Als Algorithm

Question 1

Outline algorithm

Answer 1

Unresponsive not breathing
CPR 30:2
Attach pads and monitor
Rhythm check
VF /pVT -shock
Pea - cpr 2 mins

Question 2

Actions during CPR

Answer 2

Give oxygen
Waveform capnography
Continuous compressions when advanced airway in
Vascular access- iv or io

Give adrenaline 1mg when access achieved then every 3-5 mins (every other cycle)
Give amiodarone 300mg after 3 shocks

Question 3

How many joules for first shock?

Answer 3

150 J

Same or higher there on

Question 4

4 Hs and 4 Ts

Answer 4

Hypoxia
Hypovolaemia
Hyper/hypokalaemia (metabolic)
Hypothermia

Tension pneumothorax
Thrombosis (coronary or PE)
Tamponade
Toxins (check drugs)

Question 5

Airway management in ALS

Answer 5

In absence of anaesthetist, supraglottic airway devices used (igel) then deliver uninterrupted chest compressions
Vent 10 breaths per minute

Wave form capnography to monitor output

Question 6

Role of waveform capnography

Answer 6

Ensure placement of ett in trachea
Monitor vent rate in cpr
Quality of cpr
Identifying rosc in cpr - increase in end tidal co2

Question 7

Intra-osseous access sites

Answer 7

Humeral head
Proximal tibia
Distal tibia