Bvm Bag Valve Mask Manual Resuscitation Systems
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ABCDE Approach
The ABCDE and SAMPLE History Approach Basic Emergency Care Course Objectives • List the hazards that must be considered when approaching an ill or injured person • List the elements to approaching an ill or injured person safely • List the components of the systematic ABCDE approach to emergency patients • Assess an airway • Explain when to use airway devices • Explain when advanced airway management is needed • Assess breathing • Explain when to assist breathing • Assess fluid status (circulation) • Provide appropriate fluid resuscitation • Describe the critical ABCDE actions • List the elements of a SAMPLE history • Perform a relevant SAMPLE history. Essential skills • Assessing ABCDE • Needle-decompression for tension • Cervical spine immobilization pneumothorax • • Full spine immobilization Three-sided dressing for chest wound • • Head-tilt and chin-life/jaw thrust Intravenous (IV) line placement • • Airway suctioning IV fluid resuscitation • • Management of choking Direct pressure/ deep wound packing for haemorrhage control • Recovery position • Tourniquet for haemorrhage control • Nasopharyngeal (NPA) and oropharyngeal • airway (OPA) placement Pelvic binding • • Bag-valve-mask ventilation Wound management • • Skin pinch test Fracture immobilization • • AVPU (alert, voice, pain, unresponsive) Snake bite management assessment • Glucose administration Why the ABCDE approach? • Approach every patient in a systematic way • Recognize life-threatening conditions early • DO most critical interventions first - fix problems before moving on -
Strategies to Support the COVID-19 Response in Lmics a Virtual Seminar Series Screening, Triage and Patient Flow
Strategies to support the COVID-19 response in LMICs A virtual seminar series Screening, Triage and Patient Flow Bhakti Hansoti, MBChB, MPH, PhD - Associate Professor in Emergency Medicine, Johns Hopkins University OBJECTIVES 1. Clinical Features 2. Preparing the Department 3. Initial Management 4. Other Management Considerations 5. Summary Clinical Features Severity • Most people with COVID-19 develop mild or uncomplicated illness • Approximately 14% develop severe disease requiring hospitalization and oxygen support • 5% require admission to an intensive care unit • In severe cases, COVID-19 can be complicated by • Acute respiratory disease syndrome (ARDS) • Sepsis and septic shock • Multiorgan failure, including acute kidney injury and cardiac injury. Preparing the Department Elements to be assessed have been divided into the following areas: • Establishment of a core team and key internal and external contact points • Human, material and facility capacity • Communication and data protection • Hand hygiene, personal protective equipment (PPE), and waste management • Triage, first contact and prioritization • Patient placement, moving of the patients in the facility, and visitor access • Environmental cleaning https://www.ecdc.europa.eu/en/publications-data/checklist- hospitals-preparing-reception-and-care-coronavirus-2019-covid-19 Split flow Protecting Yourself These videos can help with PPE donning and doffing technique: • Donning and doffing PPE https://www.youtube.com/watch?v=I94l IH8xXg8 • Recommended PPE during care https://www.youtube.com/watch?v=oPL -
High Performance CPR Update
High Performance CPR Update Page | 1 Final Revision 8/8/2012 As part of our ongoing Quality Assurance in Cardiac Arrest incidents, Skagit County EMS under the direction of Dr. Don Slack, MPD is making changes to the way that ALS and BLS providers perform CPR. Overview: CPR quality has a dramatic impact on pt survival when done according to these guidelines. Minimal breaks in compressions, full chest recoil, adequate compression depth and adequate compression rate are all components of CPR that an increase survival from sudden cardiac arrest. Together these components go together to create High Performance CPR (HP CPR). Roles: As a rule for the unconscious, unresponsive, pulseless patient the FIRST person to the patient starts compressions. SECOND person does defibrillation (If there are only 2 responders to begin with, ventilations should begin after the rhythm analysis and shock if indicated). THIRD person should start ventilating the patient, placing a King Airway as soon as is practical. A timekeeper needs to be assigned to ensure high quality CPR, minimal interruption and help track the ALS interventions. Principles of HP CPR 1. EMT’s own CPR!! 2. Minimize interruption in CPR at all times, use a timekeeper 3. Ensure proper depth of compressions (>2 inches) 4. Ensure full chest recoil/decompression 5. Ensure proper chest compression rate (100-120/min) 6. Rotate compressors at least every 2 minutes 7. Do not interrupt compressions to ventilate patient, even if an advanced airway is not placed 8. Hands off the chest only during analysis and shock delivery, hover hands over chest during shock delivery and be ready to resume compressions 9. -
Small Adult CPR-2 Bag with Litesaver Manometer Brochure
ORDERING INFORMATION Your Need ... Our Innovation® O Manometer 2 Detector 2 AerosolTubing Reservoir Infant Cushion Mask Expandable Large Bore Color-Coded Mask PEEP w/Filter StatCO Manometer LiteSaverTiming Light with CPR (Synthetic Rubber) CPR-2 (PVC) Light Blue Oxygen Bag Reservoir (22mm) Adult Cushion Mask SmallAdult Cushion Mask with Flange #3 Pediatric Cushion Mask Child Cushion Mask PEEP Valve Pop-Off Dark Blue Oxygen Reservoir 0-60 cm H PART # OTHER #10-56402 X X X X X X #10-56403 X X X X #10-56404 X X X X X #10-56411 X X X X #10-56412 X X X X X #10-56423 X X X X X X #10-56424 X X X X X X CPR-2 Small Adult Bag with Manometer #10-56432 X X X X X #10-56435 X X X X X X X #10-56437 X X X X #10-56438 X X X X X #10-56440 X X X X #10-58500 X X X X #10-58501 X X X X X #10-58502 X X X X X #10-58503 X X X X X X #10-58506 X X X X X X #10-58507 X X X X X #10-58509 X X X X X #10-58512 X X X X X X X #10-55901 X X X #10-55904 X X X #10-55907 X X X #10-55909 X X X X #10-55910 X X X X #10-55912 X X X #10-55913 X X X X X X No lock clip #10-55915 X X X X X #10-55916 X X X #10-55917 X X X X X #10-55918 X X X X X X #10-55922 X X X X X X X #10-55923 X X X X #10-55924 X X X X X #10-55928 X X X #10-58400 X X X X #10-55365 LiteSaver Manometer Assy 20/Box 0-60 cm H2O, Adult Frequency 10 BPM #10-55366 LiteSaver Manometer Assy 20/Box Assembly 0-60 cm H2O In-Line Tee Right Orientation, Adult Frequency 10 BPM #10-55367 LiteSaver Manometer Assy 20/Box Assembly 0-60 cm H2O In-Line Tee Left Orientation, Adult Frequency 10 BPM = CPR-2 Small Adult Bags *References Can EMS Providers Provide Appropriate Tidal Volumes in a Simulated Adult-sized Patient with a Pediatric-sized Bag-Valve-Mask? Journal Pre-hospital Emergency Care, Volume 21, 2017, Issue 1, Jeffery Siegler, MD, EMT-P, Melissa Kroll, MD, Susan Wojcik, PhD, ATC & Hawnwan Philip May, MD Avoid Airway Catastrophes on the Extremes of Minute Ventilation, Acepnow.com, January 20, 2015, Richard M. -
Cert Disaster Medical Operations Guidelines & Treatment Protocol
WALNUT CREEK, CA COMMUNITY EMERGENCY RESPONSE TEAMS (CERT) CERT DISASTER MEDICAL OPERATIONS GUIDELINES & TREATMENT PROTOCOL TRAINING MANUAL October, 2013 Walnut Creek Community Emergency Response Teams (CERT) Disaster Medical Operations Guidelines & Treatment Protocol Training Manual CERT Disaster Medical Operations (CERT MED OPS) Mission Statement Mission: To provide the greatest good for the greatest number of people. Following a major disaster, CERT volunteers will be called upon to Triage and provide basic first aid care to members of the community that sustain injury of all types and levels of severity. Policy: CERT Medical Operations will function and provide care consistent with national CERT Training guidelines. The CERT Volunteers will function within these guidelines. Structure: CERT Medical Operations (CERT MED OPS) reports to Operations Section. CERT MED OPS Volunteer Requirements CERT MED OPS volunteers will Triage and assess each victim, as needed, according to the RPM & Simple Triage and Rapid Treatment (START) techniques that they learned during CERT training. They will treat airway obstruction, bleeding, and shock by using START techniques. They will treat the victims according to the CERT training guidelines and CERT skills limitations. CERT MED OPS volunteers will also evaluate each victim by conducting a Head-To-Toe Assessment, and perform basic first aid in a safe and sanitary manner. CERT MED OPS volunteers will ensure that victim care is documented so information can be communicated to advanced medical care when and as it becomes available. CERT MED OPS volunteers understand that CPR is not initiated in Disaster Medical Operations e.g., mass casualty disaster situations. The utmost of care and compassion will be undertaken with family members to assist them with their grieving process. -
Capnography (ILS/ALS)
Capnography (ILS/ALS) Clinical Indications: 1. Capnography shall be used as soon as possible in conjunction with any airway management adjunct, including endotracheal, Blind Insertion Airway Devices (BIAD) or Bag Valve Mask (BVM). 2. Capnography should also be used on all patients treated with CPAP or epinephrine for respiratory distress. 3. Acute respiratory distress. 4. Assisted ventilations. 5. Sustained altered mental status. Procedure: 1. Attach capnography sensor to the BIAD, endotracheal tube, or oxygen delivery device. 2. Note CO2 level and waveform changes. These will be documented on each respiratory failure, cardiac arrest, or respiratory distress patient. 3. The capnometer shall remain in place with the airway and be monitored throughout the prehospital care and transport. 4. Any loss of CO2 detection or waveform indicates an airway problem and should be documented. 5. The capnogram should be monitored as procedures are performed to verify or correct the airway problem. 6. Document the procedure and results on/with the Patient Care Report (PCR) and the Airway Evaluation Form. 7. In all patients with a pulse, an ETCO2 >20 is anticipated. In the post-resuscitation patient, no effort should be made to lower ETCO2 by modification of the ventilatory rate. Further, in post- resuscitation patients without evidence of ongoing, severe bronchospasm, ventilatory rate should never be < 6 breaths per minute. 8. In the pulseless patient, and ETCO2 waveform with an ETCO2 value >10 may be utilized to confirm the adequacy of an airway to include BVM and advanced devices when Sp02 will not register. Critical Comment: • When CO2 is NOT detected, three factors must be quickly assessed : 1. -
Information on Defibrillation and Ventilation with the LUCAS® Chest Compression System
® LUCAS CHEST COMPRESSION SYSTEM Information on Defibrillation and Ventilation with the LUCAS® Chest Compression System The goal when using the LUCAS device is to provide effective, After Defibrillation consistent, and uninterrupted chest compressions. When an After the shock is delivered it is important to verify the position of the interruption to chest compressions occurs, the patient’s coronary suction cup to see it has not moved out of place. This is easier to do perfusion pressure (CPP) drops rapidly. CPP is the measure of the if an ink marker line was marked where the suction cup was originally pressure that drives blood flow through the coronary arteries to the positioned on the patient. Readjust as necessary. heart muscle. The heart normally maintains a CPP of 60 millimeters of mercury (mmHg) or more. During cardiac arrest, the CPP drops dramatically, threatening the heart muscle’s blood supply. As it can take Oxygenation with Ventilation some time to build up CPP again, interruptions to chest compressions should be minimized. To supply adequate concentrations of oxygen in the blood, ensure the patient is properly ventilated. Ventilations should be provided in The current American Heart Association Guidelines emphasize conjunction with mechanical chest compressions. Interruptions to 1 minimizing interruptions when delivering high quality CPR: chest compressions should be minimized to maintain the level of • Minimize pre- and post-shock pauses (class I), oxygen delivered to tissues. During the first few minutes of sudden cardiac arrest, chest compressions to improve blood flow have been • Pause compressions for less than 10 seconds when delivering two shown to be more important than ventilations because oxygen blood breaths (class IIa), levels remain high initially.4 • Maximize the time with chest compressions (class IIb). -
The Golden Hour > How Time Shapes Airway Management > by Charlie Eisele,BS,NREMT-P
September 2008 The A supplement to JEMS (the Journal of Emergency Medical Services) Conscience of EMS JOURNAL OF EMERGENCY MEDICAL SERVICES Sponsored by Verathon Inc. ELSEVIER PUBLIC SAFETY The Perfect View How Video Laryngoscopy Is Changing the Face of Prehospital Airway Management A supplement to September 2008 JEMS, sponsored by Verathon Inc. 4 Foreword > To See or Not to See, That Is the Question > By A.J.Heightman,MPA,EMT-P 5 5 The Golden Hour > How Time Shapes Airway Management > By Charlie Eisele,BS,NREMT-P 9 The Video Laryngoscopy Movement > Can-Do Technology at Work > By John Allen Pacey,MD,FRCSc 11 ‘Grounded’ Care > Use of Video Laryngoscopy in a Ground 11 EMS System: Better for You, Better for Your Patients > By Marvin Wayne,MD,FACEP,FAAEM 14 Up in the Air > Video Laryngoscopy Holds Promise for In-Flight Intubation > By Lars P.Bjoernsen,MD,& M.Bruce Lindsay,MD 16 16 The Military Experience > The GlideScope Ranger Improves Visualization in the Combat Setting > By Michael R.Hawkins,MS,CRNA 19 Using Is Believing > Highlights from 72 Cases Involving Video Laryngoscopy at Martin County (Fla.) Fire Rescue > By David Zarker,EMT-P 21 Teaching the Airway > Designing Educational Programs for 21 Emergency Airway Management > By Michael F.Murphy,MD; Ron M.Walls,MD; & Robert C.Luten,MD COVER PHOTO KEVIN LINK Disclosure of Author Relationships: Authors have been asked to disclose any relationships they may have with commercial supporters of this supplement or with companies that may have relevance to the content of the supplement. Such disclosure at the end of each article is intended to provide readers with sufficient information to evaluate whether any material in the supplement has been influenced by the writer’s relationship(s) or financial interests with said companies. -
Resuscitation and Defibrillation
AARC GUIDELINE: RESUSCITATION AND DEFIBRILLATION AARC Clinical Practice Guideline Resuscitation and Defibrillation in the Health Care Setting— 2004 Revision & Update RAD 1.0 PROCEDURE: signs, level of consciousness, and blood gas val- Recognition of signs suggesting the possibility ues—included in those conditions are or the presence of cardiopulmonary arrest, initia- 4.1 Airway obstruction—partial or complete tion of resuscitation, and therapeutic use of de- 4.2 Acute myocardial infarction with cardio- fibrillation in adults. dynamic instability 4.3 Life-threatening dysrhythmias RAD 2.0 DESCRIPTION/DEFINITION: 4.4 Hypovolemic shock Resuscitation in the health care setting for the 4.5 Severe infections purpose of this guideline encompasses all care 4.6 Spinal cord or head injury necessary to deal with sudden and often life- 4.7 Drug overdose threatening events affecting the cardiopul- 4.8 Pulmonary edema monary system, and involves the identification, 4.9 Anaphylaxis assessment, and treatment of patients in danger 4.10 Pulmonary embolus of or in frank arrest, including the high-risk de- 4.11 Smoke inhalation livery patient. This includes (1) alerting the re- 4.12 Defibrillation is indicated when cardiac suscitation team and the managing physician; (2) arrest results in or is due to ventricular fibril- using adjunctive equipment and special tech- lation.1-5 niques for establishing, maintaining, and moni- 4.13 Pulseless ventricular tachycardia toring effective ventilation and circulation; (3) monitoring the electrocardiograph and recogniz- -
Abc of Occupational and Environmental Medicine
ABC OF OCCUPATIONAL AND ENVIRONMENT OF OCCUPATIONAL This ABC covers all the major areas of occupational and environmental ABC medicine that the non-specialist will want to know about. It updates the OF material in ABC of W ork Related Disorders and most of the chapters have been rewritten and expanded. New information is provided on a range of environmental issues, yet the book maintains its practical approach, giving guidance on the diagnosis and day to day management of the main occupational disorders. OCCUPATIONAL AND Contents include ¥ Hazards of work ¥ Occupational health practice and investigating the workplace ENVIRONMENTAL ¥ Legal aspects and fitness for work ¥ Musculoskeletal disorders AL MEDICINE ¥ Psychological factors ¥ Human factors ¥ Physical agents MEDICINE ¥ Infectious and respiratory diseases ¥ Cancers and skin disease ¥ Genetics and reproduction Ð SECOND EDITION ¥ Global issues and pollution SECOND EDITION ¥ New occupational and environmental diseases Written by leading specialists in the field, this ABC is a valuable reference for students of occupational and environmental medicine, general practitioners, and others who want to know more about this increasingly important subject. Related titles from BMJ Books ABC of Allergies ABC of Dermatology Epidemiology of Work Related Diseases General medicine Snashall and Patel www.bmjbooks.com Edited by David Snashall and Dipti Patel SNAS-FM.qxd 6/28/03 11:38 AM Page i ABC OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE Second Edition SNAS-FM.qxd 6/28/03 11:38 AM Page ii SNAS-FM.qxd 6/28/03 11:38 AM Page iii ABC OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE Second Edition Edited by DAVID SNASHALL Head of Occupational Health Services, Guy’s and St Thomas’s Hospital NHS Trust, London Chief Medical Adviser, Health and Safety Executive, London DIPTI PATEL Consultant Occupational Physician, British Broadcasting Corporation, London SNAS-FM.qxd 6/28/03 11:38 AM Page iv © BMJ Publishing Group 1997, 2003 All rights reserved. -
Pediatric Trauma and Critical Care Provides Six (6) Hours of Continuing Education Credit
PEDIATRIC TRAUMA AND CRITICAL CARE PROVIDES SIX (6) HOURS OF CONTINUING EDUCATION CREDIT AGENDA 0800-0830 Registration 0830-0930 Transport Pearls for the Neonate Patty Duncan, BSN, RNC 0930-0940 Break 0940-1140 Pediatric Airway and Prehospital Golden Hour Dave Duncan, MD 1145-1215 Lunch 1215-1315 State of the Art EMS Protocols are Created, Not Born That Way Paul S. Rostykus, MD, MPH, FAEMS 1315-1325 Break 1325-1525 Pediatric Trauma Heather Summerby, RN 1525-1530 Evaluation Transport Pearls for the Neonate Patty Duncan There are not many careers where your decisions and interactions can positively impact the life of a human for up to 80 plus years. Dr. Stephen Butler PEARLS OF NEONATAL TRANSPORT FROM A 35 YEAR NICU RN PATTY DUNCAN BSN RNC PATTY DUNCAN BSN RNC • ADVANCED LIFE SUPPORT COORDINATOR • ALS NICU TRANSPORT COORDINATOR • ASSISTANT NURSE MANAGER 61 BED LEVEL 3 NICU • STABLE INSTRUCTOR • NRP INSTUCTOR NICU TRANSPORT TEAM • VIA GROUND, FIXED WING AND ROTOR • SERVE 27 COUNTIES IN NORTHERN CA • 3 OUT OF HOUSE TRANPORT ISOLETTE CONTAIN CONV VENT HFJV NITRIC OXIDE ACTIVE COOLING TECOTHERM BCPAP THE NEONATE-WHY THEY ARE SPECIAL • OF, RELATING TO ,OR AFFECTING THE NEWBORN AND ESPECIALLY THE HUMAN INFANT DURING THE FIRST MONTH AFTER BIRTH • MERRIAM-WEBSTER Large surface area compared to size keep them warm (BSA is 3X greater than adult) Correct ventilation is the key to solving most issue be smart Glucose is their energy source - keep them sweet NEONATES: MASTERS OF DISGUISE KEY = TREAT THE SYMPTOM! • Tachypnea: the most common symptom! • Respiratory Distress Syndrome • Transient tachypnea of the newborn, Hyaline Membrane Disease, pneumothorax, pneumonia • Sepsis-bacterial, virus • Cardiac-ductal dependent vs non ductal dependent • Metabolic Acidosis • Hypoglycemia, • Hypothermia TREAT THE SYMPTOMS! THE DIAGNOSIS WILL FOLLOW (MAYBE) S.T.A.B.L.E. -
2018 EMT-M Module 2.Pdf
EMT-Miner RE-CERTIFICATION CLASS MODULE - 2 The Well-Being of the EMT-Miner Covers the emotional aspects of emergency medical care, stress management, introduction to Critical Incident Stress Debriefing (CISD), scene safety, body substance isolation (BSI), personal protection equipment (PPE), and safety precautions that can be taken prior to performing the role of a EMT Miner At the completion of this lesson, the EMT Miner will be able to: • List possible emotional reactions that the EMT-Miner may experience when faced with trauma, illness, death and dying. • Discuss the possible reactions that (co-workers) a family member may exhibit when confronted with death and dying. • State the steps in the EMT-Miner’s approach to the (co-worker) family confronted with death and dying. • State the possible reactions that the (co-worker) family of the EMT Miner may exhibit. • Recognize the signs and symptoms of critical incident stress. • State possible steps that the EMT-Miner may take to help reduce/alleviate stress. • Explain the need to determine scene safety. • Discuss the importance of body substance isolation (BSI) . • Describe the steps the EMT-Miner should take for personal protection from airborne and blood borne pathogens. Legal and Ethical Issues Explores the scope of practice, ethical responsibilities, advance directives, consent, refusals, abandonment, negligence, duty to act, confidentiality, medical identification symbols, and accident scenes. At the completion of this lesson, the EMT Miner will be able to: • Define the EMT Miner scope of care. • Discuss the importance of Do Not Resuscitate [DNR] (advance directives) and local or state provisions regarding EMS application.