By Michael Colquhoun, Anthony J. Handley, T. R. Evans
This consultant has concise and useful details on all features of resuscitation. New instructions are only one of many adjustments to the fifth variation of this ebook as some of the chapters were thoroughly rewritten.
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Extra info for ABC of resuscitation
In the unconscious patient relaxation of the tongue, neck, and pharyngeal muscles causes soft tissue obstruction of the supraglottic airway. This may be corrected by the techniques of head tilt with jaw lift or jaw thrust. The use of head tilt will relieve obstruction in 80% of patients but should not be used if a cervical spine injury is suspected. Chin lift or jaw thrust will further improve airway patency but will tend to oppose the lips. With practice, chin lift Normal ventilation of a 70 kg adult comprises: ● ● ● ● A respiratory minute volume of 6 l/min air containing 21% oxygen, with a tidal volume of 500 ml at 12 breaths/min An expired oxygen level of 16-17%, hence its use in expired air resuscitation Cardiac output is typically 5 l/min at 60-80 beats/min.
Both are treated in the same way, by following the right-hand side of the algorithm. When using a manual defibrillator and ECG monitor, non-VF/VT will be recognised by the clinical appearance of the patient and the rhythm on the monitor screen. When using an automated defibrillator, non-VF/VT rhythms are diagnosed when the machine dictates that no shock is indicated and the patient has no signs of a circulation. When the rhythm is checked on a monitor screen, the ECG trace should be examined carefully for the presence of P waves or other electrical activity that may respond to cardiac pacing.
This will be timed by the machine, after which it will prompt the operator to reanalyse the rhythm. Alternatively, this procedure may start automatically, depending on the machine’s individual features or settings. Shocks should be repeated as indicated by the AED. If a circulation returns after a shock, check for breathing and continue to support the patient by rescue breathing if required. Check the patient every minute to ensure that signs of a circulation are still present. If the patient shows signs of recovery, place in the recovery position.