Weinmann MEDUVENT Standard - Page 14

ERWEITERTE REANIMATIONSMASSNAHMEN
Patient reagiert nicht
fehlende oder nicht normale Atmung
CPR 30:2
Debrillator/Monitor anschließen
Schockbar
(VF/PULSLOSE VT)
Nicht-schockbar
(PEA/ASYSTOLIE)
Rhythmuskontrolle
1 Schock
Sofort wieder Thoraxkompressionen
für 2 Minuten
Return of spontaneous
circulation (ROSC)
Sofort wieder Thoraxkompressionen
für 2 Minuten
Rettungsdienst- oder
Reanimationsteam rufen
Hochwertigen Thoraxkompressionen und
• Sauerstoffgabe
• Kapnograe
• Kontinuierliche Thoraxkompressionen wenn der
Atemweg gesichert ist
• Minimale Unterbrechungen der Thorax kompression
• IV- oder IO-Zugang
• Adrenalin alle 3-5 Minuten
• Amiodaronnach3Debrillationsversuchen
• ErkennenundBehandelnreversiblerUrsachen
Erkennen und Behandeln reversibler Ursachen
• Hypoxie
• Hypovolämie
• Hypo-/Hyperkalämiemetabolisch
• Hypo-/Hyperthermie
• Herzbeuteltamponade
• Intoxikation
• Thrombose, koronar oder pulmonal
• Spannungspneumothorax
Eventuell Sonographie und Bildgebung zum
Erkennen reversibler Ursachen einsetzen
Eventuell
• KoronarangiograeundPCI
• MechanischeReanimationfürPatiententransport/Therapie
• ExtrakorporaleCPR
Nach ROSC
• NachABCDEvorgehen
• Zielwert SpO
2
94–98%undnormalerPaCO
2
• 12-Kanal-EKG
• Erkennen und Behandeln der Ursache
• Targeted temperature management
www.grc-org.de; www.erc.edu publiziert Mai 2021 durch German Resuscitation Council, c/o Universitätsklinikum Ulm, Sektion Notfallmedizin, 89070 Ulm Copyright: © European Resuscitation Council vzw Referenz: Poster_ALS_Algorithmus_GER_2021 über GRC
Advanced Life Support
European Resuscitation Council Guidelines 2021
https://cprguidelines.eu/
ADVANCED LIFE SUPPORT
Unresponsive with absent
or abnormal breathing
CPR 30:2
Attach debrillator/monitor
Shockable
(VF/PULSELESS VT)
Non-shockable
(PEA/ASYSTOLE)
Assess rhythm
1 shock
Immediately resume chest
compressions for 2 minutes
Return of spontaneous
circulation (ROSC)
Immediately resume chest
compressions for 2 minutes
Call EMS/Resuscitation team
Give high-quality chest compressions and
• Give oxygen
• Use waveform capnography
• Continuous compressions if advanced airway
• Minimise interruptions to compressions
• Intravenous or intraosseous access
• Give adrenaline every 3-5 min
• Give amiodarone after 3 shocks
• Identify and treat reversible causes
Identify and treat reversible causes
• Hypoxia
• Hypovolaemia
• Hypo-/hyperkalemia/metabolic
• Hypo-/hyperthermia
• Thrombosis – coronary or pulmonary
• Tension pneumothorax
• Tamponade- cardiac
• Toxins
Consider ultrasound imaging to identify
reversible causes
Consider
• Coronary angiography/percutaneous coronary
intervention
• Mechanical chest compressions to facilitate transfer/treatment
• Extracorporeal CPR
After ROSC
• Use an ABCDE approach
• Aim for SpO
2
of 94-98% and normal PaCO
2
• 12 Lead ECG
• Identify and treat cause
• Targeted temperature management
Give high-quality chest
compressions and
• Give oxygen
• Use waveform
capnography
• Continuous
compressions if
advanced airway
• Minimise interruptions
to compressions
• Intravenous or
intraosseous access
• Give adrenaline
every 3-5 min
• Give amiodarone after
3 shocks
• Identify and treat
reversible causes
Identify and treat
reversible causes
• Hypoxia
• Hypovolaemia
• Hypo-/hyperkalemia/
metabolic
• Hypo-/hyperthermia
• Thrombosis –
coronary or
pulmonary
• Tension
pneumothorax
• Tamponade- cardiac
• Toxins
Consider ultrasound
imaging to identify
reversible causes
Consider
• Coronary
angiography/
percutaneous
coronary
intervention
• Mechanical chest
compressions to
facilitate transfer/
treatment
• Extracorporeal CPR
After ROSC
• Use an ABCDE
approach
• Aim for SpO
2
of
94-98% and
normal PaCO
2
• 12 Lead ECG
• Identify and treat
cause
• Targeted temperature
management