SlideShare a Scribd company logo
1 of 43
Resuscitation in OHCA: When to START and When to STOP ,[object Object],[object Object],[object Object]
Goals of Resuscitation  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Ethical Issues ,[object Object],[object Object]
Healthcare Advance Directive ,[object Object],[object Object],[object Object],[object Object]
Do Not Attempt Resuscitation (DNAR) order ,[object Object],[object Object],[object Object],[object Object]
āļžāļĢāļš .  āļŠāļļāļ‚āļ āļēāļžāđāļŦāđˆāļ‡āļŠāļēāļ•āļī āļž . āļĻ .  āđ’āđ•āđ•āđ ,[object Object]
 
Withholding & Withdrawing CPR in OHCA ,[object Object],[object Object],[object Object],[object Object]
Criteria for Not Starting CPR (OHCA) ,[object Object],[object Object],[object Object],[object Object]
DNAR Orders in OHCA ,[object Object],[object Object]
Advance Directives in OHCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Termination of Resuscitation (TOR) in OHCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
When to STOP BLS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
BLS Termination of Resuscitation Rule for Adult OHCA ,[object Object],[object Object],[object Object],[object Object],Morrison LJ, et al. Validation of a rule for termination of resuscitation in out-of-hospital cardiac arrest. N Engl J Med. 2006;355: 478-487.
[object Object],Use the rule to develop protocols in areas where ALS is not available or may be significantly delayed (Class I, LOE A).
When to STOP ALS ,[object Object],[object Object],[object Object]
ALS Termination of Resuscitation Rule for Adult OHCA ,[object Object],[object Object],[object Object],[object Object],[object Object],Morrison LJ, et al. Derivation and evaluation of a termination of resuscitation clinical prediction rule for advanced life support providers. Resuscitation. 2007;74: 266.275.
It is reasonable to employ this rule in all ALS services (Class IIa, LOE B). ,[object Object]
TOR in a Combined BLS and ALS Out-of-Hospital System ,[object Object],[object Object]
Implementation of the Rules ,[object Object],[object Object],[object Object],[object Object]
 
When to Start/Stop CPR ? ,[object Object],[object Object],[object Object]
General Rule ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Organ Procurement ,[object Object],[object Object]
Traumatic Cardiopulmonary Arrest (TCPA)
[object Object]
Blunt Trauma ,[object Object],[object Object],[object Object],[object Object]
Penetrating Trauma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Penetrating or Blunt Trauma ,[object Object],[object Object],[object Object]
Nontraumatic Cause of Arrest ? ,[object Object],[object Object]
Termination of Resuscitation (TOR) ,[object Object],[object Object],[object Object]
Special Consideration  ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
â€Ķ Still Controversy
[object Object],[object Object],[object Object],J Trauma. 2005;5:951-958 .
[object Object],[object Object],[object Object],[object Object],[object Object],Injury, Int. J. Care Injured (2006) 37, 448—454
[object Object],[object Object],[object Object],[object Object],Ann Emerg Med. 2006;48:240-244.
[object Object]
THANK YOU

More Related Content

What's hot

emergency nursing (management in emergency) ppt
emergency nursing (management in emergency) pptemergency nursing (management in emergency) ppt
emergency nursing (management in emergency) pptNehaNupur8
 
Acs0801 Cardiac Resuscitation
Acs0801 Cardiac ResuscitationAcs0801 Cardiac Resuscitation
Acs0801 Cardiac Resuscitationmedbookonline
 
AHA ACLS BLS CPR Guideline 2020
AHA ACLS BLS CPR Guideline 2020AHA ACLS BLS CPR Guideline 2020
AHA ACLS BLS CPR Guideline 2020Subha Deep
 
Emergency Care in Nursing
Emergency Care in Nursing Emergency Care in Nursing
Emergency Care in Nursing TheRoyAshish
 
Trauma management protocol (ABCDE)
Trauma management protocol (ABCDE)Trauma management protocol (ABCDE)
Trauma management protocol (ABCDE)sisn_nepal
 
Scene size up and initial assessment
Scene size up and initial assessmentScene size up and initial assessment
Scene size up and initial assessmentkkirkemtp
 
A to Z Trauma Management
A to Z Trauma Management A to Z Trauma Management
A to Z Trauma Management Vaibhav Bagaria
 
Structured Approach to Critically Ill and Injured Patient
Structured Approach to Critically Ill and Injured PatientStructured Approach to Critically Ill and Injured Patient
Structured Approach to Critically Ill and Injured Patientmetriccertain
 
MANAGEMENT OF TRAUMA
MANAGEMENT OF TRAUMAMANAGEMENT OF TRAUMA
MANAGEMENT OF TRAUMAannaselvabai
 
Lesson 11
Lesson 11Lesson 11
Lesson 11jopaulv
 
Pediatric Trauma Update For Trauma Call Surgeons
Pediatric Trauma Update For Trauma Call SurgeonsPediatric Trauma Update For Trauma Call Surgeons
Pediatric Trauma Update For Trauma Call SurgeonsDang Thanh Tuan
 

What's hot (20)

emergency nursing (management in emergency) ppt
emergency nursing (management in emergency) pptemergency nursing (management in emergency) ppt
emergency nursing (management in emergency) ppt
 
Pitfalls in ATLS 2007-12
Pitfalls in ATLS 2007-12Pitfalls in ATLS 2007-12
Pitfalls in ATLS 2007-12
 
Acs0801 Cardiac Resuscitation
Acs0801 Cardiac ResuscitationAcs0801 Cardiac Resuscitation
Acs0801 Cardiac Resuscitation
 
AHA ACLS BLS CPR Guideline 2020
AHA ACLS BLS CPR Guideline 2020AHA ACLS BLS CPR Guideline 2020
AHA ACLS BLS CPR Guideline 2020
 
Emergency Care in Nursing
Emergency Care in Nursing Emergency Care in Nursing
Emergency Care in Nursing
 
Trauma management protocol (ABCDE)
Trauma management protocol (ABCDE)Trauma management protocol (ABCDE)
Trauma management protocol (ABCDE)
 
Approach to trauma- ATLS update by Dr.Damodhar.M.V
Approach to trauma- ATLS update by Dr.Damodhar.M.VApproach to trauma- ATLS update by Dr.Damodhar.M.V
Approach to trauma- ATLS update by Dr.Damodhar.M.V
 
Structured approach for critically ill patient
Structured approach for critically ill patient Structured approach for critically ill patient
Structured approach for critically ill patient
 
Scene size up and initial assessment
Scene size up and initial assessmentScene size up and initial assessment
Scene size up and initial assessment
 
Trauma
TraumaTrauma
Trauma
 
A to Z Trauma Management
A to Z Trauma Management A to Z Trauma Management
A to Z Trauma Management
 
Structured Approach to Critically Ill and Injured Patient
Structured Approach to Critically Ill and Injured PatientStructured Approach to Critically Ill and Injured Patient
Structured Approach to Critically Ill and Injured Patient
 
Prehospital care 'n' trauma life support
Prehospital care 'n' trauma life support Prehospital care 'n' trauma life support
Prehospital care 'n' trauma life support
 
Resucitacion
Resucitacion Resucitacion
Resucitacion
 
Initial Assess Trauma
Initial Assess TraumaInitial Assess Trauma
Initial Assess Trauma
 
ABCDE Assessment
ABCDE AssessmentABCDE Assessment
ABCDE Assessment
 
MANAGEMENT OF TRAUMA
MANAGEMENT OF TRAUMAMANAGEMENT OF TRAUMA
MANAGEMENT OF TRAUMA
 
Lesson 11
Lesson 11Lesson 11
Lesson 11
 
Pediatric Trauma Update For Trauma Call Surgeons
Pediatric Trauma Update For Trauma Call SurgeonsPediatric Trauma Update For Trauma Call Surgeons
Pediatric Trauma Update For Trauma Call Surgeons
 
Nursing in emergencies
Nursing in emergenciesNursing in emergencies
Nursing in emergencies
 

Viewers also liked

University of Kansas Hospital - Four Page Wrap
University of Kansas Hospital - Four Page WrapUniversity of Kansas Hospital - Four Page Wrap
University of Kansas Hospital - Four Page WrapMarcia Francis
 
CPR Capabilities Presentation
CPR Capabilities PresentationCPR Capabilities Presentation
CPR Capabilities PresentationCPRComm
 
Sutures and suturing
Sutures and suturingSutures and suturing
Sutures and suturingvarshitha tp
 
CPR MY PRESENTATION
CPR MY PRESENTATIONCPR MY PRESENTATION
CPR MY PRESENTATIONSonal Patel
 
Pre Hospital Resuscitation
Pre Hospital ResuscitationPre Hospital Resuscitation
Pre Hospital ResuscitationChew Keng Sheng
 
Cpr Presentation
Cpr PresentationCpr Presentation
Cpr Presentationsmsknight
 

Viewers also liked (6)

University of Kansas Hospital - Four Page Wrap
University of Kansas Hospital - Four Page WrapUniversity of Kansas Hospital - Four Page Wrap
University of Kansas Hospital - Four Page Wrap
 
CPR Capabilities Presentation
CPR Capabilities PresentationCPR Capabilities Presentation
CPR Capabilities Presentation
 
Sutures and suturing
Sutures and suturingSutures and suturing
Sutures and suturing
 
CPR MY PRESENTATION
CPR MY PRESENTATIONCPR MY PRESENTATION
CPR MY PRESENTATION
 
Pre Hospital Resuscitation
Pre Hospital ResuscitationPre Hospital Resuscitation
Pre Hospital Resuscitation
 
Cpr Presentation
Cpr PresentationCpr Presentation
Cpr Presentation
 

Similar to Resuscitaion in ohca

2010 ECC overview cole v0.2
2010 ECC overview cole v0.22010 ECC overview cole v0.2
2010 ECC overview cole v0.2Robert Cole
 
Decision making in Polytrauma.pptx
Decision making in Polytrauma.pptxDecision making in Polytrauma.pptx
Decision making in Polytrauma.pptxCHANDRAKANT SABALE
 
Advance trauma life support
Advance trauma life supportAdvance trauma life support
Advance trauma life supportIna
 
Health Issue, dilemma, Do not Resuscitate, Leave against medical advice (LAMA...
Health Issue, dilemma, Do not Resuscitate, Leave against medical advice (LAMA...Health Issue, dilemma, Do not Resuscitate, Leave against medical advice (LAMA...
Health Issue, dilemma, Do not Resuscitate, Leave against medical advice (LAMA...MrTauqeerAhmedFacult
 
Medical Record for Medical Scribes
Medical Record for Medical ScribesMedical Record for Medical Scribes
Medical Record for Medical ScribesDonella Aubuchon
 
Doctors order sheet
Doctors order sheetDoctors order sheet
Doctors order sheetyusufrawash
 
DNR in Emergency Department - The Practice and the Islamic view
DNR in Emergency Department - The Practice and the Islamic view DNR in Emergency Department - The Practice and the Islamic view
DNR in Emergency Department - The Practice and the Islamic view Rashid Abuelhassan
 
Sicu Intro Bioethics
Sicu Intro BioethicsSicu Intro Bioethics
Sicu Intro Bioethicsshivabirdi
 
ETHICAL ISSUES IN BLS PRESENTATIONS.pptx
ETHICAL ISSUES IN BLS PRESENTATIONS.pptxETHICAL ISSUES IN BLS PRESENTATIONS.pptx
ETHICAL ISSUES IN BLS PRESENTATIONS.pptxkitati1
 
Perioperative nursing care in critical care icu
Perioperative nursing care in critical care icuPerioperative nursing care in critical care icu
Perioperative nursing care in critical care icukhunteta
 
Ethical dilemmas in neurosciences
Ethical dilemmas in neurosciencesEthical dilemmas in neurosciences
Ethical dilemmas in neurosciencesSudhir Kumar
 
Grey book 55th
Grey book 55thGrey book 55th
Grey book 55thElsa von Licy
 
Cardiac arrest and sudden cardiac death
Cardiac arrest and sudden cardiac deathCardiac arrest and sudden cardiac death
Cardiac arrest and sudden cardiac deathShreyash Trived
 
Atls; Advanced Trauma Life Support
Atls; Advanced Trauma Life SupportAtls; Advanced Trauma Life Support
Atls; Advanced Trauma Life SupportFaisalRawagah1
 

Similar to Resuscitaion in ohca (20)

2010 ECC overview cole v0.2
2010 ECC overview cole v0.22010 ECC overview cole v0.2
2010 ECC overview cole v0.2
 
Decision making in Polytrauma.pptx
Decision making in Polytrauma.pptxDecision making in Polytrauma.pptx
Decision making in Polytrauma.pptx
 
Advance trauma life support
Advance trauma life supportAdvance trauma life support
Advance trauma life support
 
Health Issue, dilemma, Do not Resuscitate, Leave against medical advice (LAMA...
Health Issue, dilemma, Do not Resuscitate, Leave against medical advice (LAMA...Health Issue, dilemma, Do not Resuscitate, Leave against medical advice (LAMA...
Health Issue, dilemma, Do not Resuscitate, Leave against medical advice (LAMA...
 
Medical Record for Medical Scribes
Medical Record for Medical ScribesMedical Record for Medical Scribes
Medical Record for Medical Scribes
 
Doctors order sheet
Doctors order sheetDoctors order sheet
Doctors order sheet
 
DNR in Emergency Department - The Practice and the Islamic view
DNR in Emergency Department - The Practice and the Islamic view DNR in Emergency Department - The Practice and the Islamic view
DNR in Emergency Department - The Practice and the Islamic view
 
Photic2014
Photic2014Photic2014
Photic2014
 
Sicu Intro Bioethics
Sicu Intro BioethicsSicu Intro Bioethics
Sicu Intro Bioethics
 
Triage
TriageTriage
Triage
 
ETHICAL ISSUES IN BLS PRESENTATIONS.pptx
ETHICAL ISSUES IN BLS PRESENTATIONS.pptxETHICAL ISSUES IN BLS PRESENTATIONS.pptx
ETHICAL ISSUES IN BLS PRESENTATIONS.pptx
 
Perioperative nursing care in critical care icu
Perioperative nursing care in critical care icuPerioperative nursing care in critical care icu
Perioperative nursing care in critical care icu
 
Ethical dilemmas in neurosciences
Ethical dilemmas in neurosciencesEthical dilemmas in neurosciences
Ethical dilemmas in neurosciences
 
Grey book 55th
Grey book 55thGrey book 55th
Grey book 55th
 
Ot nursing & suturing
Ot nursing & suturingOt nursing & suturing
Ot nursing & suturing
 
CPR
CPRCPR
CPR
 
Pathogroup2
Pathogroup2Pathogroup2
Pathogroup2
 
Cardiac arrest and sudden cardiac death
Cardiac arrest and sudden cardiac deathCardiac arrest and sudden cardiac death
Cardiac arrest and sudden cardiac death
 
Presentacion
PresentacionPresentacion
Presentacion
 
Atls; Advanced Trauma Life Support
Atls; Advanced Trauma Life SupportAtls; Advanced Trauma Life Support
Atls; Advanced Trauma Life Support
 

More from sand whale

AED in public area
AED in public areaAED in public area
AED in public areasand whale
 
Acute asthma in adults
Acute asthma in adultsAcute asthma in adults
Acute asthma in adultssand whale
 
TB by kanok
TB by kanokTB by kanok
TB by kanoksand whale
 
High altitude syndrome
High altitude syndromeHigh altitude syndrome
High altitude syndromesand whale
 
Carbon monoxide poisoning
Carbon monoxide poisoningCarbon monoxide poisoning
Carbon monoxide poisoningsand whale
 
COPD review
COPD reviewCOPD review
COPD reviewsand whale
 
Wrist forearm elbow
Wrist forearm elbowWrist forearm elbow
Wrist forearm elbowsand whale
 
Sep11 summary diarrhea
Sep11 summary diarrheaSep11 summary diarrhea
Sep11 summary diarrheasand whale
 
Sep 11 quiz diarrhea
Sep 11 quiz diarrheaSep 11 quiz diarrhea
Sep 11 quiz diarrheasand whale
 
5hos2010 june
5hos2010 june5hos2010 june
5hos2010 junesand whale
 
2 My Day With Airmed
2 My Day With Airmed2 My Day With Airmed
2 My Day With Airmedsand whale
 

More from sand whale (11)

AED in public area
AED in public areaAED in public area
AED in public area
 
Acute asthma in adults
Acute asthma in adultsAcute asthma in adults
Acute asthma in adults
 
TB by kanok
TB by kanokTB by kanok
TB by kanok
 
High altitude syndrome
High altitude syndromeHigh altitude syndrome
High altitude syndrome
 
Carbon monoxide poisoning
Carbon monoxide poisoningCarbon monoxide poisoning
Carbon monoxide poisoning
 
COPD review
COPD reviewCOPD review
COPD review
 
Wrist forearm elbow
Wrist forearm elbowWrist forearm elbow
Wrist forearm elbow
 
Sep11 summary diarrhea
Sep11 summary diarrheaSep11 summary diarrhea
Sep11 summary diarrhea
 
Sep 11 quiz diarrhea
Sep 11 quiz diarrheaSep 11 quiz diarrhea
Sep 11 quiz diarrhea
 
5hos2010 june
5hos2010 june5hos2010 june
5hos2010 june
 
2 My Day With Airmed
2 My Day With Airmed2 My Day With Airmed
2 My Day With Airmed
 

Recently uploaded

Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingCall Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingNehru place Escorts
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...Miss joya
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceCollege Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceNehru place Escorts
 
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Modelssonalikaur4
 
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment BookingCall Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Bookingnarwatsonia7
 
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service MumbaiLow Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbaisonalikaur4
 
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photosnarwatsonia7
 
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowKolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowNehru place Escorts
 
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service LucknowVIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknownarwatsonia7
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknownarwatsonia7
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...narwatsonia7
 
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...narwatsonia7
 
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersBook Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersnarwatsonia7
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Servicesonalikaur4
 

Recently uploaded (20)

Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment BookingCall Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
Call Girls Service Nandiambakkam | 7001305949 At Low Cost Cash Payment Booking
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
 
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceCollege Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
 
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
 
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Servicesauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
sauth delhi call girls in Bhajanpura 🔝 9953056974 🔝 escort Service
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
 
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment BookingCall Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
 
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service MumbaiLow Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
 
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
 
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
 
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowKolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service LucknowVIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
 
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
 
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersBook Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
 

Resuscitaion in ohca