than 94%. To avoid oxygen toxicity, be sure not to over ventilate in order to avoid potential adverse hemo dynamic effects. Keep ventilation rates at 10 to 12 breaths per minute to achieve E T t 02 at 35 to 40 millimeters of Mercury I V fluids and vaso Active medications should be tight traded for him. Oh, dynamic stability. Perk you Tania's Coronary Intervention or PC I is preferred overthrown politics Individual should be taken by M s directly to a hospital that performs PC I. If the individual is delivered to a center that Onley delivers from politic, so they should be transferred to a center that offers PC I. If time permits neurological care assessment are key, especially when withdrawing care that his brain death to decrease false positive rates, you should obtain a specialty consultation to monitor neurologic signs and symptoms through the post resuscitation period. This concludes our lesson on post cardiac arrest care. Next, we'll review acute coronary syndrome 26. Acute Coronary Syndrome: Welcome to the lesson on acute coronary syndrome. In this video, we'll we'll discuss acute coronary syndrome care Using the stem e chain of survival for individuals with acute coronary syndrome or a CS proper care starts during the call TMS first responders must be aware of and look for signs of a CS. Quick diagnosis and treatment yield the best chance to preserve healthy heart tissue. It's very important that as a health care provider, you recognize individuals with potential A CS in order to initiate evaluation, appropriate triage and timely management. Stemming chain of survival begins with recognising symptoms and activating E. M s. Then the individual receives E. M s pre hospital care. Next they receive E d evidence based care, followed by re perfusion with PC I or fiber analytics. Lastly, the individual receives quality post m. I care The goals of ace guest treatment called for early CMS communication, which allows the emergency department personnel and cardiac catheterization lab and staff to prepare for the individual. Once the A. C s patient arrives at the receiving facility, established protocols should direct care, the shorter the time until re profusion, the greater the amount of heart tissue that can be saved and the more optimal the overall outcome. Major adverse cardiac events or Macy includes death and non fatal myocardial infarction. Life threatening complications of a CS include ventricular fibrillation, pulseless ventricular tachycardia, ready arrhythmias, cardiogenic shock and pulmonary oedema. E m s should have the capacity to perform E C gs unseen and on the way to the hospital. Receiving hospital should be made aware of possible A CS especially S T elevation, myocardial infarction, elevation or stem e and non S T elevation myocardial infarction. Or instead me refer to figure 16 in your corresponding a c. L s manual. For a brief summary of goals of a CS treatment. This concludes our lesson on acute coronary syndrome. Next review. Acute stroke. 27. Acute Stroke: Welcome to the lesson on acute stroke. In this video, we'll discuss US acute stroke, the stroke chain of survival and goals of acute stroke care. Outcomes for individuals with stroke have improved significantly due to the implementation of acute stroke system of care. The community is better equipped to recognize stroke as a brain attack, and there is greater awareness of the importance of medical care within one hour of symptom onset. Likewise, VMS systems have been enhanced transport individuals to regional stroke care centers that are equipped to administer fiber analytics. The stroke chain of survival suggests to first recognize symptoms and activate PMS and expects a timely E. M s response. Next, you should notify a stroke capable center and transport the individual to the center. At the stroke center, the individual receives guideline based stroke care. Lastly, they receive quality post stroke care. Stroke centers are equipped with resource is often not available at smaller community hospitals. The presence of specialists, including neurologists and stroke care specialists, multi disciplinary teams experienced in stroke care, advanced imaging modalities and other therapeutic options make transport to stroke centers the most suitable option. The goal of the stroke team emergency physician or other experts is to assess the individual with suspected stroke within 10 minutes. The eight dees of Stroke care highlight the major steps of diagnosis and treatment of stroke and key points at which delays can occur. Let's review the eight dees of stroke hair. First is detection, which is rapid recognition of stroke symptoms. Next is dispatch, which is the early activation and dispatch of VMS by 9 11 Delivery refers to Rapid E. M s, identification, management and transport Door. Refers to transport to stroke center. Data includes rapid triage evaluation and management, and E. D. Decision involves stroke expertise and therapy selection. Drug involves factor analytic therapy and intra arterial strategies. Lastly, this position is rapid admission of the stroke unit or critical care unit. This concludes our lesson on acute stroke. Next will review the resuscitation team. 28. The Resuscitation Team: Welcome to the lesson on the resuscitation team in this video rumor Review What makes up a resuscitation team and their roles as team members? The H A guidelines for a. C. L s highlight the importance of effective team dynamics during resuscitation in the community that is outside of health care facility. The first rescuer on the scene may be performing CPR alone. However, a code blue in a hospital may bring dozens of responders or providers to a patient's room. It is important to quickly and efficiently organized team members to effectively participate in a C. L s. The H A suggests a team structure, with each provider assuming a specific role during resuscitation. This consists of a team leader and several team members. As a team leader, you should organize the group monitor performance, be able to reform all the skills, direct team members and provide critique of group performance after the resuscitation effort. As a team member, you should understand your role clearly. Be willing, able and skilled to perform your role. I understand the pls sequences and be committed to the success of the team. Clear communication between team leaders and team members is essential it's important to know your own clinical limitations. Resuscitation is the time for implementing acquired skills, not trying new ones. Onley Take on tasks you can perform successfully clearly state when you need help and call for help early in the care of the individual resuscitation demands mutual respect, knowledge sharing, constructive criticism and follow discussion or debriefing after the event. Refer to figure 18 in your corresponding a C. L s manual for a brief time line of communication between team leader and team member during resuscitation. This concludes our lesson on the resuscitation team. Next will review education, implementation and teams. 29. Education, Implementation, Teams: welcome to the lesson on education implementation teams. In this video, we'll learn about teams formed for cardiac arrest events and the alert criteria they follow . Cardiac arrest care Onley. About 20% of the individuals who have a cardiac arrest inside a hospital will survive. This statistic prompted the development of a cardiac arrest system of care. Four out of five individuals with cardiopulmonary arrest have changes in vital signs prior to the arrest. Therefore, most individuals who eventually have a cardiac arrest showed signs of impending cardiac arrest. Survival rate could be improved if individuals are identified and treated with a C. L S protocols. Sooner. Originally specialized groups of responders within a hospital called cardiac arrest teams attended to a patient with recognized cardiac arrest. These teams responded to a code blue after someone presumably recognize an active cardiac arrest and sought help. Many believed cardiac arrest teams would improve survival rates, but the results were disappointing. Studies show that survival rates for the same in hospitals with cardiac arrest teams, as in those without a team. As a result, hospitals air replacing cardiac arrest teams with rapid response teams or rt's or medical emergency teams or M E T s. Rather than waiting for loss of consciousness and full cardiopulmonary arrest, our Artie's and M E T s closely monitor patients in order to treat them before the cardiac arrest occurs. These teams combined the efforts of nurses, physicians and family members exact an impending cardiac arrest. When hospitals implement Artie's or M E. T s. There are fewer cardiac arrests. Fewer I see you transfers improved survival rates and shorter lengths of in patients. Day alert criteria for RT's and M E T s include threatened airway or labored breathing. Altered mental status. Braddy cardio that is fewer than 40 beats per minute or tacking cardio. It is more than 100 beats per minute seizure, hypo tension or symptomatic hypertension in sudden and large decrease in urine output. This concludes our lesson on education, implementation and teams. Next we'll review respiratory arrest 30. Respiratory Arrest: Chapter seven A. C. L s cases. Welcome to the lesson on respiratory arrest. In this video, we'll discuss how to care for a respiratory arrest. Respiratory arrest is an emergent condition in which the individual is either not breathing or is breathing ineffectively. Individuals and respiratory arrest require immediate attention. There are many causes of respiratory arrest, including, but not limited to cardiac arrest or cardiogenic shock. Resuscitate individuals in apparent respiratory arrest using either BLS or a C. L s survey. BLS Survey advises to check for responsiveness, call E. M s and get e d. Check for responsiveness again and defib. Really figure 20 in your corresponding hcls manual Details the BLS survey. The A C L s survey follows the A B C D pattern in which you check for airway breathing circulation and differential diagnosis. Refer to figure 21. You're corresponding a. C. L s manual to further learn about the A. C. L s survey. When caring for individuals in respiratory arrest, he'd been mined. The two types of ventilation advanced and basic advanced ventilation includes a Self Asia trade deal to endotracheal tube, the NGO tube in the rain geo mask, airway basic ventilation include mouth to mouth or nose mouth, the bag, ventilation or offering Geul airway and nasal torrential airway. Although opiates and MPs are considered to be basic airways, they require proper placement by an experience provider. Advanced Airway insertion requires specialized training beyond the scope of a C. L s certification. While the placement of advanced airways require specialized training, all A C. L s providers should know the proper use of advanced airways once they're placed, regardless of airway type proper airway management is an important tool of a C. L s. CPR was performed with the individual lying on their back. Gravity causes the jaw, the tongue and the teachers of the throat to fall back and obstruct the airway. The airway rarely remains pooping in an unconscious individual without any external support . Therefore, you have to open the airway by lifting the chin upward while tilting the forehead back thistles known as the head tilt chin lift maneuver. The goal is to create a straighter path from the nose to the trachea. Individuals with suspected neck injury protect the cervical spine by performing the jaw thrust maneuver to open the airway, while standard practice in a suspected neck injury is two plates. A cervical collar. This should not be done in BLS or a C. L s. Cervical collars can compress the airway and interfere with resuscitation efforts. As a provider, you must ensure an open airway regardless of the basic airway use. It is your responsibility to stabilize the head or ask for assistance while maintaining control of the airway. During respiratory arrest care, Be sure not toe over ventilate. That is, give too many breaths per minute or two large volume per breath. Both can increase interest. Jurassic pressure decreased venous return to the heart diminished cardiac output. A swell as predisposed individuals to vomiting and aspiration of gastro intestinal contents . This concludes our lesson on respiratory arrest. Next, we'll review ventricular fibrillation and pulseless ventricular techie cardio. 31. Ventricular Fibrillation and Pulseless Ventricular Tachycardia: welcome to the lesson on ventricular fibrillation and pulseless ventricular tachycardia. In this video, we'll discuss ventricular fibrillation in and pulses, ventricular tachycardia and the rules to recognize each of them ventricular fibrillation or VF and pulses. Ventricular technique, cardia or VT are life threatening cardiac rhythms that results in ineffective ventricular contractions. BF is a rapid quivering of the ventricular walls that prevents them from pumping. Ventricular motion of VF is not synchronised with atrial contractions. V T is a condition in which the ventricles contract more than 100 times per minute. Emergency condition pulseless VT occurs in ventricular. Contraction is so rapid that there is no time for the heart to refill, resulting in undetectable pulse. In both cases, individual is not receiving adequate blood flow to the tissues despite being different pathological phenomena and having different E. C G rhythms. The A, C. L s management of E F and VT are essentially the same resuscitation for VF impulses. VT. Starts with a BLS survey and a D reads and analyzes the rhythm and determines if a shock is needed. The A D is programmed toe Onley prompt the user to shock V F and VT rhythms machine does not know if the individual has appalls or not. This is the primary reason you should not use an 80 in someone with a palpable pulse. A C. L s responses to VF impulses VT within a hospital will likely be conducted using a cardiac monitor. Emmanuel Defibrillator BF and pulses VT are both Shaka more rhythms. The 80 cannot tell if the individual has a pulse. Thus, as an A C. L s provider, you must read and analyze the rhythm. Onley deliver shocks for VF and pulses. VT Likewise, you may use anti arrhythmic drugs and drugs to support blood pressure rule trivia of include the regularity to have no shape of the cure s complex. Because all electrical activity is diagnosed, the rate appears rapid, but the disorganized electrical activity prevents the heart from pumping. There are no P waves or PR intervals present, and the ventricle complex varies. The rules for VT include R R intervals to be usually but not always regular. The atrial rate cannot be determined. Ventricular rate is usually between 1 52 50 beats per minute. QRS complexes are not preceded by P waves. There are occasionally P waves in the strip that they're not associated with. The ventricular rhythm peeper interval is not measured since this is eight ventricular rhythm QRS complex measures more than 0.12 seconds. Q r s will usually be wide bazaar. It's usually difficult to see a separation between the curious complex in the T. Wait. The rules for Tosa DuPont, which is irregular, wide complex tachycardia, include no regularity. Atrial rate could not be determined, and curricular rate is usually between 1 52 50 beats per minute. There are no P waves or PR intervals present in the ventricle. Complex varies. This concludes our lesson on ventricular fibrillation and pulses. Ventricular tachycardia. Next, we'll review pulseless electrical activity and assist early. 32. Pulseless Electrical Activity and Asystole: Welcome to the lesson on pulseless electrical activity and Assistant Lee. In this video, we'll discuss pulseless electrical activity and assist Ili and the rules to recognize each of them. Pulseless Electrical activity or P A and Assistant Lee are related cardiac rhythms and that they are both life threatening and uncrackable. A sisterly is a flat line E C G. There may be subtle movement away from baseline, which is considered drifting flatline, but there is no perceptible cardiac electrical activity. Always ensure that a reading of a sisterly is not a user or technical error. Make sure patches have good contact with the individual. Leads are connected. Gain is set appropriately in the power is on. P A is one of many wave forms by E. C. G, including Sinus rhythm without a detectable pulse. P A may include any pulses wave form, with the exception of VF, VT. Or a sisterly hi Po Valley. MIA and hypoxia are the two most common causes of P E A. They're also the most easily reversible and should be at the top of any differential diagnosis. If the individual has return of spontaneous circulation, are are OSC proceed to cardiac arrest care trippin is no longer recommended in cases of P a racist early. The rules for P A in a sisterly include the rhythm as a nearly flat line. There's no rate and there are no P waves present. The PR interval is unable to be measured due to know p waves. There are no cure s complexes present. Either you should owe it. Verify that our reading of a sisterly is not equipment failure. Make sure patches make good contact with the individual. All cables are connected, game is set appropriately and the power is on. The reversible causes of cardiac arrest are the ages and the teas. Ages include hyperbole. Mia hypoxia, H plus or acidosis, Hypo and hyper Cally, Mia Hypoglycemia and hypothermia. The tea's include tension, new Arthur X, Tampa nut toxins, coronary thrombosis, pulmonary thrombosis and unrecognized trauma. Now let's move on to drugs and dosages. Do not administer atra pain during P A or assistant, although there's no evidence that Atra pain has a detrimental effect turning Braddock Arctic or a systolic cardiac arrest routine use of atra pain during P A or Assistant Lee has not been shown. Debbie therapeutic benefits, therefore pH has removed at European from the cardiac arrest guidelines, you may only administer a standard dose of epinephrine or vasopressin. Preliminary research suggested that epinephrine in higher doses may produce improved results and resuscitation. However, research conducted after the 2010 guidelines publication failed to show any benefit over a standard dose of one milligram epinephrine. Likewise, the 2010 H A guidelines offered an alternative at suppressor called vasopressin, which could be used instead of or after the first dose happen effort. Subsequent research showed that vasopressin offered no benefit over standard dose epinephrine. Without a demonstration of superiority, both high dose epinephrine and vasopressin have been removed, simplifying the A C L s algorithm. This concludes our lesson on pulseless electrical activity and assist early. Next will review the adult cardiac arrest algorithm. 33. Adult Cardiac Arrest Algorithm: Welcome to the lesson on adult cardiac arrest algorithm. In this video, we'll review you the adult cardiac arrest algorithm for CPR quality. In short, the following push hard that is more than or equal to two inches and fast. That is more than 100 beats per minute and allow chest recoil. Minimize interruptions. Do not over ventilate. If there is no advanced airway, use 30 to 2 compression to ventilation ratio. Quantitative wave form kept na Griffey if e t. C 02 is less than 10 millimeters of mercury, attempt to improve CPR quality. Intra arterial pressure if diastolic pressure is less than 20 millimeters of mercury, attempt to improve CPR quality for shock energy. Ensure the following by facing delivery of energy during defibrillation has been shown to be more effective than older Monaf. Physic wave forms follow manufacturer recommendation, for example, Initial dose of 1 20 to 200 joules. If unknown, use maximum available. Second and subsequent doses should be equivalent in higher doses Should be considered. Monta Physic Should be 3 60 jewels. The return of spontaneous circulation. Note. The following return of pulse and blood pressure. Sudden sustained increase in P. T. C 02 typically more than or equal to 40 millimeters of mercury. Spontaneous arterial pressure waves with intra arterial monitoring for advanced airway. Note the following super glad IQ advanced airway or E T intubation wave form Cap Na graffiti to confirm and monitor ET tube placement 8 to 10 breaths per minute with continuous chest compressions. For drug therapy, ensure the following. Administer epinephrine dose intravenously or intra, obviously at one milligram every 3 to 5 minutes. Administer Ahmed our own dose intravenously or intra Cicely. First doses 300 milligram bolus second doses 1 50 milligram. Keep the following reversible causes in my hi Po Valley Mia Hypoxia H plus or acidosis, Hypothermia, Hypo and hyper Callie Mia Cardiac tamponade, Toxins, tension pneumothorax and pulmonary or coronary thrombosis for a full adult cardiac arrest algorithm referred to figure 29 in your corresponding a. C. L s manual. This concludes our lesson on adult cardiac arrest algorithm. Next, we'll review host cardiac arrest care 34. Post Cardiac Arrest Care: Welcome to the lesson on post cardiac arrest care. In this video, we'll discuss what what to do after cardiac arrest. Care if an individual has a return of spontaneous circulation or are OSC, start post cardiac arrest care immediately. Three. Initial BLS and A C. L s processes are meant to save an individual's life. While post cardiac arrest care is meant to optimize ventilation and circulation, preserve heart and brain tissue and function and maintain recommended blood glucose levels . Consider blood pressure support in any individual with systolic blood pressure. Less than 90 millimeters of mercury or mean arterial pressure, or M a p less than 65 unless contraindicated 1 to 2. Leaders of ivy, saline or lactating ringers is the first intervention. When blood pressure is very low. Consider vast oppressors, commonly referred to as oppressors. Epinephrine is the presser of choice for individuals who are not in cardiac arrest. The Open Meeting Final Ephron and Metaksa Me are alternatives Epinephrine. Nora Ephron effort is generally reserved for severe hypertension or as a last line agent, titrate the infusion rate to maintain the desired blood pressure. Hypothermia is the only documented intervention that improves and or enhances brain recovery after cardiac arrest. It could be performed in an unresponsive individual that is comatose and should be continued for at least 24 hours. The goal of induced hypothermia is to maintain a core body temperature between 89.6 to 93.2 degrees Fahrenheit. That is 32 to 36 degrees Celsius. Device manufacturers have developed several innovative technologies that improve the ability to effect and manage hypothermia in the post arrest. Individual hypothermia should be induced and monitored by trained professionals. Induced hypothermia should not affect the decision to perform her cue Tania's coronary Intervention or P C. I. Because concurrent PC I and hypothermia are reported to be feasible and safe for adult immediate post cardiac arrest care algorithm, please refer to figure 30 in your corresponding A C. L s manual. This concludes our less on post cardiac arrest care. Next, we'll review symptomatic bradycardia 35. Symptomatic Bradycardia: welcome to the lesson on symptomatic bradycardia. In this video, we'll discuss Braddock Cardia. It's symptoms and types of bradycardia. Bradycardia is defined as a heart rate of less than 60 beats per minute, while any heart rate less than 60 beats per minute. It's considered Braddock cardio. Not every individual bradycardia is symptomatic or having a pathological event. Individuals in excellent physical shape often have Sinus bradycardia. Symptomatic bradycardia may cause a number of signs and symptoms, including low blood pressure, pulmonary oedema and congestion, abnormal rhythm, justice, comfort, shortness of breath, lightheadedness and or confusion. Symptomatic bradycardia should be treated with the A C. L. A. Survey bradycardia is asymptomatic but occurs within arrhythmia. Listed below obtain a consultation from a cardiologists experienced in treating rhythm disorders. Symptoms of bradycardia include shortness of breath, altered mental status, hypertension, pulmonary oedema or congestion and weakness, dizziness or lightheadedness. We will review four types of bradycardia in this lesson, including Sinus bradycardia, first degree, a V block, second degree type one, a V block, which is also known as Wagenbach, and second degree type to a V block, which is also known as mo bits, too. And third degree, a V Block, which is also known as complete heart block. Sinus Bradycardia rules include R R intervals to be regular and overall rhythm to be regular. The rate is less than 60 beats per minute, but hugely more than 40 beats per minute. There is one P wave in front of every Curis in the appear uniform PR interval measures between 10.12 and 0.20 seconds in duration. And it's consistent. The cure s complex measures less than 0.12 seconds. First degree A V block rules include R R intervals to be regular, an overall rhythm to be regular. The rate depends on the underlying rhythm. There is one P wave in front of every cure us and they appear uniform. P R. Interval measures more than 0.2 seconds duration and is consistent. Curis complex measures less than 0.12 seconds. Second degree type one a V block or weapon. Bach rules include R R. Interval to be regular, but there is usually a pattern to it. The R R interval gets longer as the PR interval gets longer. The ventricular rate is usually slightly higher than the atrial rate. Who's some atrial beats not being conducted. The atrial rate is usually normal. P waves are upright and uniforms. Most complexes will have a P wave. In front of them, however, will be some that don't have a P wave. The PR interval gets progressively longer until there's a dropped QRS complex. Curious complex measures less and 0.12 seconds second degree type to a V block or bow bits to rules include the R R interval to be regular if there is consistent conduction ratio. If the conduction ratio is not constant, he R R interval will be irregular. The atrial rate is normal. The ventricular rate is slower, usually half to 1/3 slower than the atrial rate. P waves are upright and uniforms there is not. A cure s following Every P wave. Three p r. Interval can only be measured on conducted beats, and it's usually constant across the Strip. It may or may not be longer than a normal PR interval, which is 0.12 seconds. The cure is complex. Measures less than 0.12 seconds. Third degree A V block or complete heart block. Rules include R R, interval to be regular and PP interval to also be regular. The atrial rate is regular and normally 60 to 100. The rate of QRS complexes is dependent on the focus. If the focus is ventricular, rate will be 20 to 40. If the focus is junction, all rate will be 40 to 60 p. Waves are upright and uniforms. There's not a cure s following every P wave. The PR interval can only be measured. UN conducted beats and it's usually constant across the strip. It may or may not be longer than a normal PR interval, which is 0.12 seconds. The cure s complex interval maybe normal but is more likely to be prolonged. Here is a quick summary of all the symptomatic bradycardia. Sinus bradycardia is normal rhythm with slow first degree. A V block has PR interval longer than 0.2 seconds. Second degree type one A V block has PR interval increase in length until curious complexes dropped. Second degree type to a V block has PR interval same life with intermittently dropped Urs. Third degree A V block has PR interval and curious complex that are not coordinated with each other for adult breaded cardio with pulse algorithm referred to figure 36 in your correspondent A C. L s manual. This concludes our lesson on symptomatic bradycardia. Next review. Tacky cardio. 36. Tachycardia: Welcome to the overview on tacky cardio. In this video, we'll discuss tacky cardio, cardio and its symptoms. Tuckey Hardy A. Is a heart rate of greater than 100 beats per minute. When the heart beats too quickly, there is a shortened relax ation face. This causes two main problems. The ventricles are unable to fill completely, causing cardiac output to decrease, and the coronary arteries receive less blood, causing supply to the heart to decrease. Thank you. Cardia is classified as stable or unstable. Heart rates, greater than or equal to 150 beats per minute, usually cause symptoms unstable. Tacky cardio always requires prompt attention. Stable, tacky cardio can become unstable. Symptoms of tech cardio include hypertension, sweating, pulmonary oedema or congestion, jugular, venous distension, chest pain or discomfort, shortness of breath, weakness, dizziness or lightheadedness and altered mental state. This concludes our overview on tacky cardio. Next, we'll review symptomatic cardio 37. Symptomatic Tachycardia: Welcome to the lesson on symptomatic tachycardia. In this video, we'll just we'll discuss how to care for symptomatic. Tacky cardio symptomatic tachycardia refers to heart rate greater than 100 beats per minute to provide care for. Symptomatic that cardia follow these steps. However, if at any point you become uncertain or uncomfortable during the treatment of a stable individual, seek expert consultation. The treatment of stable individuals could be potentially harmful. Also keep in mind that a demon seen may cause broncho spasm. Therefore, Adina scene should given with caution to patients with asthma. If the individual is unstable, provide immediate synchronized cardioversion. Check if the tachycardia is producing hemo, dynamic instability and serious symptoms. Check if the symptoms such as pain and distress of acute myocardial infarction or AM I are producing the tachycardia. Assess the individuals Chemo Dynamic status by establishing an ivy, giving supplementary oxygen and monitoring the heart heart rate of 100 to 130 beats per minute is usually the result of underlying process and often represents Sinus tachycardia, in which the goal is to identify and treat the underlying systemic cause. Heart rate greater than 150 beats per minute may be symptomatic. The higher the rate, the more likely the symptoms air due to the tacky cardio. Assess The Cure X complex, which includes regular narrow, complex techie, cardio or probable S V T irregular, narrow, complex tachycardia or probable. A thin regular, wide complex tachycardia or probable VT and irregular wide complex tachycardia. To assess regular, narrow, complex tachycardia or probable S V T attempt Vagal maneuvers obtained 12 lead E. C. G and consider expert consultation. Administer six milligrams of Adina Zine via Rapid IVP. If there's no conversion, give 12 milligrams i v p. As a second dose, you may attempt 12 milligrams only ones to assess a regular narrow, complex tachycardia or probable a fib. Obtained. 12 lead E c. G. And consider expert consultation control rate. What they'll see is them at 15 to 20 milligrams. That is 200.25 milligrams per kilogram intravenously over two minutes or beta blockers to assess regular wide complex tachycardia or probable BT. Obtained. 12 lead E. C. G and consider expert consultation. Convert rhythm using amiodarone 150 milligrams intravenously over 10 minutes and perform elective cardioversion to assess a regular wide complex tachycardia obtained 12 lead E. C. G and consider expert consultation. Consider anti arrhythmic. If it's too said that want give magnesium sulfate 1 to 2 grams intravenously. You may follow with 0.5 to 1 gram over 60 minutes. This concludes our lesson on symptomatic tachycardia. Next, we'll review stable and unstable techie cardio. 38. Stable and Unstable Tachycardia: welcome to the lesson. Unstable and unstable. Tacky cardio in this video video will discuss Sinus tachycardia, atrial flutter, an atrial fib, relation and irregular, narrow, complex tachycardia or a fib. Sinus tachycardia Rules include R R intervals to be regular and overall rhythm to be regular. The rate is over 100 beats per minute, but usually less than 170 beats per minute. There is one P wave in front of every cure. S and P waves appear uniform. The PR interval measures between 0.12 and 0.2 seconds in duration and is consistent secure s complex measures less than 0.12 seconds. The atrial flutter rules include the atrial rate to be regular. The ventricular will usually be regular, but only if the A V node conducts the impulses in a consistent manner. Otherwise, the ventricular rate will be irregular. The atrial rate is normally between 2 50 to 3 50 Ventricular rate depends on conduction. Through the A V node to the ventricles, the P waves will be well defined and have a saw tooth pattern to them. Due to the unusual configuration P waves. The interval is not measured with atrial flutter. The cure is complex. Measures less than 0.12 seconds. The atrial fib relation and irregular, narrow, complex, tacky cardio or a fib. Rules include R R intervals to be a regular, they're over. Overall rhythm is irregularly irregular. Ventricles conduct from different atrial focus, causing the irregularity. The atrial rate usually exceeds 3 50 If the ventricular rate is between 60 and 100 beats per minute, this is known as controlled a fit. If the ventricular rate is more than 100 it's considered a fib with rapid ventricular response, or RVR, also known as uncontrolled a fib due to the atria firing so rapidly from multiple folk I there's no obvious P waves in the rhythm. The baseline appears chaotic because the atrial fibrillation and therefore no P waves air produced. Because there are no P waves, PR interval cannot be measured. The Cure X complex measures less than 0.12 seconds for adult tacky cardio with pulse algorithm referred to figure 40 corresponding A. C. L s manual. This concludes our lesson unstable and unstable. Tacky cardio. Next, we'll review acute coronary syndrome 39. Acute Coronary Syndrome: welcome to the lesson on acute coronary syndrome. In this video, we'll discuss acute acute coronary syndrome. It's symptoms and how to care for it. Acute coronary syndrome or a CS, is a collection of clinical presentations, including unstable angina, non S T elevation, myocardial infarction or, instead, me and S T elevation. Myocardial infarction, or stem E. A. CS is classically recognised by one or more of these symptoms. Crushing chest pain, shortness of breath, pain that radiates to the jaw, arm or shoulder, sweating and or nausea or vomiting. It's important to note that not all individuals with a CS will present with these classic findings, particularly women and individuals with diabetes mellitus, it's impossible to determine a specific cardiac event in the A. C S symptoms. Therefore, a CIA symptoms are managed in the same way. Every individual with these symptoms should be evaluated immediately. An individual appears to be unconscious. Begin with the BLS survey and follow the appropriate pathway for advanced care. If the individual is conscious, proceed with this pathway. Start with activating E. M s administer oxygen use four liters per minute, nasal cannula and titrate as needed. Mr. Aspirin, If there are no allergies. Give 1 62 3 25 milligrams Essay To chew, avoid coded s a administered nitro glycerine gift 0.32 point four milligrams sl or spray two doses at 3 to 5 minute intervals. Do not use if SBP is less than 90 millimeters of mercury. Do not use if fast food dye asterisks inhibitor like Viagra has been taken within 24 hours . Administer morphine. Give 1 to 5 milligrams intravenously. Onley if symptoms air not relieved by nitrates or if symptoms recur, Monitor blood pressure closely. 12. Lead E c g Evaluate the individual for M I by S T. Elevation or depression and poor are wave progression. Use a large gauge intravenously in anti cubicle fossa. Notify the hospital Take the individual to a PC I center. If probable stemming. Activate a CS protocol at the Hospital for acute coronary syndrome algorithm referred to figure 42 you're corresponding A C. L s manual. This concludes our lesson on acute coronary syndrome. Next, we'll review acute stroke 40. Acute Stroke: welcome to the lesson on acute stroke. In this video, we'll discuss acute stroke. It's it's symptoms and how to care for it. Stroke is a condition in which normal blood flow to the brain is interrupted. Strokes can occur in two variations. Ischemic and hemorrhagic. In ischemic stroke, a clot lodges in one of the brain's blood vessels, blocking blood flow through the blood vessel and hemorrhagic stroke. A blood vessel in the brain ruptures, spilling blood into the brain. Tissue. Ischemic stroke and hemorrhagic stroke account for 87% and 13% of the total incidents, respectively. In general, the symptoms of ischemic and hemorrhagic strokes are similar. However, the treatments are very different. Clinical signs of stroke depends on the region of the brain, effective by decreased or blocked blood flow. Signs and symptoms can include weakness or numbness of the face, arm or leg, difficulty walking, difficulty with balance, vision loss, slurred or absent speech, facial droop, headache, vomiting and change a level of consciousness. Not all of these symptoms are present, and the exam findings depend on the cerebral artery affected. The Cincinnati Pre Hospital Stroke Scale, or CPS s, is used to diagnose the presence of stroke in an individual. Physical findings such as Faysal Group Arm drift were abnormal speech are seen. Individuals with one of these three findings of the new event have a 72% probability of an ischemic stroke. If all three findings are present, the probability of an acute stroke is more than 85%. Becoming familiar and proficient with the tool utilized by the rescuers. VMS system is recommended. Mock scenarios and practice will facilitate the use of these valuable screening tools. Care for an individual with a stroke? Proceed with this pathway. Start with activating E. M s administer oxygen use 100% oxygen initially and titrate as needed. Perform finger stick procedure. Check glucose hyperglycemia can mimic acute stroke check History Determined precise time of symptom onset in the individual and witnesses examine the individual determined deficits such as gross motor, gross sensory and cranial nerves. Institute seizure precautions. It was a large gauge intravenously in the enter cubano fossa. Notify the hospital. Take the individual to a stroke center if possible. Individuals with ischemic stroke who are not candidates for fibre analytic therapy should receive aspirin unless contra indicated by true allergy that aspirin, all individuals within firms. Stroke should be admitted to neurologic intensive care unit if available before giving anything such as medication or food by mouth, he must perform a bedside swallow screening all acute stroke individuals are considered np o on admission. Stroke treatment includes blood pressure monitoring and regulation per protocol. Seizure precautions, frequent neurological checks, airway support as needed. Physical, occupational or speech therapy evaluation, body temperature and blood glucose Monitoring. Individuals who receive fiber Miletic therapy should be followed for signs of bleeding or hemorrhage. Certain individuals of age 18 to 79 years with mild to moderate stroke may be able to receive T P A or tissue plasminogen activator up to 4.5 hours after symptom onset. Under certain circumstances, intra arterial T P a. Is possible up to six hours after symptom onset. When the time of symptom onset is unknown, it's considered an automatic exclusion for T p. A. If time up symptom onset is known, the National Institute of Neurological Disorders and Stroke or any MPs has established the time goals. The N I N DS established Tom Goals advised the individual to have general assessment by expert an urgency T scan without contrast within 10 minutes of arrival within 25 minutes of arrival. Should perform a CT scan without contrast. Performing neurological assessment and read CT scan within 45 minutes within 60 minutes of arrival. You should evaluate criteria for using and administering fiber Analytic therapy or clot buster fibra in allergic therapy may be used within three hours of symptom onset or 4.5 hours in some cases within 180 minutes of arrival. The individual should be admitted to the stroke unit for details on emergency department staff. Referred to figure 45 corresponding. A. C. L s manual for acute stroke algorithm referred to figure 46 in your corresponding hcls manual. This concludes our lesson on acute stroke. Thank you for choosing NH CPS as your provider. 41. Adult 1 Person BLS: If the scene is safe, approach the victim and assess their responsiveness. Send another person toe. Activate the emergency response system and getting a D. If possible, Assess breathing and chuck corroded pulls. If the victim is not breathing or only gasping and has no pulse, begin CPR, starting with compressions. Perform 30 compressions at a rate of 100 to 120 compressions per minute at a depth of at least 1/3 the chest. For adults, this is at least two inches. Open the airway and deliver to breath, each lasting one second and watch for chest arise. Resume compressions. It is important to minimize interruptions and chest compressions to 10 seconds when the A D is brought to seen. Begin returning the device on. Remove any clothing from the victim and apply that a D pads plug in the connector and clear the victim while the A D analyzes the rhythm. If no shock is advice, resume CPR, beginning with chest compressions. If a shock is advice, clear the victim again before delivering the shock. Once the 80 has charged, hit the shock button after delivering the shock resume CPR, beginning with 30 chest compressions open the airway and deliver two breaths. Continue. At this race, you have 30 compressions to tuber us until the 80 prompt you to stop or further help arrives. 42. Adult 2 Person BLS: If the scene is safe, approach the victim and assess their responsiveness. Some the other person to activate the emergency response system and get an 80. Assess breathing and check the corroded pools. If the victim is not breathing or only gasping and has no polls. Begin CPR, starting with compressions. Perform 30 compressions at array of 100 to 120 compressions per minute at a depth of at least 1/3 the chest. For adults, this is at least two inches. Open the airway and deliver tuber us, each lasting one second and watch for chest arise. Resume compressions when the A. D is brought to seen. The second rescuer should begin by turning the device on. Remove any clothing from the victim and apply the A D pads, one below the right collarbone and the other to the side of the left nipple below the armpit. While the other rescuer continues performing CPR, plug in the connector and clear the victim, while the A D analyzes the rhythm. If a shock is advice, clear the victim again before delivering the shock once the A. G s chart hit the shock. But after delivering the shock resume CPR, beginning with 30 chest compressions. After the compressions, the second rescuer open, say airway and delivers two breaths. Continue CPR at this ratio of 30 compressions to two Brunt's until the 80 prompt you to stop or further help arrives. The rescuers should switch roles every two minutes or after five cycles of CPR. 43. Adult Airway: After performing compressions, you can perform the head tilt chin lift maneuver. Place one hand on the victim's forehead and the other on the chin. Tilt the head back and deliver to breath. Make sure to wash for chest arise. 44. Infant 1 Person BLS: if the scene ISI approached the victim and assess their responsiveness. Send another person to activate the emergency response system and getting a D. If possible, assess breathing and check the infants pulse. If the end is not breathing or only gasping and you can't find a pulse, begin CPR, starting with compressions. Perform 30 compressions at a rate of 100 to 120 compressions per minute at a depth of at least one through the chest. For infants, this is about 1.5 inches. When the A G is brought a scene, begin by turning the device on. Remove any clothing from the victim and apply the au de pads one on the front of them, thin chest in one on their back. Plug in the connector and clear the victim while the A D analyzes the rhythm. If no shock is advice, resume CPR, beginning with chest compressions. If a shock is advice, clear the victim again before delivering the shock. Once the A G has charged hit the shock. But after delivering the shop, resume CPR, beginning with 30 chest compressions, open the airway and deliver two breaths, each lasting one second watch for chest rice, begin again with 30 trust compression and continue at this ratio of 30 compressions to two breaths until the 80 prompt you to stop or further help arrives. 45. Infant 2 Person BLS: If the scene is safe, approach the victim and assess their responsiveness. Send the other person to activate the emergency response system and gain a D. Assess breathing and check the brake you Opal's. If the victim is not breathing or only gasping and has no polls, begin CPR, starting with compressions. Perform 30 compressions battery of 100 to 120 compressions per minute at a depth of at least 1/3 the chest. For infants, this is about 1.5 inches. Open the airway and deliver to breath, each lasting one second and watch for chest rise. Resume compressions when the A D is brought to seen. The second rescuer should begin by turning the device on. Remove any clothing from the victim and apply the I E. D pads. One on the front have been chest and one on their back, while the other rescuer continues performing CPR. Plug in the connector and clear the victim, while the A D analyzes the rhythm. If a shock is advised, clear the victim again before delivering the shock. Once the 80 has charged, hit the shock button after delivering the shock resume CPR, beginning with 15 chest compressions using then circling hand technique. After the compressions, the second rescuer opens the airway and delivers two breaths. Continue CPR at this ratio of 15 compressions to two breath until the 80 prompts you to stop or further help arrives the rescue issues, which rules every two minutes or after about five cycles of CPR. 46. Infant Airway: place one hand on the infant's forehead and the other on the chin. Tilt the head back to a neutral position and deliver two breaths. 47. Airway Management: airway management is a fundamental lifesaving skill. Your management of the airway depends upon your abilities, training and scope of practice. The best message of airway management will vary depending on patient condition, equipment available and skill level of the provider. The 1st 2 steps in any airway management response involved opening and clearing the airway . First, open the airway using a head tilt chin lift by placing one hand on the forehead and the other on the chin. Push with the palm to move the head back while lifting the jaw to bring the chin forward. Second, clear the airway suctioning baby necessary to remove foreign material or secretions. Now that the airway is open and clear, consider a couple airway adjuncts to maintain pansy. There are two main types, including the Aural Fair and Julia Lowell Airway, for unconscious patients in the nasal flaring Jaleel Airway. For conscious patients, selection of the proper size Orel Fair and Julia Will Airway is owned by assessing the playing at the lips of the patient, and the tip of the airway should be at the angle of the job. Insertion is achieved by pointing the tip toward the hard palate and then rotating 100 and 80 degrees until the tip touches the posterior all fair and Julia Wall selection of the proper size Nasal flaring tool airway is done by assessing the flange at the nostril, and the tip should just to reach the trace of the year to insert, place the tip perpendicular with the maxillary bone, using gentle pressure in a spiral motion until the device is in place. Beyond the nasal firings, providing a patent airway after placement. Listen to the chest. Ensure that the patient is receiving adequate breath sounds. Now that we have our airway at junk in place, we now move to bag mask ventilation. To properly use the bag mask. Use the EEC formation with your hands to do so for must see with the index finger in a thumb on one hand on the top side of the mask on the bridge of the nose. This securely applied the master the face now the three remaining fingers for money and use these fingers to lift the job, forming the airway. Now, maintaining this position, the provider squeezes the back, taking one second to purified one ventilation. If a second providers available to assist with bag mask ventilation. One provider will deliver ventilation with the bag mask, while the other provider provides the same E C formation with both hands to the mask. So you have completed the airway management skills training. Please feel free to review as often as you would like, and we encourage you to practice your skills with a skilled health care provider, so please go out there and save lives. 48. Who is NHCPS?: Welcome to National Health care provider Solutions, the most trusted name in online medical certification. Today, our certification courses can be accessed 100% online and completed from any device designed by board certified physicians. Adhering to the latest H A standards, you can now join thousands of health care providers around the world who have received certifications completely online in less than an hour. Our A, C. L s, BLS and Pals courses are eligible for A M, a Category one credits and our CPR courses eligible for a. M. A Category two CMI partnered with the Save A Life Initiative. We seek to empower others to save lives by providing advanced healthcare education. Here's how enroll in the course you need. Review the online handbooks, watch the skills videos and passed the exam. Your digital provider card is instantly available, and your physical card will be mailed to you. Choose the certification you need and get started today and HCPs the Save a Life Initiative and you together. Let's save lives