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CB 3CX 4CX Service Manual eng - PDF Drive.

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Keep people around you informed of what you will be doing. If you will be working with other people, make sure any hand signals that may be used are understood by everybody.

Work sites can be noisy, do not rely on spoken commands. Do not open the engine cover while the engine is running. Do not use the machine with the cover open. Make sure ramps and trailers are clean before driving onto them. Use extreme caution when driving onto ramps and trailers. Use the step s and handrails. Make sure the step s , handrails and your boot soles are clean and dry. Do not jump from the machine. Do not use the machine controls as handholds, use the handrails.

Do not use the machine in closed areas where there is flammable material, vapour or dust. If only the rear wheels are raised, the machine could still drive through the front axle.

Otherwise the machine will rapidly decelerate, you or others could be killed or seriously injured. When selecting lower gears, allow the engine speed to drop before each gear change. GEN Battery A battery with frozen electrolyte can explode if it is used or charged.

Do not use a machine with a frozen battery. To help prevent the battery from freezing, keep the battery fully charged. Parts of the machine are made from cast iron; welds on cast iron can weaken the structure and break.

Do not weld cast iron. Contact your JCB distributor for advice before modifying the machine. Keep flames and sparks away from the battery. Do not smoke close to the battery.

Make sure there is good ventilation in closed areas where batteries are being used or charged. Do not check the battery charge by shorting the terminals with metal; use a hydrometer or voltmeter.

Use a soft faced hammer or drift to remove and fit metal pins. Always wear safety glasses. Always connect the negative pole of the battery to earth. When connecting the battery, connect the earth - lead last. When disconnecting the battery, disconnect the earth - lead first.

If two or more people are working on the machine, make sure each is aware of what the others are doing. Before starting the engine make sure the others are clear of the danger areas; examples of danger areas are: the rotating blades and belt on the engine, the attachments and linkages, and anywhere beneath or behind the machine.

People can be killed or injured if these precautions are not taken. Do not mix petrol with the diesel fuel; in storage tanks the petrol will rise to the top and form flammable vapours. Hydraulic Fluid Fine jets of hydraulic fluid at high pressure can penetrate the skin. Do not use your fingers to check for hydraulic fluid leaks.

Do not put your face close to suspected leaks. Hold a piece of cardboard close to suspected leaks and then inspect the cardboard for signs of hydraulic fluid. If hydraulic fluid penetrates your skin, get medical help immediately.

Before disconnecting or connecting hydraulic hoses, stop the engine and operate the controls to release pressure trapped in the hoses. Make sure the engine cannot be started while the hoses are open. Do not smoke while refuelling the machine or working on the engine. Do not refuel with the engine running. There could be a fire and injury if you do not follow these precautions. Rams The efficiency of the rams will be affected if they are not kept free of solidified dirt.

Clean dirt from around the rams regularly. When leaving or parking the machine, close all rams if possible to reduce the risk of weather corrosion. If you swallow any oil, do not induce vomiting, seek medical advice.

Used engine oil contains harmful contaminants which can cause skin cancer. Do not handle used engine oil more than necessary. Always use barrier cream or wear gloves to prevent skin contact. Wash skin contaminated with oil thoroughly in warm soapy water. Do not use petrol, diesel fuel or paraffin to clean your skin.

Use only recommended cleaning agents and solvents. Renew whenever disturbed unless otherwise instructed.

Do not use Triochloroethane or paint thinners near 'O' rings and seals. Never work under a machine on soft ground. Follow the instructions in this handbook for inflating the tyres. Do not weld or cut rims. INT Fires If your machine is equipped with a fire extinguisher, make sure it is checked regularly. Keep it in the operator's cab until you need to use it.

Do not use water to put out a machine fire, you could spread an oil fire or get a shock from an elecrical fire. Use carbon dioxide, dry chemical or foam extinguishers. Contact your nearest fire department as quickly as possible.

Firefighters should use self-contained breathing apparatus. Hot coolant can spray out when you remove the radiator cap. Let the system cool before removing the radiator cap.

To remove the cap; turn it to the first notch and let the system pressure escape, then remove the cap. Always chock the wheels at the opposite end of the machine that is to be jacked.

Do not work underneath a machine supported only by jacks. Always support a jacked-up machine on axle stands before working underneath it.

INT Always wear safety glasses when dismantling assemblies components under pressure from springs. This will protect against eye injury from components accidently flying out. Inspect the hoses regularly for: - Damaged end fittings - Chafed outer covers - Ballooned outer covers - Kinked or crushed hoses - Embedded armouring in outer covers - Displaced end fittings.

To avoid burning, wear protective gloves when handling hot components. To protect your eyes, wear goggles when using a wire brush to clean components. HYD ! The repeated swallowing of very small quantities can cause chronic lead poisoning.

Do not smoke or touch food while handling this lubricant. Dispose of waste rags etc. Before working under raised loader arms, fit the loader arm safety strut. Position the machine on a firm, level surface before raising one end. Ensure the other end is securely chocked. Do not rely solely on the machine hydraulics or jacks to support the machine when working under it. Disconnect the battery, to prevent the engine being started while you are beneath the machine. Keep flames away when applying Waxoyl.

Waxoyl can take a few weeks to dry completely. Keep flames away during the drying period. Do not weld near the affected area during the drying period. Take the same precautions as for oil to keep Waxoyl off your skin. Do not breathe the fumes. Apply in a well-ventilated area. Fluoroelastomeric materials subjected to high temperatures can produce highly corrosive hydrofluoric acid.

New fluoroelastomeric components at ambient temperature require no special safety precautions. If evidence of decomposition e. Make sure that heavy duty gloves and special safety glasses are worn: 1 Ensure that components have cooled then remove and place material into plastic bags.

Make the machine safe before working underneath it.

   

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Acls provider manual pdf free download. Advanced Cardiovascular Life Support (ACLS) - Provider Manual – American Heart Association

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Read as many books as you like Personal use and Join Over We cannot guarantee that every book is in the library. This provider manual features case scenarios that help course participants apply new concepts to real-life situations.

Although it is primarily intended for use during their courses, the handbook was also created to serve as daily reference material for health care professionals. Information covered in the handbook includes ACLS instruction for adults and children through multiple case scenarios.

Case scenarios include, but are not limited to, respiratory arrest, ventricular fibrillation and bradycardia. All material included in this handbook is delivered in a manner meant to enhance learning in the most comprehensive and convenient way possible.

This Provider Course manual "is designed for healthcare providors who either direct or participate in the managment of cardiopulmunoary arrest or other cardiovascular emergencies. Through didactic instruction and active participation in simulated cases, students will enhance their skills in the diagnosis and treatment of cardiopulmunary arrest, acute arrhythmia, stroke, and acute coronary syndrome ACS "--Page 1.

Advanced Cardiac Life Support examination questions and answers to improve knowledge of cardiovascular health for students and proffessionals. A nasopharyngeal airway, which extends from the nose to the pharynx, can be used in both conscious and unconscious patients. An oropharyngeal airway can only be used in unconscious patients because it may stimulate the gag reflex. Advanced airways such as endotracheal tubes ET tubes and laryngeal mask airways LMAs usually require specialized training, but are useful in-hospital resuscitations especially LMAs.

Many different disease processes and traumatic events can cause cardiac arrest, but in an emergency, it is important to be able to rapidly consider and eliminate or treat the most typical causes of cardiac arrest.

To facilitate remembering the main, reversible causes of cardiac arrest, they can be organized as the Hs and the Ts. Atrial fibrillation is the most common arrhythmia. It is diagnosed by electrocardiogram, specifically the RR intervals follow no repetitive pattern. Some leads may show P waves while most leads do not. Atrial contraction rates may exceed bpm. The ventricular rate often range is between to bpm. Atrial flutter is a cardiac arrhythmia that generates rapid, regular atrial depolarizations at a rate of about bpm.

This often translates to a regular ventricular rate of bpm, but may be far less if there is a or conduction. By electrocardiogram, or atrial flutter is recognized by a sawtooth pattern sometimes called F waves. Narrow QRS complex tachycardias include several different tachyarrhythmias. One of the more common narrow complex tachycardias is supraventricular tachycardia, shown below. Wide complex tachycardias are difficult to distinguish from ventricular tachycardia.

Ventricular tachycardia leading to cardiac arrest should be treated using the ventricular tachycardia algorithm. A wide complex tachycardia in a conscious person should be treated using the tachycardia algorithm.

There are four main types of atrioventricular block: first degree, second degree type I, second degree type II, and third degree heart block. Second degree heart block Mobitz type I is also known as the Wenckebach phenomenon.

Atrioventricular blocks may be acute or chronic. Chronic heart block may be treated with pacemaker devices. From the perspective of ACLS assessment and intervention, heart block is important because it can cause hemodynamic instability and can evolve into cardiac arrest.

In ACLS, heart block is often treated as a bradyarrhythmia. The PR interval is a consistent size, but longer or larger than it should be in first degree heart block. Complete dissociation between P waves and the QRS complex. No atrial impulses reach the ventricle. The results of the ECG will be the primary guidance for how the patient with possible cardiac chest pain is managed. The ECG diagnosis of acute coronary syndrome can be complex.

In people who are candidates for fibrinolytics, the goal is to ad mister the agent within 3 hours of the onset of symptoms. ACLS in the hospital will be performed by several providers. These individuals must provide coordinated, organized care. Providers must organize themselves rapidly and efficiently. Resuscitation demands mutual respect, knowledge sharing, and constructive criticism, after the code. When performing a resuscitation, the Team Leader and Team Members should assort themselves around the patient so they can be maximally effective and have sufficient room to perform their role.

Advanced Cardiac Life Support, or ACLS, is a system of algorithms and best practice recommendations intended to provide the best outcome for patients in cardiopulmonary crisis. ACLS protocols are based on basic and clinical research, patient case studies, clinical studies, and reflect the consensus opinion of experts in the field.

Once you become certified in ACLS, the certification is valid for two years. However, we encourage you to regularly login back in to your account to check for updates on resuscitation science advances. As we learn more about resuscitation science and medicine, physicians and researchers realize what works best and what works fastest in a critical, life-saving situation.

Therefore, it is necessary to periodically update life-support techniques and algorithms. If you have previously certified in advanced cardiovascular life support, then you will probably be most interested in what has changed since the latest update in The table below also includes changes proposed since the last AHA manual was published.

These changes will likely appear in future editions of the provider manual. The Chain of Survival is a sequence of steps or links that, when followed to its completion, increases the likelihood that a victim of a life-threatening event will survive. The adult and pediatricchains of survival are slightly different. The person who is providing BLS is only responsible for the early links, that is, making sure the person is cared for by emergency personnel.

The emphasis on early care is to reinforce that time is a critical factor in life supportcare. The standards include the concept of out of hospital care versus in-hospital care. In fact, it is assumed that all people who are pursuing ACLS will be competent in the techniques of BLS—so much so that it is considered a prerequisite to ACLS The first step in any resuscitation is to make sure the rescuers you!

Assuming you and the victim are in a safe location, the next step is to assess whether the patient is responsiv If patient is not responsive, move to BLS survey If patient is responsive, move to ACLS survey.

Shake and Shout! Check for effective breathing for 5 to 10 seconds. In the community, call and send for an AED 3. Circulation Check the carotid pulse for no more than 10 seconds. If no pulse, begin high quality CPR. Defibrillation If there is a shockable rhythm, pulseless ventricular tachycardia or ventricular fibrillation, provide a shock.

If you are alone and witness a victim suddenly collapse: Assume cardiac arrest with a shockable rhythm. If you are alone and find an unresponsive adult: Tailor response to the prospective cause of injury.

Check to see if the victim is responsive. Shake and shout! Is the victim breathing effectively? Does the victim have a pulse in the carotid artery? If you witnessed the victim suddenly collapse, assume cardiac arrest with a shockable rhythm. Follow directions on the AED. After providing a shock, immediately resume CPR. Keep going until EMS arrives or the victim regains circulation.

The other provider s stays with the victim. Provide High Quality CPR includes Fast and deep compressions, compressions per minute Two inches deep, complete rebound If you can provide breaths, 2 breaths for 30 comps If you cannot provide breaths, just give chest comps The provider who retrieved the AED applies the AED and follows directions given by the device.

Check for a pulse and cardiac rhythm every two minutes. If a shock is indicated, clear everyone and administer a shock.

After providing a shock, immediately resume Team CPR. In Team CPR, the provider giving chest compressions changes every 2 minutes Keep going until EMS arrives or the victim regains spontaneous circulation. Cardiac Arrest Cardiac arrest is the sudden sensation cessation of blood flow to the tissues in brain the results from a heart that is not pumping effectively.

Ventricular fibrillation is recognized by a disordered waveform, appearing as rapid peaks and valleys as shown in this ECG rhythm strip: Ventricular tachycardia may provide waveform similar to any other tachycardia; however, the biggest difference in cardiac arrest is that the patient will not have a pulse and, consequently, will be unconscious and unresponsive. Ventricular Fibrillation and Pulseless Ventricular Tachycardia Algorithm Once you have determined that a patient has a shockable rhythm, immediately provide an unsynchronized shock.

If you are using biphasic energy, use recommended settings on the device. If you do not know what that setting is, use the highest available setting, to J.

If you are using a monophasic energy source, administer J. Resume CPR immediately after a shock. Minimize interruptions of chest compressions. Provide 2 rescue breaths for each 30 compressions.

Lidocaine may replace amiodarone when amiodarone is not available. First dose: Pulseless Electrical Activity and Asystole Pulseless electrical activity or PEA is a cardiac rhythm that does not create a palpable pulse is even though it should.

After 2 min. Remember, chest compressions are a means of artificial circulation, which should deliver the epinephrine to the heart. Without chest compressions, epinephrine is not likely to be effective. Chest compressions should be continued while epinephrine is administered. Rhythm checks every 2 min. Respiratory Arrest While cardiac arrest is more common in adults than respiratory arrest, there are times when patients will have a pulse but are not breathing or not breathing effectively e.

Airway Management In ACLS, the term airway is used to refer both to the pathway between the lungs and the outside world and victim in the devices that help keep that airway open. Choose the device that extends from the corner of the mouth to the earlobe Clear the mouth or blood or secretions with suction, if possible. Insert the device so that the point is toward the roof of the mouth or parallel to the teeth Do not press the tongue back into the throat Once the device is almost fully inserted, turn it so that the tongue is cupped by the interior curve of the device.

Choose the device that extends from the tip of the nose to the earlobe. Use the largest diameter device that will fit. Lubricate the airway with a water-soluble lubricant Insert the device slowly, straight into the face not toward the brain! It should feel snug; do not force the device.

If it feels stuck, remove it and try the other nostril. Tips on Suctioning Adequate suctioning usually requires negative pressures of — 80 to mmHg.

Wallmounted suction can deliver this, but portable devices may not. When suctioning the oropharynx, do not insert the catheter too deeply. Extend the catheter to the maximum safe depth and suction as you withdraw. Therefore sterile technique should be used. Each suction attempt should be for no longer than 10 seconds. Monitor vital signs during suctioning and stop suctioning immediately if the patient experiences hypoxemia O2 sats 94 has a new arrhythmia, or becomes cyanotic. You can detect spontaneous circulation by feeling a palpable pulse at the carotid artery.

The patient is at risk for reentering cardiac arrest at any time. Therefore, the patient should be moved to an intensive care unit.

If so, it should be placed. If not, there may be neurological compromise. Does the person have signs of myocardial infarction by ECG? Move to ACS algorithm. Rapid Differential Diagnosis of Cardiac Arrest Many different disease processes and traumatic events can cause cardiac arrest, but in an emergency, it is important to be able to rapidly consider and eliminate or treat the most typical causes of cardiac arrest.

Bradycardia Bradycardia Algorithm. Bradycardia is any heart rate less than 60 bpm. In practice, however, bradycardia is only a concern if it is unusual or abnormal for the patient or causing symptoms. New cases of bradycardia should be evaluated, but most will not require specific treatment. Evaluation of bradycardia includes cardiac and blood oxygen monitoring and a 12 lead ECG if available. Unstable bradycardia i. Unstable bradycardia is first treated with intravenous atropine at a dose of 0.

Additional doses can be given every 3 to 5 min. Pulseless bradycardia is considered PEA. If atropine is unsuccessful in treating symptomatic, unstable bradycardia, consider transcutaneous pacing, dopamine or norepinephrine infusion, or transvenous pacing.

An intensive or cardiologist may need to be consulted for these interventions and the patient may need to be moved to the intensive care unit. Tachycardia Atrial fibrillation is the most common arrhythmia. Tachycardia Algorithm Tachycardia is any heart rate greater than bpm. In practice, however, tachycardia is usually only a concern if it is New cases of tachycardia should be evaluated with cardiac and blood oxygen monitoring and a 12 lead ECG if available. Consider beta-blocker or calcium channel blocker.

Wide QRS tachycardia may require antiarrhythmic drugs. Acute Coronary Syndrome Acute coronary syndrome or ACS is a spectrum of signs and symptoms ranging from angina to myocardial infarction. Cardiac chest pain any new chest discomfort should be evaluated promptly. This includes high degree of suspicion by individuals in the community, prompt rapid action by EMS personnel, assessment in the emergency department, and definitive treatment.

People with symptoms of cardiac ischemia should be given oxygen, aspirin if not allergic , nitroglycerin, and possibly morphine. The patient should be assessed in the ED within 10 min.

Draw and send labs e. Give statin if not contraindicated. Obtain chest Xray. Unstable angina is new onset cardiac chest pain without ECG changes, angina that occurs at rest and lasts for more than 20 min.

People with unstable angina will not have elevated cardiac markers. His may include anti-platelet drug s , anticoagulation, a beta-blocker, an ACE inhibitor, a statin, and either PCI or a fibrinolytic. Patients with unstable angina are admitted and monitored for evidence of MI. While in transit, the EMS team should try to determine the time at which the patient was last normal, which is considered the onset of symptoms.

EMS administer oxygen via nasal cannula or face mask, obtain a fingerstick glucose measurement, and alert the stroke center. Within 10 min.

 

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Case scenarios include, but are not limited to, respiratory arrest, ventricular fibrillation and bradycardia. All material included in this handbook is delivered in a manner meant to enhance learning in the most comprehensive and convenient way possible.

This Provider Course manual "is designed for healthcare providors who either direct or participate in the managment of cardiopulmunoary arrest or other cardiovascular emergencies. Through didactic instruction and active participation in simulated cases, students will enhance their skills in the diagnosis and treatment of cardiopulmunary arrest, acute arrhythmia, stroke, and acute coronary syndrome ACS "--Page 1.

Advanced Cardiac Life Support examination questions and answers to improve knowledge of cardiovascular health for students and proffessionals. This book is a perfect study guide to understanding Advanced Cardiovascular Life Support.

Case scenarios include, but are not limited to, respiratory arrest, ventricular fibrillation, and bradycardia. Provider Manual by Anonim. A Book by American Heart Association. A Book by Karl Disque. Adult BLS is slightly different if there is one provider solo or more than one provider team present.

The difference between solo provider BLS and team BLS is that responsibilities are shared when more than one person is present. For healthcare providers, the difference between a witnessed cardiac arrest and a victim who is found down is the order of the initial steps.

Cardiac arrest is the sudden sensation cessation of blood flow to the tissues in brain the results from a heart that is not pumping effectively. Four rhythms may occur during cardiac arrest: ventricular fibrillation, pulseless ventricular tachycardia, pulseless electrical activity, and asystole. While ACLS provides algorithms for each of these cardiac arrest rhythms, in the real world a patient may move between these rhythms during a single instance of cardiac arrest.

Therefore, the provider must be able to accurately assess and adapt to changing circumstances. After every 2 minutes of CPR, check for a pulse and check the cardiac rhythm. If the rhythm has switched from shockable or to shockable, then switch algorithms. This energy may come in the form of an automated external defibrillator AED defibrillator paddles, or defibrillator pads. VFib and VTach are treated with unsynchronized cardioversion, since there is no way for the defibrillator to decipher the disordered waveform.

In fact, it is important not to provide synchronized shock for these rhythms. Ventricular fibrillation is recognized by a disordered waveform, appearing as rapid peaks and valleys as shown in this ECG rhythm strip:.

Ventricular tachycardia may provide waveform similar to any other tachycardia; however, the biggest difference in cardiac arrest is that the patient will not have a pulse and, consequently, will be unconscious and unresponsive. Two examples of ventricular tachycardia are shown in this ECG rhythm strips.

The first is narrow complex tachycardia and the second is wide complex tachycardia:. Pulseless electrical activity or PEA is a cardiac rhythm that does not create a palpable pulse is even though it should. A PEA rhythm can be almost any rhythm except ventricular fibrillation incl. It represents a lack of electrical activity in the heart.

It is critically important not to confuse true asystole with disconnected leads or an inappropriate gain setting on an in-hospital defibrillator. Asystole may also masquerade as a very fine ventricular fibrillation. If the ECG device is optimized and is functioning properly, a flatline rhythm is diagnosed as asystole. Note that asystole is also the rhythm one would expect from a person who has died.

Consider halting ACLS efforts in people who have had prolonged asystole. It is inappropriate to provide a shock to pulseless electrical activity or asystole. Cardiac function can only be recovered in PEA or asystole through the administration of medications. While cardiac arrest is more common in adults than respiratory arrest, there are times when patients will have a pulse but are not breathing or not breathing effectively e.

A person who has a pulse but is not breathing effectively is in respiratory arrest. When you encounter a patient in need, you will not know he or she is in respiratory arrest, so perform a BLS survey:. In ACLS, the term airway is used to refer both to the pathway between the lungs and the outside world and victim in the devices that help keep that airway open.

As if the victim may have experienced head or neck trauma, airway management should include a jaw thrust, which leaves the head and neck unmoved, but which opens up the airway. A nasopharyngeal airway, which extends from the nose to the pharynx, can be used in both conscious and unconscious patients.

An oropharyngeal airway can only be used in unconscious patients because it may stimulate the gag reflex. Advanced airways such as endotracheal tubes ET tubes and laryngeal mask airways LMAs usually require specialized training, but are useful in-hospital resuscitations especially LMAs.

Many different disease processes and traumatic events can cause cardiac arrest, but in an emergency, it is important to be able to rapidly consider and eliminate or treat the most typical causes of cardiac arrest.

To facilitate remembering the main, reversible causes of cardiac arrest, they can be organized as the Hs and the Ts. Atrial fibrillation is the most common arrhythmia. It is diagnosed by electrocardiogram, specifically the RR intervals follow no repetitive pattern.

Some leads may show P waves while most leads do not. Atrial contraction rates may exceed bpm. The ventricular rate often range is between to bpm. Atrial flutter is a cardiac arrhythmia that generates rapid, regular atrial depolarizations at a rate of about bpm. This often translates to a regular ventricular rate of bpm, but may be far less if there is a or conduction.

By electrocardiogram, or atrial flutter is recognized by a sawtooth pattern sometimes called F waves. Narrow QRS complex tachycardias include several different tachyarrhythmias. One of the more common narrow complex tachycardias is supraventricular tachycardia, shown below. Wide complex tachycardias are difficult to distinguish from ventricular tachycardia. Ventricular tachycardia leading to cardiac arrest should be treated using the ventricular tachycardia algorithm.

A wide complex tachycardia in a conscious person should be treated using the tachycardia algorithm. There are four main types of atrioventricular block: first degree, second degree type I, second degree type II, and third degree heart block. Second degree heart block Mobitz type I is also known as the Wenckebach phenomenon.

Atrioventricular blocks may be acute or chronic. Chronic heart block may be treated with pacemaker devices. From the perspective of ACLS assessment and intervention, heart block is important because it can cause hemodynamic instability and can evolve into cardiac arrest. In ACLS, heart block is often treated as a bradyarrhythmia.

The PR interval is a consistent size, but longer or larger than it should be in first degree heart block. Complete dissociation between P waves and the QRS complex. No atrial impulses reach the ventricle. The results of the ECG will be the primary guidance for how the patient with possible cardiac chest pain is managed. The ECG diagnosis of acute coronary syndrome can be complex. In people who are candidates for fibrinolytics, the goal is to ad mister the agent within 3 hours of the onset of symptoms.

ACLS in the hospital will be performed by several providers. These individuals must provide coordinated, organized care. Providers must organize themselves rapidly and efficiently. Resuscitation demands mutual respect, knowledge sharing, and constructive criticism, after the code. When performing a resuscitation, the Team Leader and Team Members should assort themselves around the patient so they can be maximally effective and have sufficient room to perform their role.

Advanced Cardiac Life Support, or ACLS, is a system of algorithms and best practice recommendations intended to provide the best outcome for patients in cardiopulmonary crisis. ACLS protocols are based on basic and clinical research, patient case studies, clinical studies, and reflect the consensus opinion of experts in the field. Once you become certified in ACLS, the certification is valid for two years. However, we encourage you to regularly login back in to your account to check for updates on resuscitation science advances.

As we learn more about resuscitation science and medicine, physicians and researchers realize what works best and what works fastest in a critical, life-saving situation. Therefore, it is necessary to periodically update life-support techniques and algorithms.

If you have previously certified in advanced cardiovascular life support, then you will probably be most interested in what has changed since the latest update in The table below also includes changes proposed since the last AHA manual was published. These changes will likely appear in future editions of the provider manual. The Chain of Survival is a sequence of steps or links that, when followed to its completion, increases the likelihood that a victim of a life-threatening event will survive.

The adult and pediatricchains of survival are slightly different. The person who is providing BLS is only responsible for the early links, that is, making sure the person is cared for by emergency personnel. The emphasis on early care is to reinforce that time is a critical factor in life supportcare. The standards include the concept of out of hospital care versus in-hospital care.

In fact, it is assumed that all people who are pursuing ACLS will be competent in the techniques of BLS—so much so that it is considered a prerequisite to ACLS The first step in any resuscitation is to make sure the rescuers you! Assuming you and the victim are in a safe location, the next step is to assess whether the patient is responsiv If patient is not responsive, move to BLS survey If patient is responsive, move to ACLS survey.

Shake and Shout! Check for effective breathing for 5 to 10 seconds. In the community, call and send for an AED 3. Circulation Check the carotid pulse for no more than 10 seconds. If no pulse, begin high quality CPR. Defibrillation If there is a shockable rhythm, pulseless ventricular tachycardia or ventricular fibrillation, provide a shock.

If you are alone and witness a victim suddenly collapse: Assume cardiac arrest with a shockable rhythm. If you are alone and find an unresponsive adult: Tailor response to the prospective cause of injury. Check to see if the victim is responsive. Shake and shout! Is the victim breathing effectively? Does the victim have a pulse in the carotid artery?

If you witnessed the victim suddenly collapse, assume cardiac arrest with a shockable rhythm. Follow directions on the AED. After providing a shock, immediately resume CPR. Keep going until EMS arrives or the victim regains circulation.

The other provider s stays with the victim. Provide High Quality CPR includes Fast and deep compressions, compressions per minute Two inches deep, complete rebound If you can provide breaths, 2 breaths for 30 comps If you cannot provide breaths, just give chest comps The provider who retrieved the AED applies the AED and follows directions given by the device. Check for a pulse and cardiac rhythm every two minutes. If a shock is indicated, clear everyone and administer a shock. After providing a shock, immediately resume Team CPR.

In Team CPR, the provider giving chest compressions changes every 2 minutes Keep going until EMS arrives or the victim regains spontaneous circulation.

Cardiac Arrest Cardiac arrest is the sudden sensation cessation of blood flow to the tissues in brain the results from a heart that is not pumping effectively. Ventricular fibrillation is recognized by a disordered waveform, appearing as rapid peaks and valleys as shown in this ECG rhythm strip: Ventricular tachycardia may provide waveform similar to any other tachycardia; however, the biggest difference in cardiac arrest is that the patient will not have a pulse and, consequently, will be unconscious and unresponsive.

Ventricular Fibrillation and Pulseless Ventricular Tachycardia Algorithm Once you have determined that a patient has a shockable rhythm, immediately provide an unsynchronized shock. If you are using biphasic energy, use recommended settings on the device. If you do not know what that setting is, use the highest available setting, to J. If you are using a monophasic energy source, administer J. Resume CPR immediately after a shock.

Minimize interruptions of chest compressions. Provide 2 rescue breaths for each 30 compressions. Lidocaine may replace amiodarone when amiodarone is not available. First dose: Pulseless Electrical Activity and Asystole Pulseless electrical activity or PEA is a cardiac rhythm that does not create a palpable pulse is even though it should. After 2 min. Remember, chest compressions are a means of artificial circulation, which should deliver the epinephrine to the heart.

Without chest compressions, epinephrine is not likely to be effective. Chest compressions should be continued while epinephrine is administered. Rhythm checks every 2 min. Respiratory Arrest While cardiac arrest is more common in adults than respiratory arrest, there are times when patients will have a pulse but are not breathing or not breathing effectively e.

Airway Management In ACLS, the term airway is used to refer both to the pathway between the lungs and the outside world and victim in the devices that help keep that airway open. Choose the device that extends from the corner of the mouth to the earlobe Clear the mouth or blood or secretions with suction, if possible. Insert the device so that the point is toward the roof of the mouth or parallel to the teeth Do not press the tongue back into the throat Once the device is almost fully inserted, turn it so that the tongue is cupped by the interior curve of the device.

Choose the device that extends from the tip of the nose to the earlobe. Use the largest diameter device that will fit. Lubricate the airway with a water-soluble lubricant Insert the device slowly, straight into the face not toward the brain!

It should feel snug; do not force the device. If it feels stuck, remove it and try the other nostril. Tips on Suctioning Adequate suctioning usually requires negative pressures of — 80 to mmHg.

Wallmounted suction can deliver this, but portable devices may not. When suctioning the oropharynx, do not insert the catheter too deeply. Extend the catheter to the maximum safe depth and suction as you withdraw. Therefore sterile technique should be used. Each suction attempt should be for no longer than 10 seconds. Monitor vital signs during suctioning and stop suctioning immediately if the patient experiences hypoxemia O2 sats 94 has a new arrhythmia, or becomes cyanotic.

You can detect spontaneous circulation by feeling a palpable pulse at the carotid artery. The patient is at risk for reentering cardiac arrest at any time. Therefore, the patient should be moved to an intensive care unit. If so, it should be placed. If not, there may be neurological compromise.

Does the person have signs of myocardial infarction by ECG? Move to ACS algorithm. Rapid Differential Diagnosis of Cardiac Arrest Many different disease processes and traumatic events can cause cardiac arrest, but in an emergency, it is important to be able to rapidly consider and eliminate or treat the most typical causes of cardiac arrest.

   

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Student Membership can be obtained by completing the appropriate Student Registration Application form and returning the form and the Student Registration Fee to the Institute. The Student Registration fee is valid for one year and can be renewed annually. Copies of all qualifications and Awards obtained by the student must also accompany the Academic History form. The Academic History form is used to ensure that students are qualified to commence their studies at the Level they have selected.

Group 3: A special rate exists for students in countries which have a emerged from conflict b countries in which the general population is subject to great poverty and c countries in which the UN acknowledge that the level of economic activity and national per capita income is unacceptably low. These Levels are designed to provide a structured and progressive level of knowledge. All students are required to commence their studies at the Diploma Level of all programmes unless they are able to claim subject-for-subject or Level exemptions.

Applicants over the age of 20 who do not hold one of the recommended entry qualifications may also register for some Diploma Level programmes providing they have been in full-time employment for a minimum of two years and can produce a letter from their employer to confirm this. Invigilation of examinations is undertaken either by external Invigilators who are appointed by the Institute or by the British Council.

Candidates must be registered and paid-up Student Members of the Institute at the time they undertake their examinations. Full details of Examination dates can be found on the ICM website. There are however some specialist programmes where a higher subject fee may be payable. If you have any queries relating to fees please contact your Teaching Centre.

To enter for an examination you need to complete the relevant Examination Entry form and submit it to the Institute. The Timetable for each year states the Closing Date for receipt of entries for each examination Series. Please visit the website to view the ICM examination timetable. The Institute operates a triple marking and moderation system.

In the event that the moderator increases the original marks awarded, the fee for re-marking your script will be refunded to you. The Institute retains answer scripts for a maximum period of six months. If you sit, for example, for one or more subjects in March you will not receive your results until June.

This means that if you were to fail a subject in March, you would not be able to re- sit the subject in June, as you will have missed the Closing Date for the June Series. Our advice is that you try to split your subject examinations between two consecutive Examination Series e.

If your programme has four subjects you could take two subjects in one series and two in another series. On this basis, were you to fail one subject in March you would be able to re-sit it in September, giving you plenty of time for revision. Examination Timetables indicate the closing date for receipt of entries for each sitting and this information also appears on the ICM website. Entries received after the Closing Date are automatically carried forward to the next Examination Series.

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Hospitality Management 8. Customer Service Environmental Management in the Hospitality Industry The unit examines a wide range of subject areas within the operation of food and beverage management and relates these to relevant sectors in the hospitality industry. Developing trends and increasing demands from the general public are studied, using examples from the hospitality industry.

Demonstrate an understanding of the complexities of managing food and beverage outlets. Outline the function and responsibilities of food and beverage management. Summarise the duties of the purchasing manager in relation to the purchasing procedure. Specify the purpose and objectives of food and beverage control.

Compare the principles of food and beverage management across a range of catering systems. Formal lectures provide a foundation of information on which the student builds through directed learning and self managed learning outside of the class. The students are actively encouraged to form study groups to discuss course material which fosters a greater depth learning experience.

Cracknell, R. The unit examines the different records that are administered by the front office, as well as appraising financial and security issues.

A study is made of the social skills that front office personnel are expected to demonstrate. Understand the importance of the front office in the hotel industry. Demonstrate an understanding of the procedures and processes involved in dealing with advance bookings. Explain how the marketing function of the front office may be achieved. Outline suitable procedures for front office personnel to increase sales. Describe how room occupancy may be managed and controlled. Lectures will be delivered on the key underpinning knowledge and will be supported by class discussions, using a more interactive approach to the lecture material.

These class discussions will allow the opportunity for learners to form study groups that actively engage with the key issues of this unit. It examines the hotel as a business providing commercial hospitality and focuses on markets, money and people.

It uses examples from hotel operations throughout the world embracing a comprehensive profile of the hotel business. Data, quotes and extracts from a wide range of authoritative industry sources are used and there is a focus on markets, money and people throughout. Understand the importance of hotels to economies and society. Evaluate principal products in the supply of hotel guest services.

Outline the elements of the human resource function in hotels. Demonstrate an understanding of the marketing function in the hotel and catering industry.

Appraise the financial characteristics of the hotel and catering industry. The unit examines the range of duties and responsibilities that fall within the scope of a housekeeper.

Outline the elements of the housekeeping function in hotels and accommodation establishments. Differentiate between the roles and duties of different personnel that support the housekeeping function.

Evaluate different types of product used in the cleaning process. Demonstrate an understanding of the qualities of materials used in room interiors. The unit examines the range of dishes and accompaniments that may be included on the menu, as well as different styles of food service. Understand the importance of restaurant service in the hospitality industry. Differentiate between the roles and duties of the range of personnel that participate in the service of food and beverages.

Identify the characteristics of different types of menu. Outline suitable control procedures for food, beverages, linen and customer bills. Demonstrate an understanding of different styles of food service. Prepare statements reporting financial and management accounting performance and position of business entities. Produce solutions to management accounting problems, using a range of management accounting techniques.

Demonstrate an awareness of the context of financial and management accounting within the hospitality industry. It provides students with a solid grounding in the industry, drawing together the main elements of hotel and catering in one unit and also featuring neglected areas such as brewing, contract catering, time share, caravanning and camping.

It introduces real life case studies and uses a student-friendly text which encourages active learning. Demonstrate an understanding of the historical role of hospitality as well as the future of the industry.

Exhibit knowledge concerning the various types of hospitality facilities, as well as the managerial segments of each type of facility. Understand how different types of hospitality facilities appeal to specific market segments. Evaluate current trends in the hospitality industry.

Demonstrate a knowledge of the role of human resources and cultural diversity in hospitality. The unit draws on practical examples of how the law affects the working lives of those within the hospitality industry through the use of appropriate case studies. Demonstrate an understanding of the principles of law as it relates to the hospitality industry.

Analyse factors that influence the form a hospitality business will take. Outline the elements to consider when making a contract of booking with a guest. Compare the rights and duties of an innkeeper with those of a hotelier. Explain the rights and duties towards employees in respect of employment, health and safety, discrimination, and dismissal.

The unit aims to enable students to appreciate the pivotal role marketing plays within any organisation, but in particular hospitality and tourism and provide an understanding of the principles and practise of marketing as part of the business approach to hospitality and tourism. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

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Get a Demo Login. Get your free customer service training manual template Achieve consistent and thorough customer service training with this training manual. Get the resource. Customer Service Training Manual Consistent and thorough customer service training is essential—even when customers already seem satisfied. Customer Care Training Manual One crucial benefit of a training manual is that it describes a standard process for interacting with customers. Powerful training, simplified Join the hundreds of teams—from Fortune enterprises to local businesses—who use Lessonly to onboard, train, and continuously enable millions of employees to learn, practice, and Do Better Work.

Customer Service Training Topics to Include Customer service training manuals can take many shapes and forms. Soft skills: Soft skills are essential for a successful customer service interaction. And there are a number of soft skills that every top-notch rep should know. A few customer service training examples include active listening, communication, empathy, flexibility, and problem-solving.

Or, what process do they need to follow to make a special exception for a return? Be sure to include answers to these unique situations and more! Ensure your training manual features a comprehensive look at everything new reps need to know about what your company offers to customers. Customer Service Training by Industry In many ways, serving customers is the same in any industry. Customer Care Training Manual Formats Training manual examples and templates come in a range of different file formats.

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Report this Document. Description: Hospitality. Flag for inappropriate content. Download now. Jump to Page. Search inside document. Regards Writing Team of hospitality-school. How to Maintain Personal Hygiene Purpose To learn the basics Procedures and standards about professional and personal hygiene so as to ensure health and safety of every individual. You might also like Fine Dining Standards 2. Server Training Manual Restaurant Owner. Waiting Staff.

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The hospitality industry is diverse, with many people playing different roles in different environments. Cleaning and Sanitizing in Hospitality In this course, you will learn about the proper practices for cleaning and servicing restrooms, dining areas, and public areas.

Being knowledgable in these areas helps us demonstrate our commitment to good hygiene and a better customer experience.