Cardiopulmonary resuscitation & management
Post on 07-May-2015
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CARDIOPULMONARY RESUSCITATION & MANAGEMENT
Advisor: dr.Nicolaas P.S, Sp. An
By: Rosana , S.Ked Nila hapsari, S. Ked
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Time is critical
• > 300,000 people experience sudden cardiac death in prehospital settings each year.
• If resuscitation begins within a few minutes, many of these individuals have a chance for survival.
epidemiologi
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Time is Critical!
• To begin resuscitation within a few minutes:• Patient’s collapse witnessed• EMS immediately activated• CPR started immediately• Defibrillation within minutes
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Review of the Circulatory System
What is the function of the circulatory system?
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The Circulatory System
Delivers O2 and nutrients
Removes CO2 and wastes
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Why is the function of the circulatory system critical to our survival?
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Lack of O2
accumulation of wastes
quickly lead
• to death
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Major Arteries
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Heart Physiology
• LV contracts – sends wave of blood• Pressure wave felt as pulse• No contraction = No blood flow = cardiac
arrest
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Time is Critical!
• Brain damage begins in 4–6 min
• Brain damage irreversible in 8–10 min
Circulation must be restored within 4–
6 minutes.
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CPR
• Provides minimal amount of circulation/oxygenation until cause of cardiac arrest corrected
• External chest compressions circulate blood• Artificial ventilations provide O2 to lungs
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HISTORY
2010 : New Guidelines on CPR (AHA)
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Causes of Cardiac Arrest
• Heart disease• Respiratory arrest• Medical emergencies• Drowning and suffocation• Congenital heart defects• Trauma
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AMERICAN HEART ASSOCIATION
CHANGES IN THE 2010 GUIDELINES AFFECTING
ALL RESCUERS
AMERICAN HEART ASSOCIATION
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AMERICAN HEART ASSOCIATION:2010 GUIDELINES
Health Care Provider* “PUSH HARD AND PUSH FAST”
At least 100 COMPRESSIONS / MINUTE*
Allow the chest to recoil -- equal compression and relaxation times
<10 seconds for pulse checks or rescue breaths
Compression Depth*
Adults 2”
Child/Infant 1/3 depth of chest 1.5" infant 2" child
Avoid excessive ventilations
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A-B-C changed to C-A-B*
Critical element is chest compressions
Delay in A-B
Avoidance of A & B
Early defib
If alone--call and retrieve AED
Exception asphyxial arrest
AMERICAN HEART ASSOCIATION:2010 GUIDELINES
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New Sequence
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• Cricoid pressure not recommended
• Advanced airway = 1 every 6-8 seconds
• Adult: 1 every 5-6 Peds: 1 every 3
• With advanced airway- no pause
AMERICAN HEART ASSOCIATION:2010 GUIDELINES
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AMERICAN HEART ASSOCIATION:2010 GUIDELINES
AHA ECC Adult Chain of Survival - New
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Simplified Universal BLS algorithm
AMERICAN HEART ASSOCIATION:2010 GUIDELINES
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Causes of Cardiac Arrest
• Heart disease• Respiratory arrest• Medical emergencies• Drowning and suffocation• Congenital heart defects• Trauma
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CPR
Compression : ventilation remains 30 : 2
Duration of 2 breaths = 5 seconds
CPR – 1 Rescuer
• If there is no pulse, find your landmarks, lower half of the sternum, between the nipples
CPR – 1 Rescuer
• Begin chest compressions
CPR – 1 Rescuer
• Perform 30 chest compressions
• Push hard• Push fast• Allow the chest to
recoil after each compression
CPR – 1 Rescuer
• Administer two ventilations then return to compressions
CPR – 2 Rescuer
1 2
3 4
CPR - Children
• Use heel of one hand
• Keep airway open with other hand
• 30 compressions:2 ventilations if alone (2 rescuers use 15:2)
CPR - Infant
• Give chest thrusts and puffs of air
• 30 compressions:2 ventilations if alone
• 15 compressions: 2 ventilations with 2 rescuers
Copyright © 2004 Elsevier (USA). All Rights Reserved
DefibrillationDefibrillation
•Ventricular fibrillationa common cause ofarrest•Can only correct with defibrillation
Copyright © 2004 Elsevier (USA). All Rights Reserved
• Chance of success decreases with time
• AEDs save lives!
• Chance of success decreases with time
• AEDs save lives!
DefibrillationDefibrillation
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AEDs
• Safe, accurate & lightweight
• Easy to operate
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PAD
• AEDs in public places
• Training the public in CPR/AED
AED
Assess • Check your patient
Power
• Turn the power on
Patient
• Apply pads to patient
Analyze
• Stay clear while patient’s heart rhythm analyzed
Clear
• Head to toe and toe to head: everyone is clear!
Shock
• Defibrillate
Patient
• Standard is set of 1 shock
• Immediately restart CPR for 2 minutes then check pulse
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ADULT CARDIAC ARREST ALGORITHM
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Summary
• Continual beating, or contracting, of the heart is necessary to keep blood circulating throughout the body.
• Brain damage begins in 4 to 6 minutes of cardiac arrest.
• There are many causes of sudden cardiac death, but the most common is ventricular fibrillation.
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Summary
• Survival from cardiac arrest depends on the sequence (chain) of survival.
• Rescuers are critically important in maintaining the sequence (chain) of survival.
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Thank you
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