Monday, May 10, 2010

Post 6: 2222

I missed the countdown showing 22day 22 hours 22 minutes 22 sec which my fellow blogger friend managed to capture a printscreen.

A rare sight I must say. haha

But is so special about this 2222 2222?

It is a crash call!!! OMG! Crash Call for us to study even harder now and stop panicking!

Dial 2222 is to call for immediate support because someone is about to die! (Or in my public health department in the university, 2222 is the number to dial for fire!)

So lets talk abt Cardiac Resus! (Random? hehe)

I am shit at resus actually. Failed both resus stations in OSCE and OSCA

So, I tried to read from the edinburgh's emergency bible:

Tiba tiba Ahpek pengsan!

D - Danger? Check the safety around the surroundings.

R - Response? Bos, u ok bos? Bos, u ok bos?

No response - Shout TORONG!!

A - Airway: Open and secure airway. Head Tilt and Chin Lift normally, or Jaw Thrust in cases suspecting cervical trauma. Jaw thrust is actually harder than I used to think.

B - Breathing: Is the ahpek breathing himself with the airway open? Look (Chest movement), Listen and Feel (to the air flow out of ahpek's mouth) I think assess that for 10 sec.

Not breathing? - any kaypohchee around? Ask the kpc to call 2222. If not, storm to the nearest phone to call 2222. Leave ah pek alone, dun care. Calling help is much more important.

Of coz dont go buy roti yet, come back and give CPR: 30 Compression (100/min, straight arm and deep 1/3? cant remember liau roughly la) and 2 kisses.

Continue assess for signs of life, mainly breathing? Dont stop pressing and kissing.

Dont stop. Until you kenot take it already, or help team of 2222 arrived. or fella byebye.

Then: ALS already.

So still doing ABC: but in a team!

Airway: probably want to put in a oropharynx or nasopharynx to secure airway. Or even ETT terus. Suction prn.

Breathing: Attach breathing mask, with breathing reservoir bag, pressing 1/3 of the bag. each two times after 30 compressions.

Circulation: Continue checking. Pulse? Take some bloods off to do test. ABG.

Once the AED is attached:

Assessed rhythm: If VF or Pulseless VT - Shock samadia. ALL CLEAR 150 biphasic.

CPR back. 2 mins. Means 30 presses, 2 kisses. kira sampai 8 kisses i think. thats 2 mins rite...? 100 compressions a minute, so 200 compressions in 2 mins...lebih kurang 4 cycles la..ya should be correct la. hahahaha. forgot liau.

Repeat ABC assessment and CPR at the same time.

Before third shock, give Adrenaline 1mg IV. Repeat every 3-5 min. (before the 5th shock, and 7th shock)

To make things even more complicated, Amiodarone 300mg IV before the 4th shock.

And always reassess ABC and investigate causes.

4H and 4T. Hypoxaemia, Hypothermia, Hypo-Hyperkalemia, Hypovolemia. Thromboembolism, Toxins, Tamponade, Tension pneumothorax.

Ohya, for the non shockable, ie PEA and Asystole - continue CPR and assess rhythm, check pads, check ABC etc. Adrenaline 1mg still the same, every 3-5 minutes ie alternate cycle. In asystole or brady PEA, give Atropine 3mg IV. and pacing lo.

Damn long post. But essentially, I always panicked in the station and fail the resus.

ARGH.

1 comment:

pp said...

aiya, u can change ur timer n wait for 2222 again lo... 3333 also can 1111 also can..bodo