Learning outcomesAt the end of this session, the students shall be ableto:1. Demonstrate proficiency in providing BLS care,

including prioritising chest compression and integrating AED use.

2. Identify and provide nursing management and care to ischaemic chest pain and expedite care of patients with acute coronary syndromes.

3. Recognise other life-threatening clinical situations, such as stroke and provide effective initial care and transfer to reduce disability and death.

Learning outcomesAt the end of this session, the students shall be ableto:4. Describe specific assessment and nursing management

that occur with each step of the systematic approach in cardiopulmonary emergencies in the A&E and Critical Care Unit.

5. Describe how he / she can apply this approach to almost all cardiopulmonary disorders.

Recap BLS lessons:What are the emphasis?

Highlights of the 2010 AHAGuidelines for CPR & ECC

From ABCD

CAB

AHA ECC Adult Chain of Survival

The links in the new AHA ECC Adult Chain of Survivalare as follows:1. Immediate recognition of cardiac arrest and activation

of the emergency response system2. Early CPR with an emphasis on chest compressions3. Rapid defibrillation4. Effective advanced life support (ACLS)5. Integrated post–cardiac arrest care

• Refinements have been made to recommendations for immediate recognition and activation of the emergency response system based on signs of unresponsiveness, as well as initiation of CPR if the victim is unresponsive with no breathing or no normal breathing (ie, victim is only gasping).

! “Look, listen, and feel for breathing” has been removed from the algorithm.

AHA ECC Adult Chain of Survival

Emphasis on High-Quality CPR

• A compression rate of at least 100/min (a change from “approximately” 100/min)• A compression depth of at least 2 inches (5 cm) in adults

Emphasis on High-Quality CPR

• And a compression depth of at least one third of the anteriorposterior diameter of the chest in infants and children (approximately 1.5 inches [4 cm] in infants and 2 inches [5 cm] in children).

Emphasis on High-Quality CPR

** Note that the range of 1½ to 2 inches is no longer used for adults, and the absolute depth specified for children and infants is deeper than in previous versions of the AHA Guidelines for CPR and ECC.

Emphasis on High-Quality CPR

• Allowing for complete chest recoil after each compression• Minimizing interruptions in chest compressions• Avoiding excessive ventilation

Reference:

Circulation. Journal of American Heart Associationonline version:http://circ.ahajournals.org/cgi/content/full/