Dr.Arkan
s
Session
CPR + IV access Wednesday, August 10, 2016
This CPR lecture has been discussed
Go to
https://www.muhadharaty.com/lecture/
Notes ON CPR :
1-carotid pulse is 1st pulse should be checked if present: -check it every 2min
If not:-do CPR
If not sure it's present or not :consider it's no present &do CPR
2-femoral A. checked if no access for carotid a.
3-ACLS Should be established by :1-Hx:what's problem
2-what has beeb done for him?
3-P.M.S.Hx
Then continue ACLS as lecture
4-atropine is given if the pt developed bradycardia
5-when to stop PCR?-
نقتطين بالمحاضرة
1
-regular respiratory effort 2-exhaled CO2
3-BP returned
6-hyper-k+ ---develop after dialysis & hypothermia --develop in homeless or drowning pt
Hypovolemia ---develop after bleeding and it's covered by C of ABC in CPR by doing an IV
access.
oropharyngeal airway(very important)
-separate the tongue from the pharynx
2-how to choose the probable size
Dr.Arkan
s
Session
CPR + IV access Wednesday, August 10, 2016
3-Method of use
if large size the air may enter the stomach if small size may push the tongue and cause
further obstruction
_in normal person can't use because of gag reflex
_suction could be down through it
4-nasogastric tube
for feeding suction and decompression and not use in
head injury and fracture base of skull
How to know it's on right position
؟
1_ by stethoscope (gurgling sounds)
2_ aspiration is acidic and red in color
3 _ x_ray
resuscitation bag ambu bag (E and C finger holding
method)
Dr.Arkan
s
Session
CPR + IV access Wednesday, August 10, 2016
5endotracheal tube
The normal potassium level in the blood is 3.5-5.3 (mEq/L)
*
Dr.Arkan
s
Session
CPR + IV access Wednesday, August 10, 2016
Session 2
IV access (You can find this topic in Remix and all aspects has been discussed) Go to
https://www.muhadharaty.com/lecture/
Notes :
Site:
1-upper arm 2-non-dominant limb 3-more distal 4-avoid joints 5-avoid burned or
operated surgically
*in obese pt & child try on volar aspect of wrist bz it's least fatty region.
Duration < 3days but don't remove it until find new one
Points to consider in cannulation
1-torniquate –to occlude the vein not the artery so not so tight should be applied
2-striaght & engorged vein
3-sometimes ask him to fist
4-gental tapping on vein ----local vasodilatation
5-down the limb to be dependent ----below the heart level
6-distally tract the skin over the vein
7-good light
8-do loop on tube of IVF
to avoid avulsion of
cannula
*the tape should be
special type bz 1-
semipermiable 2-
transparent 3-writable
on it(dating&naming)
*Gender is not consider
significant factor
Dr.Arkan
s
Session
CPR + IV access Wednesday, August 10, 2016
Thrombophelobitis is caused either 1-mechanical cause is main type(vein wall frition)
*
2-chemical 3-infectin Mx is supportive like elevation & removal
*Packed RBC PCV is 70
ints on fluids
o
P
Colloid
Crystalloid
Dexrane & hydroxylethyl starch
N.s & GW & Ringer lactate(which is
most physiologically similar to plasma)
Half life is loger
Half life is 3-6 hr
1;1 ratio is used that mean for 500cc
blood lost replaced by 500cc colloid
Each cc of blood lose shoud be replaced
3:1 ratio
M.W IS > 40,000 dalton
Points on fluid therapy
1-maintence __4:2:1 that mean
&after that 20kg give
10 kg give 2 ml/kg/hr
nd
10 kg of pt give 4ml/kg/hr &for 2
st
for 1
1ml/kg
2-defecient -----fasting 5hr for ex.
3-ongoing lose----here from NGT or other but U need chart for giving fluids