ADULT
TCA
HOTT
HYPOVOLAEMIA
OXYGENATION
TENSION
TAMPONADE
ADULT
ANAPHYLAXIS
FIND TRIGGER + FLUIDS + FLAT
@ASAP: ADRENALINE 500MCG IM
@5MIN: REPEAT ADRENALINE 500MCG IM + 500ML NACL 0.9% IV
@10MIN: REFRACTORY ANAPHYLAXIS = ADRENALINE INFUSION 1MG IN 100ML @ 1ML/KG/HR
OTHER: MAST CELL TRYPTASE
ADULT
SEIZURE
@ASAP: COMA = CABC AX + OXYGEN + MONITORING + ACCESS
@5MIN: MIDAZOLAM 5MG IM
@10MIN: MIDAZOLAM 2.5MG IV
@15MIN: LEVETIRACETAM 60MG/KG (MAX 4.5G) IV
@20MIN: DW ANAESTHETICS
ADULT
TACHYCARDIA
SHOCK VS NO SHOCK
SHOCK?
SHIP = SYNCOPE / HYPOTENSION / ISCHAEMIA / PSOT ROSC
120 J DC CARDIOVERSION
AMIODERONE 300MG IV [POST 3 SHOCKS]
NO SHOCK?
VABCD = VAGAL MANOEUVRES / ADENOSINE 6 + 12 + 18MG IV / BETA BLOCKER / CA CHANNEL BLOCKER / DIGOXIN
OTHER: TORSADE DES POINTES = MAGNESIUM SULPHATE 8MMOL IV
ADULT
BRADYCARDIA
SHOCK VS NO SHOCK
SHOCK?
SHIP = SYNCOPE / HYPOTENSION / ISCHAEMIA / POST ROSC
ATROPINE 500MCG (MAX 3MG) IV
TRANSCUTANEOUS PACING (80BPM + LOWEST AMPS)
NO SHOCK
CONSIDER TRANSCUTANEOUS PACING IF 2ND/3RD HEART BLOCK OR VENTRICULAR PAUSE > 3 SEC
OTHER: GLUCAGON IF ON BETA BLOCKER
ADULT
CHOKING
COUGH VS NO COUGH
COUGH?
ENCOURAGE TO COUGH + REASSESS
NO COUGH?
5X BACK BLOWS + RECHECK
5X ABDO THRUSTS + RECHECK
REPEAT
UNCONSCIOUS?
ALS
PAEDS
ALS
15:2
SHOCK
CAUSE: VF OR VT
4 J / KG
ADRENALINE 10MCG/KG @ 3 SHOCKS [3-5MIN AFTER]
AMIODERONE 5MG/KG @ 3 SHOCKS [REPEAT @ 5 SHOCKS]
NO SHOCK
CAUSE: ASYSTOLE OR PEA
ADRENALINE 10MCG/KG ASAP [3-5MIN AFTER]
WETLAG
WEIGHT = (AGE+4) X 2 KG
ENERGY = 4J/KG
TUBE = (AGE/4)+4 MM
FLUID = 10ML/KG
LORAZEPAM = 0.1MG/KG
ADRENALINE = 10MCG/KG [0.1ML/KG]
GLUCOSE = 2ML/KG (10% DEXTROSE)
PAEDS
SEIZURE
@ASAP: COMA = CABC AX + OXYGEN + MONITORING + ACCESS (BM)
@5MIN: MIDAZOLAM 0.3MG/KG BUCCAL OR 0.2MG/KG IM
@10MIN: MIDAZOLAM 0.15MG/KG IV
@15MIN: LEVETRIACETAM 60MG/KG [MAX 4.5G] IV
@20MIN: DW ANAESTHETICS
PAEDS
ANAPHYLAXIS
FIND TRIGGER + FLAT + FLUID
@ASAP: ADRENALINE 500MCG (>12) / 300MCG (6-12) / 150MCG (0.5-6)
@5MIN: REPEAT ADRENALINE + FLUID 10ML/KG IV
@10MIN: REFRACTORY ANAPHYLAXIS = ADREANLINE INFUSION 1MG IN 100ML @ 1ML/KG/HR
OTHER: MAST CELL TRYPTASE
PAEDS
CHOKING
COUGH VS NO COUGH?
COUGH?
ENCOURAGE TO COUGH + REASSESS
NO COUGH?
5X BACK BLOWS + RECHECK
5X CHEST (<1) OR ABDO (>1) THRUSTS + RECHECK
REPEAT
UNCONSCIOUS = ALS
PAEDS
TACHYCARDIA
SICK VS NOT SICK
SICK
1J/KG SHOCK
BROAD = AMIODERONE 5MG/KG IV POST 3 SHOCKS
NARROW = ADENOSINE 0.2MG/KG [MAX 18MG] IV
NOT SICK
VAGAL MANOUVRES
OTHER: TORSADE DES POINTS = MAGNESIUM SULPHATE 50MG/KG [MAX 2G] IV
PAEDS
BRADYCARDIA
SICK VS NOT SICK
SICK?
ATROPINE 20MG/KG [MAX 500MG] IV
ADRENALINE INFUSION 2MCG/KG IV
NOT SICK?
OXYGEN
OTHER: HR < 60 = TREAT
PAEDS
ASTHMA
O SHIT ME
OXYGEN: 15L NRB
SALBUTAMOL: 5MG NEBS (REPEAT TO 15MG)
HIGH DOSE DSTEROID = 40MG PRED PO
IPRATROPOUM BROMIDE: 250MCG NEBS
THEOPHYLLINE / AMINOPHYLLINE: 6MG/KG [MAX 500MG]
MAGNESIUM SULPHATE: 50MG/KG [MAX 2G]
ESCALATE CARE
PAEDS
NEONATAL LIFE SUPPORT
@ASAP: NLS - NEED HEAT + LOOK @ RR/HR + STIMULATE
AIRWAY: CLEAR
BREATHING: 5X INFLATION BREATHS [3SEC] + RECHECK
- CHEST MOVE = 30X VENTILATION BREATHS [1SEC] + RECHECK
- CHEST NOT MOVE: REPEAT 5X INFLATION BREATHS [3SEC] WITH A CHANGE [SGA/2PAX] + RECHECK
CIRCULATION: HR < 60 = NLS 15X 3:1 + RECHECK @ 30SEC
DISABILITY: BM
ESCALATE CARE
ADULT
SPECIAL
PREGNANCY
POSITION: LEFT LATERAL / LEFT UTERINE DISPLACEMENT
PROCEDURE: PERIMORTEN C SECTION IF > 20 WEEKS
ADULT
SPECIAL
DROWNING
5X VENTILATION BREATHS
ADULT
SPECIAL
OVERDOSE
TCA = 50ML SODIUM BICARBONATE 8.4% IV
OPIOID = NALOXONE 400MCG IV
MIMMS
TST
WALKING - P3
BLEEDING - P1
TALKING - P1/P2
BREATHING - NOT BREATHING
MIMMS
MITT
BLEEDING - P1
WALKING - P3
BREATHING - DEAD
VOICE - P1
AGE > 2 - P1
RR 12-23 - P1
HR > 100 - P1/P2
ADULT
ALS
NON SHOCK
CAUSE: ASYSTOLE OR PEA
ADRENALINE 1MG IV ASAP [3-5MIN AFTER]
ADULT
ALS
SHOCK
CAUSE: VF OR VT
ADRENALINE 1MG IV @ 3 SHOCKS [3-5MIN AFTER]
AMIODERONE 300MG IV @ 3 SHOCKS [150MG @ 5 SHOCKS]
ADULT
ALS
REVERSIBLE CAUSES
4H + 4T
HYPOXIA / HYPOTHERMIA / HYPOVOLAEMIA / HYPERKALAEMIA
TENSION / TAMPONADE / THROMBUS / TOXINS
GENERAL INTRODUCTION
MARCH
MY NAME IS OLLIE IM WITH THE MEDICAL TEAM
ALERT CONTROL
RECHECK SAFETY / PPE
CONSENT
HOW CAN I HELP?
GENERAL EXIT
CD
CONSIDER SAFETY / SAFEGUARDING + DOCUMENT
