ACLS
Elements of a system of care
Structure
Processes
System
Outcomes
Structure
People
Equipment
Education
Processes
Policies
Procedure
Protocols
System
Programs
Organizations
Culture
Outcomes
Patient safety
Quality
Satisfaction
high performance teams
team leader
,-organizes, monitors performance, backs up team members, models excellent behavior,
trains, facilitates understanding, focuses on comprehensive pt care, temporarily
designates another team member to take over if an advanced procedure is required
team members
-proficient in performing the skills in their clear scope of practice, clear about role
assignments, prepared to fulfil responsibilities, well practiced in resuscitation skills,
knowledgeable about algorithms, commited to success
team member/cpr coach
-coordinates the start of CPR, coaches to imrove quality of chest compressions, states
the mid range targets, helps minimize length of pauses in compression
RRT or MET
Rapid Response Team
Medical Emergency Team
Examples of critiea for RRT
Airway compromise
Respiratory rate less than 6/minute or more than 30/minute
Heart rate less that 40 bpm or greater than 140 bpm
Systolic blood pressure less than 90 mmHg
Symptomatic hypertension
Unexpected decrease in level of consciousness
Unexplained agitation
Seizure
Significant decrease in urine output
Subjective concern about the pt
, ➡️ ➡️ defibrillation➡️advanced
OHCA Chain of Survival
➡️ ➡️
Activation of emergency response high quality cpr
resuscitation post cardiac arrest care recovery
➡️ ➡️ high quality
ICHA chain of survival
➡️ ➡️ ➡️
Early recognition and prevention activation of emergency response
CPR defibrillation post cardiac arrest care recovery
BLS assessment
Use ABCs
-airway -breathing -circulation
➡️ ➡️
➡️
Check responsiveness shout for help, active EMS, get AED check for breathing
➡️ ➡️
and pulse for 5-10 seconds no pulse begin high quality CPR, if pt has pulse start
rescue breathing (1 breath every 6 sec) check pulse every 2 minutes when AED
➡️
arrives turn on, follow prompts, place pads, clear pt and check for shockable rhythm, if
appropriate clear pt and shock check pulse if no pulse resume CPR
High quality CPR
Rate of 100-120 per minute (30:2 compression to breath ratio)
Compression depth of 2-2.4 inches
Allow complete recoil
Switch compressors every 2 minutes or sooner if needed
Minimize interruptions to less than 10 seconds
Avoid excessive ventilation
Coronary profusion pressure/ CPP
Aortic relaxation (diastolic) pressure - right atrial relaxation (diastolic) pressure
Elements of a system of care
Structure
Processes
System
Outcomes
Structure
People
Equipment
Education
Processes
Policies
Procedure
Protocols
System
Programs
Organizations
Culture
Outcomes
Patient safety
Quality
Satisfaction
high performance teams
team leader
,-organizes, monitors performance, backs up team members, models excellent behavior,
trains, facilitates understanding, focuses on comprehensive pt care, temporarily
designates another team member to take over if an advanced procedure is required
team members
-proficient in performing the skills in their clear scope of practice, clear about role
assignments, prepared to fulfil responsibilities, well practiced in resuscitation skills,
knowledgeable about algorithms, commited to success
team member/cpr coach
-coordinates the start of CPR, coaches to imrove quality of chest compressions, states
the mid range targets, helps minimize length of pauses in compression
RRT or MET
Rapid Response Team
Medical Emergency Team
Examples of critiea for RRT
Airway compromise
Respiratory rate less than 6/minute or more than 30/minute
Heart rate less that 40 bpm or greater than 140 bpm
Systolic blood pressure less than 90 mmHg
Symptomatic hypertension
Unexpected decrease in level of consciousness
Unexplained agitation
Seizure
Significant decrease in urine output
Subjective concern about the pt
, ➡️ ➡️ defibrillation➡️advanced
OHCA Chain of Survival
➡️ ➡️
Activation of emergency response high quality cpr
resuscitation post cardiac arrest care recovery
➡️ ➡️ high quality
ICHA chain of survival
➡️ ➡️ ➡️
Early recognition and prevention activation of emergency response
CPR defibrillation post cardiac arrest care recovery
BLS assessment
Use ABCs
-airway -breathing -circulation
➡️ ➡️
➡️
Check responsiveness shout for help, active EMS, get AED check for breathing
➡️ ➡️
and pulse for 5-10 seconds no pulse begin high quality CPR, if pt has pulse start
rescue breathing (1 breath every 6 sec) check pulse every 2 minutes when AED
➡️
arrives turn on, follow prompts, place pads, clear pt and check for shockable rhythm, if
appropriate clear pt and shock check pulse if no pulse resume CPR
High quality CPR
Rate of 100-120 per minute (30:2 compression to breath ratio)
Compression depth of 2-2.4 inches
Allow complete recoil
Switch compressors every 2 minutes or sooner if needed
Minimize interruptions to less than 10 seconds
Avoid excessive ventilation
Coronary profusion pressure/ CPP
Aortic relaxation (diastolic) pressure - right atrial relaxation (diastolic) pressure
