Erc Als Lecture 1 Introduction

EUROPEAN RESUSCITATION COUNCIL ADVANCED LIFE SUPPORT PROVIDER COURSE

© Resuscitation Council (UK)

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Cardiovascular Disease • In Europe cardiovascular disease accounts for 40% of all deaths < 75 yrs • One third of all people developing an MI die before reaching hospital • Presenting rhythm in most of these cases is VF/VT i.e. shockable • In-hospital cardiac arrest more likely NonVF/VT ERC

Chain of Survival

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BUT… • Earlier recognition of abnormal physiology • Identifying patients ‘at risk’ of cardiorespiratory arrest • Cardiorespiratory arrest prevention ERC

Cardiac Arrest

Universal ALS Algorithm

Precordial Thump if appropriate BLS Algorithm if appropriate Attach Defib-Monitor

Assess Rhythm

VF/V T Defibrillate X 3 as necessary CPR 1 min

+/- Check Pulse

During CPR

Correct reversible causes If not already: •check electrodes, paddle position and contact airway & O2, •attempt / verify: i.v. access •give epinephrine every 3 min •give amiodarone after 3 unsuccessful shocks Consider: buffers, magnesium, atropine

NonVF/VT

CPR 3 min* * 1 min if immediately after defibrillation

Potential reversible causes: • Hypoxia • Hypovolaemia • Hypo/hyperkalaemia & metabolic disorders • Hypothermia • Tension pneumothorax • Tamponade • Toxic/therapeutic disorders • Thrombo-embolic & mechanical obstruction

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ALS Course Objectives • Standardised CPR for adults • Multidisciplinary: – doctors, senior nurses & other relevant healthcare personnel throughout Europe • Resuscitation team members • Resuscitation team leaders ERC

ALS Course Format • Manual – common to RC (UK) and ERC

• • • •

Lectures Skill Stations Workshops Cardiac arrest simulation (CAS) training

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ALS Course Assessment • • • • • •

MCQ Practical skills Cardiac arrest simulation (CASTest) Provider certificate valid for 5 years Recertification Instructor potential ERC

Any Questions ?

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Summary • Cardiovascular disease remains a major cause of cardiac arrest in adults • Earlier recognition of patients ‘at risk’ may reduce the number of cardiac arrests • The ALS Course teaches a standardised approach using a variety of educational formats and assessment tools • The modifications to the content of the manual in the techniques of ALS being taught on this “2004” course are based on current evidence ERC