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resuscitation
council
If not responsive
Open airway & check for breathing
CPR 30:2
If the victim starts to wake up: to move, to open eyes and to breathe normally, stop CPR.
If still unconscious, turn him into the recovery position*.
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_BLSAED_01_01_ENG Copyright European Resuscitation Council
european
resuscitation
council
In-hospital Resuscitation
Collapsed/sick patient
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_IHBLS_01_01_ENG Copyright European Resuscitation Council
european
resuscitation
council
In-hospital Resuscitation
Collapsed/sick patient
CPR 30:2
with oxygen and airway adjuncts
www.erc.edu | info@erc.edu | Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium | Product reference: Poster_10_IHBLS-A_01_01_ENG Copyright European Resuscitation Council
european
resuscitation
council
Unresponsive?
Not breathing or only occasional gasps
Call
Resuscitation Team
CPR 30:2
Attach defibrillator/monitor
Minimise interruptions
Assess
rhythm
Shockable Non-shockable
(VF/Pulseless VT) (PEA/Asystole)
Return of
1 Shock spontaneous
circulation
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_ALS_01_01_ENG Copyright European Resuscitation Council
european
resuscitation
council
Atropine
500 mcg IV
Satisfactory
Yes
Response?
No Risk of asystole?
• Recent asystole
Yes • Möbitz II AV block
• Complete heart block with broad QRS
• Ventricular pause > 3s
Interim measures:
• Atropine 500 mcg IV
repeat to maximum of 3 mg
No
• Isoprenaline 5 mcg min-1
• Adrenaline 2-10 mcg min-1
• Alternative drugs*
OR
• Transcutaneous pacing
* Alternatives include:
• Aminophylline
• Dopamine
• Glucagon (if beta-blocker or calcium channel
blocker overdose)
• Glycopyrrolate can be used instead of atropine
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_ALS-BRAD_01_01_ENG Copyright European Resuscitation Council
european
resuscitation
council
Possibilities include: If Ventricular Tachycardia Normal sinus rhythm restored? No Seek expert help
• AF with bundle branch block (or uncertain rhythm):
treat as for narrow complex • Amiodarone 300 mg IV over
• Pre-excited AF 20-60 min; then 900 mg over 24 h
Yes
consider amiodarone
• Polymorphic VT If previously confirmed
(e.g. torsades de pointes - SVT with bundle branch block:
give magnesium 2 g over 10 min) • Give adenosine as for regular
narrow complex tachycardia
Probable re-entry PSVT: Possible atrial flutter
• Record 12-lead ECG in sinus rhythm • Control rate (e.g. ß-Blocker)
• If recurs, give adenosine again &
consider choice of anti-arrhythmic
*Attempted electrical cardioversion is always undertaken under sedation or general anaesthesia prophylaxis
www.erc.edu | info@erc.edu | Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium | Product reference: Poster_10_ALS-TACH_01_01_ENG Copyright European Resuscitation Council
european
resuscitation
council
UNRESPONSIVE?
Open airway
5 rescue breaths
NO SIGNS OF LIFE?
15 chest compressions
2 rescue breaths
15 compressions
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_PaedBLS_01_01_ENG Copyright European Resuscitation Council
european
resuscitation
council
Unresponsive?
Not breathing or only occasional gasps
Assess
rhythm
Shockable Non-shockable
(VF/Pulseless VT) (PEA/Asystole)
Return of
1 Shock 4 J/Kg spontaneous
circulation
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_PALS_01_01_ENG Copyright European Resuscitation Council
european
resuscitation
council
Re-assess
If no increase in heart rate
Look for chest movement
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_NLS_01_01_ENG Copyright European Resuscitation Council