3. By Dr. Ahmed Mostafa Assist. Prof. of anesthesia & I.C.U. Benha faculty of medicine

4. 1-Ensure personal safety. 2-Stimulate patient. 3-Shout for help.

5. Airway Signs of airway obstruction: - Snoring. - Paradoxical chest and abdominal movement (see- saw respirations). - Use of accessory muscles of respiration. - Cyanosis is a late sign. Airway may be: - Clear & safe. - At risk. - Obstructed : Partial or complete.

6. Treatment of airway obstruction: - Head tilt chin left.

8. Treatment of airway obstruction: - Jaw thrust.

10. Treatment of airway obstruction: - Oro-pharyngeal airway.

14. Treatment of airway obstruction: Nasal airway.

16. Treatment of airway obstruction: - Oxygen. - Suction. - In case of trauma  neck collar.

17. Breathing 1- Look, listen & feel for general signs of respiratory distress: Sweating, central cyanosis, use of the accessory ms of respiration, abdominal breathing.

18. Breathing * Rate: - Normal rate is 12-20. - Critically ill patient may be: o < 6 min. o > 30 min * Tidal volume (depth of breathing). * Work of breathing: (chest deformity, abdominal distension and unequal chest movement). * Oxygenation: e.g., cyanosis, SaO2 (pulse oximeter) Give: oxygen.

19. Treatment: - Mouth to mouth breathing. - Mouth to mask breathing.

20. ●- Bag - valve - mask ventilation (Ambo bag).

21. ●- Endotracheal intubation.

24. Circulation Rate: pulse rate 120/min. Pulse volume. Pressure (blood pressure). Systolic BP < 90 mm Hg. Peripheral perfusion: Coldness, pallor, capillary refill time < 2 sec. If more than 2 sec. It is the early sign of shock. Preload (neck veins): If collapsed  hypovolaemia. If congested  heart failure.

25. Circulation Treatment: - Wide bore canulae. - I.V fluid. - Blood sample for blood grouping. - Stop external hemorrhage if present. - If the patient has primary chest pain and suspected acute coronary syndrome, aspirin, nitroglycerine sublingual, oxygen & morphine.

26. Disability Conscious level of patient: Alert. Verbal response. Pain response. Unresponsive.

27. Exposure Respect patient’s dignity and minimize heat less.

29. Thank you Dr. Ahmed Mostafa