PALS Scenario Review

Course overview

Objectives Describe the updates to the 2020 PALS course Describe pediatric ALS responses and how they differ from adults Discuss the chain of survival and EMS role in cardiac arrest response Content Anatomy and Physiology Review 1 Respiratory System Passageway for fresh oxygen to enter the lungs and blood supply Respiratory waste products to leave the blood and lungs 2 Cardiovascular System Heart Four chambers Pumps blood to the lungs to pick up oxygen Pumps blood around the body To deliver oxygen and nutrients to the tissues To remove waste products from the tissues Vascular System Arteries carry blood to tissues Carotid pulse Femoral pulse Radial pulse Brachial pulse Veins carry blood to heart Respiratory Failure Pathophysiology Constrictive Obstructive Destructive Assessment Pulmonary symptoms Cardiovascular symptoms Neurological symptoms Other symptoms Treatment Oxygen therapy Ventilatory support Carbon dioxide clearance Pharmacological therapy Respiratory Arrest Assessment Treatment Oxygen therapy Ventilatory support Carbon dioxide clearance Advanced airways Cardiac Arrest Pathophysiology If the heart stops contracting no blood will flow The body cannot survive when the heart stops Organ damage begins quickly after the heart stops Brain damage begins four to six minutes after cardiac arrest and becomes irreversible in eight to ten minutes Cardiopulmonary Resuscitation CPR Artificial ventilation oxygenates the blood External chest compressions squeeze the heart and simulate contraction Oxygenated blood circulates to the brain and vital organs General Reasons for the Heart to Stop Beating Sudden death and heart disease Breathing stops especially in infants and children Medical emergencies Trauma Resuscitation System Components to Maximize Survival Early access Public education and awareness Rapid recognition of cardiac emergency Rapid notification before CPR starts phone first Nine one one pre arrival instructions and dispatcher directed CPR Early CPR Lay public Family Bystanders Emergency Medical Responders Early defibrillation Early advanced care Basic Cardiac Life Support Refer to current American Heart Association guidelines Adult CPR and foreign body airway obstruction Child CPR and foreign body airway obstruction Infant CPR and foreign body airway obstruction Airway Control and Ventilation Basic airway adjuncts Ventilation Delivery of excessive rate or depth of ventilation reduces blood return to the right side of the heart Reduces overall blood flow generated with CPR Chest Compressions Factors that decrease effectiveness Compressions that are too shallow Slow compression rate Sub maximum recoil Frequent interruptions Devices to assist circulation Impedance threshold device Mechanical piston device Load distributing band or vest CPR Automated External Defibrillation AED Refer to current American Heart Association guidelines Adult AED use Child AED use Infant AED use Special AED situations Pacemaker Wet patients Transdermal medication patches Shock Poor Perfusion Definition Perfusion is the passage of blood oxygen and essential nutrients to body cells Circulatory system removes waste such as carbon dioxide Shock is a state of hypoperfusion Hypoperfusion can lead to death if not corrected Anatomy and Physiology Review Heart and blood vessels Physiology of respiration Gas exchange Alveolar level Tissue level Circulation Pulmonary Systemic Essential components for normal perfusion Functioning pump heart Pump delivers blood to tissue Pump collects blood from body Controlled by autonomic nervous system during shock Adequate volume Blood contains formed elements Red blood cells transport oxygen White blood cells fight infection Platelets form blood clots Plasma transports formed elements Intact container vessels Arteries surrounded by smooth muscle contract and dilate Capillary beds are site of perfusion Veins return blood to heart Smooth muscle and sphincters controlled by autono