POSTPARTUMCOLLAPSE.ppt

Clark et al have suggested renaming this clinical syndrome the anaphylactoid syndrome of pregnancy * Cardiogenic shock is defined by sustained hypotension with tissue hypoperfusion despite adequate left ventricular filling pressure. Signs of tissue hypoperfusion include oliguria (30 mL/h), cool extremities, and altered level of consciousness * Why CPR May Fail Delay in starting Improper procedures (ex. Forget to pinch nose) No ACLS follow-up and delay in defibrillation Only 15% who receive CPR live to go home Improper techniques Terminal disease or unmanageable disease (massive heart attack) Injuries Related to CPR Rib fractures Laceration related to the tip of the sternum Liver, lung, spleen Complications of CPR Vomiting Aspiration Place victim on left side Wipe vomit from mouth with fingers wrapped in a cloth Reposition and resume CPR Stomach Distension Air in the stomach Creates pressure against the lungs Prevention of Stomach Distension Don’t blow too hard Slow rescue breathing Re-tilt the head to make sure the airway is open Use mouth to nose method Mouth to Mouth Barrier Devices Masks Shields Choking The tongue is the most common obstruction in the unconscious victim (head tilt- chin lift) Vomit Foreign body Balloons Foods Swelling (allergic reactions/ irritants) Spasm (water is inhaled suddenly) How To Recognize Choking Can you hear breathing or coughing sounds? High pitched breathing sounds? Is the cough strong or weak? Can’t speak, breathe or cough Universal distress signal (clutches neck) Turning blue Recognizing Choking #2 A partial airway obstruction with poor air exchange should be treated as if it were a complete airway blockage. If victim is coughing strongly, do not intervene Conscious Choking (Adult Foreign Body Airway Obstruction) Give 5 abdominal thrusts (Heimlich maneuver) Place fist just above the umbilicus (normal size) Give 5 upward and inward thrusts Pregnant or obese? 5 chest thrusts Fists on sternum If unsuccessful, support chest w