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Substitute date is for students, who were not able to arrive for normal date.

First aid fundamentals (28th October 2010) 1 st part : education Department of anaesthesiology and inten. medicine, SNP 1 st. 2 nd part :education Department of Traumatology, Rastislavova 43 st.

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Substitute date is for students, who were not able to arrive for normal date.

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  1. First aid fundamentals (28th October 2010) 1st part : education Department of anaesthesiology and inten. medicine, SNP 1 st. 2nd part :education Department of Traumatology, Rastislavova 43 st. Seminary room KAIM 2nd floor, SNP st. 1, we ask students to wait for teacher on the 2nd floor in front of University Department of Anaesthesiology & Intensive Care Substitute date is for students, who were not able to arrive for normal date. 3.12.2010 14.00h TEST: 10 MCQ First aid ( Basic life support adults, Pediatric basic life support, Shock, Wounds, Heat Stroke, Burns ,Emergency Rescue and Transfer – Removal from Automobile,…Literature: First Aid Manual, Latest Update, St John Ambulance Association, 2005, www.erc.com, Moule P., Albarran J., 2009: Practical resuscitation for healthcare professionals www. books.google.com

  2. KLINIKA ANESTÉZIOLÓGIE a INTENZÍVNEJ MEDICÍNY UPJŠ LF a UNLP KOŠICE Paediatric basic life support Monika Grochová MD, PhD Klinika anestéziológie a intenzívnej medicíny LF UPJŠ a UNLP Košice

  3. www.erc.eduwww.resus.org.uk • Resuscitation (2005, 2010) 67 Supplement • Resuscitation (2005, 2010) 67

  4. Basic life support Airway – airways opening Breathing – arteficial ventilation Circulation – recovery of circulation CBA adults

  5. Paediatric basic life support • simplification based on the knowledge that many children receive no resuscitation at all because rescuers fear doing harm Age: - An infant is a child under 1 year of age - a child is between 1 year and puberty 25 kg, 8. years

  6. Adult CPR techniques can be used on children Compressions 1/3 of the depth of the chest CPR IN CHILDREN

  7. 30 30

  8. Campbell BASIC LIFE SUPPORT (BLS) Approach safely Check response Shout for help Open airway head tilt and chin lift,

  9. BASIC LIFE SUPPORT (BLS) Approach safely Check response Shout for help Open airway Check breathing • Look, listen and feel for NORMAL breathing

  10. Breathing • Take a breath and cover the mouth and nasal apertures of the infant with your mouth, making sure you have a good seal • Blow steadily into the infant’s mouth and nose over 1—1.5 s, sufficient to make the chest visibly rise • Take another breath and repeat this sequence five times

  11. Breathing No effective breathing:- the airway may be obstructed • Open the child’s mouth and remove any visible obstruction. • Ensure that there is adequate head tilt and chin lift, try the jaw thrust method • Make up to five attempts to achieve effective breaths; if still unsuccessful, move on to chest compressions

  12. Breathing, circulation • look for signs of a circulation any movement, coughing normal breathing=circulation is present (not agonal gasps, which are infrequent, irregular breaths)

  13. Basic life support • Chest compressions • To 1. year 2 fingers (2 thumbs circular) • Over 1. yer one hand/two hands • Low part of sternum • Thumb over processus xiphoideus • Compression by 1/3 of antero-posterior distance • AED • Children > 1 year • Smaller size of pads for children to 8 years • 50 – 75 J (4 J/kg)

  14. Chest compression

  15. Chest compressions • to depress the sternum by approximately one third of the depth of the chest • and repeat at a rate of about 100 min−1

  16. Chest compressions : breaths30:2

  17. AED IN CHILDREN • Age > 8 years • use adult AED • Age 1-8 years • use paediatric pads / settings if available (otherwise use adult mode) • Age < 1 year • use only if manufacturer instructions indicate it is safe

  18. AED DEFIBRILLATION

  19. ATTACH PADS TO CASUALTY’S BARE CHEST

  20. ANALYSING RHYTHM - DO NOT TOUCH VICTIM

  21. Stand clear Deliver shock SHOCK INDICATED

  22. SHOCK DELIVEREDFOLLOW AED INSTRUCTIONS 302

  23. Recovery position

  24. Approach safely Approach safely Check response Check response Shout for help Shout for help Open airway Open airway Check breathing Check breathing Call 112 Call 112 5 rescue breaths Attach AED 30chest cmpressions Follow voice prompts

  25. Anatomical diferencies of airwais by children

  26. Postresuscitation care • Aproppriate tissue perfusion • Cooling – if unconsiousness after CPR • 32 – 34°C of body core 12 – 24 hours • Warming 0,25 – 0,5°C / hour • AE- infection, koagulopathy, glykémia, ións, circulation • Avoid hyperthermia - antipyretics

  27. ETICS and CPR • Start – not start • Parents´presens during CPR • Decision to stp CPR- team leader, not parents

  28. CPR of newborn

  29. Newborn resuscitation • Lungs distension- ambu- bag with face mask,in term newborn f: 30-60/min if bradycardia persists - increase oxygen concentration • Mecónium – desuflation by weak newborns • Compressions- breathing ratio 3:190 compressionsií and 30 breaths • Adrenalín, if despite art. Vent.with O2 bradycardia <60/mindose 0,01-0,03 mg/kg i.v., into ETT 5-7 x more • Check HR every 30 sekúnd, STOP if HR > 60/min • Circulation support evective only by lungs distension • Temperature of body core maintenance

  30. Foreign body airway obstruction • Combination of methods needed • 5 hits back blows • 5 chest compressions (till 1year) / abdominal thrusts over 1 year • Horisontal rib´s position – abdominal organs damage risk

  31. KLINIKA ANESTÉZIOLÓGIE a INTENZÍVNEJ MEDICÍNY UPJŠ LF a UNLP KOŠICE ANY QUESTIONS?

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