Lesson 4: CHEST COMPRESSIONS
|
|
- Silas Greene
- 7 years ago
- Views:
Transcription
1 Lesson 4: CHEST COMPRESSIONS Neonatal Resuscitation Program Slide Presentation Kit The American Academy of Pediatrics is not responsible for any changes or modifications to this program made by the Neonatal Resuscitation Training Team of Latter-day Saint Charities. This program, as modified, may not be distributed in the United States.
2 Chest Compressions Lesson content: Indications for chest compressions Performance of chest compressions Coordination of chest compression with positive-pressure ventilation Stopping chest compressions 4-2
3 Chest Compressions Chest Compressions Temporarily increase circulation Must be accompanied by ventilation Should use 100% oxygen 4-3
4 Chest Compressions: Indications Heart rate remains less than 60 beats per minute (bpm) despite 30 seconds of effective positivepressure ventilation 4-4
5 Chest Compressions: Compress the heart against the spine Increase intrathoracic pressure Circulate blood to vital organs, including the brain Click on the image to play video 4-5
6 One person compresses chest One person continues ventilation Chest Compressions: 2 People Needed 4-6
7 Comparison of Chest Compression Techniques Thumb Technique (Preferred) Less tiring Better control of compression depth 2-Finger Technique Better for small hands Provides access to umbilicus for medications 4-7
8 Chest Compressions: Positioning of Thumbs or Fingers Run your fingers along the lower edge of the rib cage until you locate the xyphoid Place your thumbs or fingers on the sternum, above the xyphoid and on a line connecting the nipples 4-8
9 Thumbs compress sternum Chest Compressions: Fingers support back Thumb Technique
10 Chest Compressions: Tips of middle finger and index or ring finger of one hand compress sternum Other hand supports back 2-Finger Technique 4-10
11 Apply pressure during compression on the sternum, releasing pressure to allow chest recoil and ventilation Chest Compressions: Pressure and Depth Depress sternum one third of the anteriorposterior diameter of chest 4-11
12 Chest Compressions: Compression Pressure and Depth Depress sternum one third of the anteriorposterior diameter of chest
13 Chest Compressions: Technique Duration of downward stroke shorter than duration of release 4-13
14 Chest Compressions: Complications Laceration of liver Broken ribs 4-14
15 Chest Compressions: Coordination With Ventilation Click on the image to play video 4-15
16 Chest Compressions: Coordination With Ventilation One cycle of 3 compressions and 1 breath takes 2 seconds The breathing rate is 30 breaths per minute and the compression rate is 90 compressions per minute. This equals 120 events per minute 4-16
17 After 30 seconds of compressions and ventilation, stop and check heart rate Chest Compressions: Stopping Compressions 4-17
18 Chest Compressions: Heart Rate Remains Less than 60 bpm Check adequacy of ventilation Consider intubation if not already done Insert an umbilical catheter to give epinephrine 4-18
19 Thumb Technique Click on the image to play video 4-19
20 Chest Compressions: 2-Finger Technique Click on the image to play video 4-20
21 Lesson 5: ENDOTRACHEAL INTUBATION Neonatal Resuscitation Program Slide Presentation Kit The American Academy of Pediatrics is not responsible for any changes or modifications to this program made by the Neonatal Resuscitation Training Team of Latter-day Saint Charities. This program, as modified, may not be distributed in the United States.
22 Endotracheal Intubation Lesson content: Indications for intubation Equipment selection and preparation Laryngoscope use and endotracheal tube insertion Determination of tube placement Suctioning meconium from trachea Positive-pressure ventilation via endotracheal tube 5-22
23 Endotracheal Intubation: Indications To suction trachea in presence of meconium when the newborn is not vigorous To improve efficacy of ventilation after several minutes of bag-and-mask ventilation or ineffective bag-and-mask ventilation To facilitate coordination of chest compressions and ventilation To administer epinephrine while IV access is being established 5-23
24 Endotracheal Intubation: Equipment Equipment should be clean, protected from contamination and Supplies 5-24
25 Characteristics of Endotracheal Tubes: Sterile, disposable Uniform diameter (not tapered) Centimeter marks and vocal cord guides helpful Uncuffed 5-25
26 Endotracheal Tube: Appropriate Size Select tube size based on weight and gestational age Consider shortening tube to 13 to 15 cm Stylet optional Tube Size (mm) Weight Gestational Age (inside diameter) (g) (wks) 2.5 Below 1,000 Below ,000-2, ,000-3, Above 3,000 Above
27 Preparation of Laryngoscope: Supplies The correct-sized laryngoscope blade: No. 0 for preterm and term newborns No. 1 for term newborns Check laryngoscope light Adjust suction source to 100 mm Hg Use large suction catheter (greater than or equal to 10F) for oral secretions Have small catheter for suctioning endotracheal tube 5-27
28 Preparation for Intubation Prepare resuscitation device and mask Turn on oxygen Get stethoscope Cut tape or prepare endotracheal tube stabilizer 5-28
29 Assisting During Intubation The assistant for the procedure should Ensure equipment available, prepared Correctly position baby, stabilize head Provide free-flow oxygen Provide suction Hand endotracheal tube to intubator Apply cricoid pressure if asked 5-29
30 Assisting During Intubation The assistant for the procedure should Provide positive-pressure ventilation between attempts Connect endotracheal tube to resuscitation device Auscultate heart rate to assess improvement Auscultate breath sounds and observe chest movement Help secure tube 5-30
31 Endotracheal Intubation: Upper Airway Anatomy 5-31
32 Endotracheal Intubation: Anatomic Landmarks 5-32
33 Endotracheal Intubation: Positioning the Newborn 5-33
34 Endotracheal Intubation: Always Hold the Laryngoscope in the Left Hand 5-34
35 Endotracheal Intubation: Step 1: Preparation for Insertion Stabilize the newborn s head in the sniffing position Deliver free-flow oxygen during the procedure Click on the image to play video 5-35
36 Endotracheal Intubation: Step 2: Insert Laryngoscope Slide the laryngoscope over right side of the tongue Push tongue to left side of mouth Advance blade until the tip lies just beyond the base of the tongue 5-36
37 Endotracheal Intubation: Step 3: Lift Blade Lift the blade slightly Raise the entire blade, not just the tip Visualize pharyngeal area Do not use rocking motion 5-37
38 Endotracheal Intubation: Step 4: Visualize Landmarks Look for landmarks. Vocal cords should appear as vertical stripes on each side of the glottis or as an inverted letter V Applying downward pressure on cricoid may help bring glottis into view Suction, if necessary, for visualization 5-38
39 Endotracheal Intubation: Step 5: Inserting Tube Insert the tube into the right side of the mouth with the curve of the tube lying in the horizontal plane If the cords are closed, wait for them to open Insert the tip of the endotracheal tube until the vocal cord guide is at the level of the cords Limit attempts to 20 seconds Click on the image to play video 5-39
40 Endotracheal Intubation: Step 6: Remove Laryngoscope Hold the tube firmly against the baby s palate while removing the laryngoscope Hold the tube in place while removing the stylet if one was used Click on the image to play video 5-40
41 Endotracheal Intubation Click on the image to play video 5-41
42 Suctioning Meconium via Endotracheal Tube Connect endotracheal tube to meconium aspirator and suction source Occlude suction port to apply suction Gradually withdraw endotracheal tube Repeat intubation and suction as necessary until newborn s heart rate indicates that positivepressure ventilation is needed Click on the image to play video 5-42
43 Suctioning Meconium via Endotracheal Tube Suction for only 3 to 5 seconds as tube is withdrawn If no meconium is recovered, proceed to resuscitation If meconium is recovered, check heart rate No significant bradycardia Reintubate, suction again if needed Significant bradycardia Administer positive-pressure ventilation 5-43
44 Endotracheal Intubation: Checking Tube Position Signs of correct tube position Improved vital signs (heart rate, color, and activity) Breath sounds over both lung fields but decreased or absent over stomach No gastric distention with ventilation 5-44
45 Endotracheal Intubation: Checking Tube Position Additional signs of correct tube placement Vapor in the tube during exhalation Chest movement with each breath Chest x-ray confirmation if the tube is to remain in place past initial resuscitation Direct visualization of tube passing between vocal cords 5-45
46 Endotracheal Intubation: Checking Tube Position The tube is not likely in the trachea if Newborn remains cyanotic and bradycardic No breath sounds over lungs Abdomen becomes distended Air noises over stomach No mist in endotracheal tube Chest not moving symmetrically with positivepressure breaths 5-46
47 Endotracheal Intubation: Tube Location in Trachea 5-47
48 Endotracheal Intubation: Tube Location in Trachea Tip-to-lip measurement Weight (kg) Depth of insertion (cm from upper lip) 1*
49 Endotracheal Intubation: Radiographic Confirmation Correct Incorrect 5-49
50 Endotracheal Intubation: Limiting Hypoxia During Intubation Pre-oxygenate with positive-pressure ventilation (unless intubating to suction meconium) Deliver free-flow oxygen during intubation Limit attempts to 20 seconds 5-50
51 Endotracheal Intubation: What can go wrong during intubation? Laryngoscope not inserted far enough You see the tongue around the blade Advance the blade farther 5-51
52 Endotracheal Intubation: What can go wrong during intubation? Laryngoscope inserted too far You see the walls of the esophagus surrounding the blade Withdraw the blade slowly until the epiglottis and glottis are seen 5-52
53 Endotracheal Intubation: Special Indications Extreme Prematurity Surfactant Administration Suspected Diaphragmatic Hernia A person experienced in endotracheal intubation should be immediately available to assist at every delivery. 5-53
54 Endotracheal Intubation: A person experienced in endotracheal intubation should be immediately available to assist at every delivery. 5-54
55 Endotracheal Intubation: What can go wrong during intubation Endotracheal tube inserted too far Breath sounds heard louder over right side of chest Withdraw ET tube slowly while listening for breath sounds QuickTime and a TIFF (LZW) decompressor are needed to see this picture. 5-55
56 Lesson 6: MEDICATIONS Neonatal Resuscitation Program Slide Presentation Kit The American Academy of Pediatrics is not responsible for any changes or modifications to this program made by the Neonatal Resuscitation Training Team of Latter-day Saint Charities. This program, as modified, may not be distributed in the United States.
57 Lesson content: Medications for Neonatal Resuscitation Indications for medications Indications for placement of umbilical venous catheter How to insert umbilical venous catheter How to give epinephrine When and how to administer volume expanders 6-57
58 Epinephrine Indications Epinephrine, a cardiac stimulant, is indicated when the heart rate remains below 60 beats per minute despite 30 seconds of assisted ventilation followed by 30 seconds of coordinated compressions and ventilation Total = 60 seconds Note: Epinephrine is not indicated before adequate ventilation is established. 6-58
59 Medication Administration Placing catheter in umbilical vein Preferred route for intravenous access 3.5F or 5F end-hole catheter Sterile technique via Umbilical Vein 6-59
60 Medication Administration via Umbilical Vein Insert catheter 2 to 4 cm Note free flow of blood when aspirated Use less depth in preterm newborns Insertion in liver may cause damage 6-60
61
62
63 Epinephrine: Effects, Repeated Dosing Increases strength and rate of cardiac contractions Causes peripheral vasoconstriction Repeat doses should be given via umbilical vein, if possible Repeat dose via umbilical vein if first dose given via endotracheal tube 6-63
64 Epinephrine Administration Dilute 1:1000 concentration to 1:10,
65 Epinephrine: Poor Response (Heart Rate < 60 bpm) Recheck effectiveness of Ventilation Chest compressions Endotracheal intubation Epinephrine delivery Consider possibility of Hypovolemia 6-65
66 Poor Response to Resuscitation: Hypovolemia Indications for volume expansion Baby is not responding to resuscitation AND Baby appears in shock (pale color, weak pulses, persistently low heart rate, no improvement in circulatory status despite resuscitation efforts) There may be a history of a condition associated with fetal blood loss (eg, extensive vaginal bleeding, abruptio placentae, placenta previa, twin-to-twin transfusion, etc) 6-66
67 Blood Volume Expansion Recommended: Normal saline Acceptable: Ringer s lactate 6-67
68 Blood Volume Expansion: Dose and Administration Recommended solution = Normal saline Acceptable solution = Ringer s lactate, Recommended dose = 10 ml/kg Recommended route = Umbilical vein Recommended preparation = Correct volume drawn into large syringe Recommended rate = Over 5 to 10 minutes 6-68
69 Expected Response: Volume Expanders Expected signs of volume expansion Heart rate increases Pulses stronger Pallor lessens Blood pressure increases Follow up if hypovolemia persists Repeat volume expanders (dose 10 ml/kg) 6-69
70 Medication Given: No Improvement 6-70
71 Medication Administration: Alternative Routes Endotracheal tube Intraosseous (more likely in outpatient setting) 6-71
NRP Study Guide. This packet is intended for review only. Requirements to successfully complete NRP:
This packet is intended for review only Requirements to successfully complete NRP: Completed NRP Pretest is required for admission to the course. Score 84% on the multiplechoice posttest. You may be allowed
More informationNeonatal Intubation. Purpose. Scope. Indications. Equipment Cardiorespiratory monitor SaO 2 monitor. Anatomic Considerations.
Page 1 of 5 Purpose Scope Indications Neonatal Intubation To assure proper placement of endotracheal tubes for maximum ventilation using proper intubation procedures. The policy applies to all Respiratory
More informationNEONATAL RESUSCITATION PROVIDER (NRP) RECERTIFICATION TABLE OF CONTENTS
NEONATAL RESUSCITATION PROVIDER (NRP) RECERTIFICATION TABLE OF CONTENTS NEONATAL FLOW ALGORITHM.2 INTRODUCTION 3 ANTICIPATION OF RESUSCITATION 4 TEMPERATURE CONTROL.4 CLEARING THE AIRWAY OF MECONIUM 5
More informationAddendum to the NRP Provider Textbook 6 th Edition Recommendations for specific modifications in the Canadian context
Addendum to the NRP Provider Textbook 6 th Edition Recommendations for specific modifications in the Canadian context A subcommittee of the Canadian Neonatal Resuscitation Program (NRP) Steering Committee
More informationAHE: NRP AAP/AHA COURSE COMPONENTS
ADVANCED HEALTHCARE EDUCATION 2011 6 TH EDITION - KEY POINT STUDY GUIDE IMPORTANT INFORMATION FOR STUDENTS REGISTERING FOR CLASSES AFTER 01/011/2012. AAP HAS RESTRUCTURED NRP TO NOW REQUIRE COMPLETION
More informationNRP 2012 Putting New Resuscitation Guidelines into Practice
Outreach Education Online Video Library for Healthcare Professionals NRP 2012 Putting New Resuscitation Guidelines into Practice. Jeanette Zaichkin, RN, MN, NNP-BC December 2, 2010 Program Handouts This
More informationNeonatal Emergencies. Care of the Neonate. Care of the Neonate. Care of the Neonate. Student Objectives. Student Objectives continued.
Student Objectives Neonatal Emergencies After completing this section the student will be able to: 1. Identify three physiologic and/or anatomic features unique to the newborn 2. List three perinatal factors
More informationAHA/AAP Neonatal Resuscitation Guidelines 2010: Summary of Major Changes and Comment on its Utility in Resource-Limited Settings
AHA/AAP Neonatal Resuscitation Guidelines 2010: Summary of Major Changes and Comment on its Utility in Resource-Limited Settings Resuscitation step Recommendations (2005) Recommendations (2010) Comments/LOE
More information(C) AMBULANCE VICTORIA
The Newborn Baby: Definitions and Contacts Newborn definition 'Newborn' refers to the first min to hours post birth. For the purpose of resuscitation, AV accepts up to the first 24 hours from birth in
More informationObstetrical Emergencies
Date: July 18, 2014 Page 1 of 5 Obstetrical Emergencies Purpose: To provide the process for the assessment and management of the patient with an obstetrical related emergency. Pre-Medical Control 1. Follow
More informationProcedure 17: Cardiopulmonary Resuscitation
Cardiopulmonary Resuscitation 349 Procedure 17: Cardiopulmonary Resuscitation Introduction Cardiopulmonary arrest (CPA) occurs when a patient s heart and lungs stop functioning. In children, CPA usually
More informationPediatric Airway Management
Pediatric Airway Management Dec 2003 Dr. Shapiro I., PICU Adult Chain of Survival EMS CPR ALS Early Defibrillation Pediatric Chain of Survival Prevention CPR EMS ALS Out-of-Hospital Cardiac Arrest SIDS
More informationAEROSPACE MEDICAL SERVICE SPECIALTY INDEPENDENT DUTY MEDICAL TECHNICIAN EMERGENCY MEDICINE PROCEDURES
QTP4N0X1C-9 02 July 2015 AEROSPACE MEDICAL SERVICE SPECIALTY INDEPENDENT DUTY MEDICAL TECHNICIAN EMERGENCY MEDICINE PROCEDURES Volume 9 TOTAL FORCE, TOTAL CARE EVERYTIME, ANYWHERE 383d TRAINING SQUADRON/XUFB
More informationTOWN OF FAIRFIELD HEALTH DEPARTMENT PUBLIC HEALTH NURSING
TOWN OF FAIRFIELD HEALTH DEPARTMENT PUBLIC HEALTH NURSING PROGRAM: School Health APPROVED BY: Board of Health School Medical Advisor POLICY: With Portable Suction Machine DATE: March 14, 1994 POLICY DEFINITION:
More informationGUIDELINE 13.8 THE RESUSCITATION OF THE NEWBORN INFANT IN SPECIAL CIRCUMSTANCES
AUSTRALIAN RESUSCITATION COUNCIL GUIDELINE 13.8 THE RESUSCITATION OF THE NEWBORN INFANT IN SPECIAL CIRCUMSTANCES PREMATURITY Temperature management Very premature infants are at particular risk of hypothermia.
More information10. An infant with a history of vomiting and diarrhea arrives by ambulance. During your primary assessment the infant responds only to painful stimula
1. You are called to help resuscitate an infant with severe symptomatic bradycardia associated with respiratory distress. The bradycardia persists despite establishment of an effective airway, oxygenation,
More information11 Newborn Life Support
11 Newborn Life Support Introduction Passage through the birth canal is a hypoxic experience for the fetus, since significant respiratory exchange at the placenta is prevented for the 50-75 s duration
More informationCPR/AED for Professional Rescuers and Health Care Providers HANDBOOK
CPR/AED for Professional Rescuers and Health Care Providers HANDBOOK TABLE OF CONTENTS SECTION 1: THE PROFESSIONAL RESCUER The Duty to Respond 2 Preventing the Spread of Bloodborne Pathogens 3 Taking Action
More informationLaryngeal Mask Airways (LMA), Indications and Use for the Pre-Hospital Provider. www.umke.org
Laryngeal Mask Airways (LMA), Indications and Use for the Pre-Hospital Provider Objectives: Identify the indications, contraindications and side effects of LMA use. Identify the equipment necessary for
More informationNeonatal Resuscitation Program 2011: Changes and Controversies
Neonatal Resuscitation Program 2011: Changes and Controversies Myra H. Wyckoff, MD Associate Professor of Pediatrics UT Southwestern Medical Center at Dallas Disclosures I am not on any speakers bureaus
More information2015 Interim Resources for BLS
2015 Interim Resources for BLS Original Release: November 25, 2015 Starting in 2016, new versions of American Heart Association online courses will be released to reflect the changes published in the 2015
More informationSuccess Manual and Cheat Sheet Notes to Pass Your Basic Life Support (BLS) Course
Success Manual and Cheat Sheet Notes to Pass Your Basic Life Support (BLS) Course Written by: Jay Snaric, MS And Kimberly Hickman, RN CPR St. Louis 44 Meramec Valley Plaza St. Louis MO 63088 www.stlcpr.com
More informationVirginia Office of Emergency Medical Services Scope of Practice - Procedures for EMS Personnel
Specific tasks in this document shall refer to the Virginia Education Standards. AIRWAY TECHNIQUES Airway Adjuncts Airway Maneuvers Alternate Airway Devices Cricothyrotomy Obstructed Airway Clearance Intubation
More informationOne Lung Ventilation Module (OLV)
1 One Lung Ventilation Module (OLV) A Thoracic Surgery Directors Association (TSDA) Cardiothoracic Surgery Resident Boot Camp Syllabus The ability to isolate one of the lungs is an essential skill set
More informationArmstrong Medical Little Joe. 1 Manikin 1 Red Cross-branded Carrying Case
Category Ambu CPR Pal Trainer Ambu Multi Man Armstrong Medical Actar D-Fib Armstrong Medical Little Joe Laerdal Little Anne Laerdal Resusci Anne Prestan Professional Adult Manikin Retail Price $257.89/each
More informationKeeping your lungs healthy
Keeping your lungs healthy A guide for you after spinal cord injury and other neurological conditions Regional Rehabilitation Program This booklet has been written by the health care providers who provide
More informationResuscitation of the baby at birth
APPENDIX I Resuscitation of the baby at birth I.1 OBJECTIVES This will teach you: I.2 INTRODUCTION the important physiological differences in the newly born baby the equipment used for resuscitation at
More informationCUESTA COLLEGE REGISTERED NURSING PROGRAM CRITICAL ELEMENTS
CUESTA COLLEGE REGISTERED NURSING PROGRAM CRITICAL ELEMENTS LEVELS I through IV A. OVERRIDING CRITICAL ELEMENTS Violation of an overriding area will result in termination and failure of the particular
More information81 First Responder Respiratory
81 First Responder Medical Scenarios Asthma Scenario: You are called to a local house for a woman with trouble breathing. You arrive to find a 67-year-old woman sitting upright in a chair. She states she
More informationUpdate on Neonatal Resuscitation
Update on Neonatal Resuscitation Ola Didrik Saugstad MD, PhD, FRCPE Professor of Pediatrics Director Department of Pediatric Research Rikshospitalet, Faculty of Medicine University of Oslo NORWAY 1st.
More informationResuscitation of the baby at birth
Chapter 8 Resuscitation of the baby at birth Objectives On successfully completing this topic, you will be able to: understand the important physiological differences in the newly born baby understand
More informationEnables MDA Medical Teams to categorize victims in mass casualty scenarios, in order to be able to triage and treat casualties
MDA Disposable ALS + BLS Medical Ambulance Equipment Prices shown in CDN. Funds Items Description Picture Mass Casualty ID tag 1000 units = $350 Enables MDA Medical Teams to categorize victims in mass
More informationTarget groups: Paramedics, nurses, respiratory therapists, physicians, and others who manage respiratory emergencies.
Overview Estimated scenario time: 10 15 minutes Estimated debriefing time: 10 minutes Target groups: Paramedics, nurses, respiratory therapists, physicians, and others who manage respiratory emergencies.
More informationAdult Choking and CPR Manual
Adult Choking and CPR Manual 2009 Breath of Life Home Medical Equipment and Respiratory Services CHOKING Description: Choking is the coughing spasm and sputtering that happen when liquids or solids get
More informationACLS Provider Manual Comparison Sheet Based on 2010 AHA Guidelines for CPR and ECC. BLS Changes
ACLS Provider Manual Comparison Sheet Based on 2010 AHA Guidelines for CPR and ECC CPR Chest compressions, Airway, Breathing (C-A-B) BLS Changes New Old Rationale New science indicates the following order:
More informationMegaCode Kid Advanced ECG Kid
MegaCode Kid Advanced ECG Kid ENGLISH www.laerdal.com Directions for Use Table of Contents Items Included... 1 Skills Taught... 1 Introduction...1 Laerdal Recommends...1 SimPad Connection... 2 Intubation...
More informationNeonatal resuscitation
Neonatal resuscitation Document title: Neonatal resuscitation Publication date: October 2011 Document number: Document supplement Replaces document: Author: Audience: MN11.5-V2-R16 The document supplement
More informationHow To Treat A Heart Attack
13 Resuscitation and preparation for anaesthesia and surgery Key Points 13.1 MANAGEMENT OF EMERGENCIES AND CARDIOPULMONARY RESUSCITATION ESSENTIAL HEALTH TECHNOLOGIES The emergency measures that are familiar
More informationPRACTICE GUIDELINE TITLE: INTRAVENOUS LINE INSERTION: PERIPHERAL AND CENTRAL
PRACTICE GUIDELINE Effective Date: 9-17-04 Manual Reference: Deaconess Trauma Services TITLE: INTRAVENOUS LINE INSERTION: PERIPHERAL AND CENTRAL PURPOSE: To outline the indications and options for intravenous
More informationWhy is prematurity a concern?
Prematurity What is prematurity? A baby born before 37 weeks of pregnancy is considered premature. Approximately 12% of all babies are born prematurely. Terms that refer to premature babies are preterm
More informationMichigan Adult Cardiac Protocols CARDIAC ARREST GENERAL. Date: May 31, 2012 Page 1 of 5
Date: May 31, 2012 Page 1 of 5 Cardiac Arrest General This protocol should be followed for all adult cardiac arrests. Medical cardiac arrest patients undergoing attempted resuscitation should not be transported
More informationCPT Pediatric Coding Updates 2009. The 2009 Current Procedural Terminology (CPT) codes are effective as of January 1, 2009.
CPT Pediatric Coding Updates 2009 The 2009 Current Procedural Terminology (CPT) codes are effective as of January 1, 2009. NEW CODES Evaluation and Management Services Normal Newborn Care Codes 99431-99440
More informationSouthern Stone County Fire Protection District Emergency Medical Protocols
TITLE Pediatric Medical Assessment PM 2.4 Confirm scene safety Appropriate body substance isolation procedures Number of patients Nature of illness Evaluate the need for assistance B.L.S ABC s & LOC Focused
More informationNational Registry of Emergency Medical Technicians Emergency Medical Responder Psychomotor Examination PATIENT ASSESSMENT/MANAGEMENT TRAUMA
PATIENT ASSESSMENT/MANAGEMENT TRAUMA Scenario # Note: Areas denoted by ** may be integrated within sequence of Primary Survey/Resuscitation SCENE SIZE-UP Determines the mechanism of injury/nature of illness
More informationRESPONDING TO ANESTHETIC COMPLICATIONS
RESPONDING TO ANESTHETIC COMPLICATIONS General anesthesia poses minimal risk to most patients when performed by a capable anesthetist using appropriate protocols and proper monitoring. However, it is vitally
More informationState of New Hampshire Department of Safety Division of Fire Standards and Training & Emergency Medical Services
State of New Hampshire Department of Safety Division of Fire Standards and Training & Emergency Medical Services September 2013 PATIENT ASSESSMENT / MANAGEMENT - TRAUMA Time allowed: 10 minutes SCENARIO
More informationAmerican Heart Association. Pediatric Advanced Life Support. Written Precourse Self-Assessment. Questions and Answer Key for Students.
E C C American Heart Association Pediatric Advanced Life Support Written Precourse Self-Assessment Questions and Answer Key for Students January 2012 PALS Written 2011 Precourse Self-Assessment ECG Rhythm
More informationUse of the A-B-C basic life support sequence.
Basic Life Support A change in the basic life support (BLS) sequence of steps for trained rescuers from A-B-C (Airway, Breathing, Chest compressions) to C-A-B (Chest compressions, Airway, Breathing) for
More informationNational Registry of Emergency Medical Technicians Emergency Medical Responder Psychomotor Examination BVM VENTILATION OF AN APNEIC ADULT PATIENT
BVM VENTILATION OF AN APNEIC ADULT PATIENT Candidate: Examiner: Date: Signature: Possible Points Checks responsiveness NOTE: After checking responsiveness and breathing for at least 5 but no 1 Checks breathing
More informationOFFICIAL AIR AMBULANCE, GROUND AMBULANCE, AND FIREFIGHTING AGENCY INVENTORY
OFFICIAL AIR AMBULANCE, GROUND AMBULANCE, AND FIREFIGHTING AGENCY INVENTORY Pursuant to Health District EMS Regulations Sections 900.100 and 1000.100 any Air Ambulance or Ground Ambulance that is permitted
More informationAirway and Breathing Skills Levels Interpretive Guidelines
Office of Emergency Medical Services and Trauma INDEX EFFECTIVE LAST REVIEW PAGES VERSION R-P11A 7/1/2011 7/1/2011 5 2011 Scope of Practice for EMS Personnel Emergency Medical Personnel are permitted to
More informationIf you do not wish to print the entire pre-test you may print Page 2 only to write your answers, score your test, and turn in to your instructor.
This is a SAMPLE of the pretest you can access with your AHA PALS Course Manual at Heart.org/Eccstudent using your personal code that comes with your PALS Course Manual The American Heart Association strongly
More informationX-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary
X-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary Introduction A Subclavian Inserted Central Catheter, or subclavian line, is a long thin hollow tube inserted in a vein under the
More informationLESSON 4 ORAL, NASOPHARYNGEAL, AND NASOTRACHEAL SUCTIONING.
LESSON 4 ORAL, NASOPHARYNGEAL, AND NASOTRACHEAL SUCTIONING. 4-1. SUCTIONING a. Suctioning is a common nursing activity performed for the purpose of removing accumulated secretions from the patient's nose,
More informationMedical Direction and Practices Board WHITE PAPER
Medical Direction and Practices Board WHITE PAPER Use of Pressors in Pre-Hospital Medicine: Proper Indication and State of the Science Regarding Proper Choice of Pressor BACKGROUND Shock is caused by a
More informationPEDIATRIC TREATMENT GUIDELINES
P1 Pediatric Patient Care P2 Cardiac Arrest Initial Care and CPR P3 Neonatal Resuscitation P4 Ventricular Fibrillation / Ventricular Tachycardia P5 PEA / Asystole P6 Symptomatic Bradycardia P7 Tachycardia
More informationNorthwestern Health Sciences University. Basic Life Support for Healthcare Providers
Northwestern Health Sciences University Basic Life Support for Healthcare Providers Pretest May 2005 This examination to be used only as a PRECOURSE TEST for BLS for Healthcare Providers Courses Based
More informationInfant CPR Skills Testing Checklist
Infant CPR Skills Testing Checklist Student Name Date of Test Scenario: While you are pushing a baby in a stroller at the park, you notice something is wrong with the baby. You do not have a phone nearby.
More informationCardiac Arrest Pediatric Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008
Cardiac Arrest Pediatric Ventricular Fibrillation / Pulseless Ventricular Tachycardia Protocol revised October 2008 Preamble In contrast to cardiac arrest in adults, cardiopulmonary arrest in pediatric
More informationEMBARGOED FOR RELEASE
Systems of Care and Continuous Quality Improvement Universal elements of a system of care have been identified to provide stakeholders with a common framework with which to assemble an integrated resuscitation
More informationObstetric Emergencies
Obstetric Emergencies Dr. Si Lay Khaing Senior Lecturer/ O&G Specialist Faculty of Medicine University of Malaya 15 th March 2014 Abstract Life Saving, The obstetric patient is unique in medicine as two
More information2015 Interim Resources for HeartCode ACLS
2015 Interim Resources for HeartCode ACLS Original Release: November 25, 2015 Starting in 2016, new versions of American Heart Association online courses will be released to reflect the changes published
More informationCardiac Arrest VF/Pulseless VT Learning Station Checklist
Cardiac Arrest VF/Pulseless VT Learning Station Checklist VF/VT 00 American Heart Association Adult Cardiac Arrest Shout for Help/Activate Emergency Response Epinephrine every - min Amiodarone Start CPR
More informationNational Registry of Emergency Medical Technicians Emergency Medical Technician Psychomotor Examination BLEEDING CONTROL/SHOCK MANAGEMENT
BLEEDING CONTROL/SHOCK MANAGEMENT Candidate: Examiner: Date: Signature: Possible Applies direct pressure to the wound 1 NOTE: The examiner must now inform the candidate that the wound continues to bleed.
More informationChapter 2 - Anatomy & Physiology of the Respiratory System
Chapter 2 - Anatomy & Physiology of the Respiratory System Written by - AH Kendrick & C Newall 2.1 Introduction 2.2 Gross Anatomy of the Lungs, 2.3 Anatomy of the Thorax, 2.4 Anatomy and Histology of the
More informationNational Registry Skill Sheets
Bleeding Control/Shock Management BVM Ventilation of an Apneic Adult Patient Cardiac Arrest Management/AED Joint Immobilization Long Bone Immobilization Oxygen Administration By Non-Rebreather Mask Patient
More informationAmerican Heart Association
American Heart Association Basic Life Support for Healthcare Providers Pretest April 2006 This examination to be used only as a PRECOURSE TEST For BLS for Healthcare Providers Courses 2006 American Heart
More informationNEEDLE THORACENTESIS Pneumothorax / Hemothorax
NEEDLE THORACENTESIS Pneumothorax / Hemothorax By: Steven Jones, NREMT-P Pneumothorax Pneumothorax is a collection of air or gas in the pleural space of the lung, causing the lung to collapse. Pneumothorax
More informationChapter 31 Obstetrics and Neonatal Care 1137. Scene Size-up. Primary Assessment
Chapter 31 Obstetrics and Neonatal Care 1137 Scene Size-up Scene Safety Mechanism of Injury (MOI)/ Nature of Illness (NOI) Ensure scene safety and safe access to the patient. Standard precautions should
More informationACLS Provider Manual Supplementary Material
ACLS Provider Manual Supplementary Material 2012 American Heart Association 1 Contents Airway Management... 4 Part 1: Basic Airway Management... 4 Devices to Provide Supplementary Oxygen... 4 Overview...
More informationNeonatal Reference Guide
Operated by REACH Air Medical Services Assessment Heart Rate (beats/min.) Age Rate
More informationPremature Infant Care
Premature Infant Care Introduction A premature baby is born before the 37th week of pregnancy. Premature babies are also called preemies. Premature babies may have health problems because their organs
More informationGallbladder Surgery with an Incision (Cholecystectomy)
Gallbladder Surgery with an Incision (Cholecystectomy) It is normal to have questions about your surgery. This handout gives you information about what will happen to you before, during and after your
More informationTRACHEOSTOMY TUBE PARTS
Page1 NR 33 TRACHEOSTOMY CARE AND SUCTIONING Review ATI Basic skills videos: Tracheostomy care and Endotracheal suction using a closed suction set. TRACHEOSTOMY TUBE PARTS Match the numbers on the diagram
More informationHeart information. CPR cardiopulmonary resuscitation
Heart information CPR cardiopulmonary resuscitation Contents 3 What is CPR? 3 What is cardiac arrest? 4 Heart attack and cardiac arrest 4 Cardiopulmonary resuscitation (CPR) 5 Danger 6 Response 7 Send
More informationFirst Responder (FR) and Emergency Medical Responder (EMR) Progress Log
First Responder (FR) and Emergency Medical Responder (EMR) Progress Log Note: Those competencies that are for EMR only are denoted by boldface type. For further details on the National Occupational Competencies
More informationGENERAL ANESTHESIA BASICS
GENERAL ANESTHESIA BASICS INTRODUCTION The goal in the administration of general anesthesia is to provide a stage of reversible unconsciousness with adequate analgesia and muscle relaxation for surgical
More informationTraining Manikin Requirements for American Red Cross Certification Courses
Training Manikin Requirements for American Red Cross Certification Courses Introduction We are pleased to announce the release of the requirements for training manikins. These requirements apply to all
More informationPlacement of Epidural Catheter for Pain Management Shane Bateman DVM, DVSc, DACVECC
Placement of Epidural Catheter for Pain Management Shane Bateman DVM, DVSc, DACVECC Indications: Patients with severe abdominal or pelvic origin pain that is poorly responsive to other analgesic modalities.
More informationPediatric Respiratory System: Basic Anatomy & Physiology. Jihad Zahraa Pediatric Intensivist Head of PICU, King Fahad Medical City
Pediatric Respiratory System: Basic Anatomy & Physiology Jihad Zahraa Pediatric Intensivist Head of PICU, King Fahad Medical City Outline Introduction Developmental Anatomy Developmental Mechanics of Breathing
More information5/30/2014 OBJECTIVES THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM. Disclosure
THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM Ona Fofah, MD FAAP Assistant Professor of Pediatrics Director, Division of Neonatology Department of Pediatrics Rutgers- NJMS, Newark OBJECTIVES
More informationU.S. ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL FORT SAM HOUSTON, TEXAS 78234-6100 CARDIAC IMPAIRMENT SUBCOURSE MD0571 EDITION 100
U.S. ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL FORT SAM HOUSTON, TEXAS 78234-6100 CARDIAC IMPAIRMENT SUBCOURSE MD0571 EDITION 100 DEVELOPMENT This subcourse is approved for resident and correspondence
More informationUnderstanding Anesthetic Delivery Systems Dean Knoll, CVT, VTS (Anes.) Anesthesia Technician Supervisor University of Wisconsin Madison, WI May 2003
Understanding Anesthetic Delivery Systems Dean Knoll, CVT, VTS (Anes.) Anesthesia Technician Supervisor University of Wisconsin Madison, WI May 2003 Knowing the functions of the anesthetic delivery system
More informationRESPIRATORY CRITICAL CARE UNIT STUDENT INTERNSHIP SKILLS LIST Provo School District
RESPIRATORY CRITICAL CARE UNIT STUDENT INTERNSHIP SKILLS LIST Provo School District The following procedures and items of equipment should be noted, observed and studied during this clinical rotation period.
More informationPICC and Midline Catheters
PICC and Midline Catheters Infusion RN s Deb Bucher RN BSN CRNI Dawn Finch RN CRNI Marianne Hansen RN BSN CRNI Karman Youngblood RN BS CRNI Infusion Pharmacist Kathy Cimakasky Pharm D Tamara Migut RPh
More information404 Section 5 Shock and Resuscitation. Scene Size-up. Primary Assessment. History Taking
404 Section 5 and Resuscitation Scene Size-up Scene Safety Mechanism of Injury (MOI)/ Nature of Illness (NOI) Ensure scene safety and address hazards. Standard precautions should include a minimum of gloves
More informationMEASURING AND RECORDING BLOOD PRESSURE
MEASURING AND RECORDING BLOOD PRESSURE INTRODUCTION The blood pressure, along with the body temperature, pulse, and respirations, is one of the vital signs. These measurements are used to quickly, easily,
More informationHuman Body Vocabulary Words Week 1
Vocabulary Words Week 1 1. arteries Any of the blood vessels that carry blood away from the heart to all parts of the body 2. heart The muscular organ inside the chest that pumps blood through the body
More informationOxygenation. Chapter 21. Anatomy and Physiology of Breathing. Anatomy and Physiology of Breathing*
Oxygenation Chapter 21 Anatomy and Physiology of Breathing Inspiration ~ breathing in Expiration ~ breathing out Ventilation ~ Movement of air in & out of the lungs Respiration ~ exchange of O2 & carbon
More informationNCCEP Standards. NCCEP Standards for EMS Equipment
NCCEP Standards NCCEP Standards for EMS Equipment Performance Standards 2009 . The baseline equipment required in all systems (including Specialty Care Transport Programs) with EMS personnel credentialed
More informationA8b. Resuscitation of a Term Infant with Meconium Staining. Session Summary. Session Objectives. References
A8b Resuscitation of a Term Infant with Meconium Staining Karen Wright, PhD, NNP-BC Assistant Professor and Coordinator, Neonatal Nurse Practitioner Program Dept. of Women, Children, and Family Nursing,
More informationAdult, Child, and Infant Written Exam CPR Pro for the Professional Rescuer
Adult, Child, and Infant Written Exam CPR Pro for the Professional Rescuer Instructions: Read each of the following questions carefully and then place an X over the correct answer on the separate answer
More informationAHA Instructor Renewal
AHA Instructor Renewal Thank you for your continuing on as American Heart Association AHA Instructor! In this packet you will we have provided information on: A detailed outline of the process to renew
More informationRegions Hospital Delineation of Privileges Nurse Practitioner
Regions Hospital Delineation of Privileges Nurse Practitioner Applicant s Last First M. Instructions: Place a check-mark where indicated for each core group you are requesting. Review education and basic
More informationQuestion-and-Answer Document 2010 AHA Guidelines for CPR & ECC As of October 18, 2010
Question-and-Answer Document 2010 AHA Guidelines for CPR & ECC As of October 18, 2010 Q: What are the most significant changes in the 2010 AHA Guidelines for CPR & ECC? A: Major changes for all rescuers,
More informationNew 7/1/2015 MCFRS 1
New 7/1/2015 MCFRS 1 The providers will summarize the need for this change from an epinephrine auto injector The provider will define the proper dosage of epinephrine for the adult and pediatric patient
More informationEmergency Medical Services Advanced Level Competency Checklist
Emergency Services Advanced Level Competency Checklist EMS Service: Current License in State of Nebraska: # (Copy of license kept in file at station) Date of joining EMS Service: EMS Service Member Name:
More informationNeonatal Reference Guide
Operated by REACH Air Medical Services Assessment Heart Rate (beats/min.) Rate
More informationHuman Growth and Reproduction
Human Growth and Reproduction Sperm reach ovum and cluster around it Only one sperm is allowed to penetrate egg When the sperm penetrates the egg, the egg immediately releases a chemical creating a hard
More informationInfant CPR. What You Need to Know. How to Do Infant CPR
Infant CPR Infant CPR also called Cardiopulmonary resuscitation is emergency care given to a baby who has stopped breathing. This sheet has the steps for CPR for newborns or babies less than 1 year old.
More information