Cardiopulmonary-Resuscitation-2015.pptx

8/17/2019 Cardiopulmonary-Resuscitation-2015.pptx

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CARDIOPULMONAR Y RESUSCITATION


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DefnitionAn emergency procedure perormed in an

eort to manually preserve intact brain

unction until urther measures are taken torestore spontaneous blood circulation andbreathing in a person who is in cardiac arrest


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IndicationAny person unresponsive to

stimulation with no breathing or

breathing only in occasional agonalgasps, as it is most likely that they arein cardiac arrest


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ContraindicationDeath sign

In circumstances when the CPwould be medically utile


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!oals

Preserve the cardiac output and

o"ygen delivery to the vital organsespecially brain until the return ospontaneous circulation #$%C& isachieved


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CP procedureBasic Life Support (BLS) ' by the lay

responder or the health care provider at the

scene

Ada!ced Life Support (ALS) ' by thehealth care provider at the hospital

(he actions included in )*% and A*% is acontinuum, and these collectively named byA+A as chain of survivals”


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Components o chain o survivals '

• Immediate recognition and activation oemergency response system

• -arly CP, w.emphasis on chest compressions

• apid defbrillation i indicated

• -ective advanced lie support

• Integrated post"cardiac arrest care


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#I$#LI$#T

C#AN$E %ORCPRBASED ON A#A&'


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)*%)*% is oundation or saving lives ollowing

cardiac arrest

(he undamental components o )*% '

/0 Immediate recognition o sudden cardiacarrest an activation o the emergency

response system

10 -arly CP w.emphasis on chest compressions

20 apid defbrillation i indicated


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#I$#LI$#

T C#AN$E%OR BLSBASED ONA#A &'


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%implife

d adult)*%algorithm


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ecognitionAlthough the gold standard to diagnose cardiac

arrest is the absence o the carotid or emoral

pulse, but or the lay responder, due to thedi3culty in detecting pulse, pulse checking isnot recommended

-very unresponsive, non breathing or

abnormal breathing adults should beconsidered as cardiac arrest


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-arly CP (o provide eective chest compressions, push

hard and push ast over the lower hal o the

sternum

At a rate o at least/44 compressions perminute with acompression depth o at least 1inches.5 cm

escuers should allow complete recoil othechest ater each compression, to allow theheart to fllcompletely beore the ne"tcompression


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I multiple rescuers is present, theyshould rotate the task o compressions

every 1 minutes


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Compression is critical (he chest compressions should be delivered frst

beore rescue breathing #A6)6C C6A6)&

(his is related to the act that in cardiac arrest, theo"ygen delivery to the vital organs is determinedlargely by the blood 7ow rather than blood o"ygencontent

Attempt to insert advanced airway should notdelayed the compression

+and only CP #only compression& has thee8uivalent survival outcome compared to the

conventional CP


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Airway #C6A6)&

Clean the airway

$pen the airway ' triple airwaymanuever

/0 +ead tilt

10 Chin lit

20 9aw thrust

.+ead tilt and chin lit is contraindicatedin suspected cervical vertebra trauma


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)reathing #C6A6)&

)reathing become more important in cardiac arrest due torespiratory problems which common in children, drowningcase, and prolonged cardiac arrest

Deliver each rescue breath over / second

!ive a su3cient tidal volume to produce visible chest rise

/0 :outh to mouth rescue breathing

10 :outh to barrier device breathing

20 )ag and mask ventilation

;0 Advanced airway


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:outh6to6mouth rescue breathing provideso"ygen and ventilationto the victim0

(o provide mouth6to6mouth rescuebreaths, openthe victimy or

lightheaded and preventsoverin7ationo the<


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?hen the victim has an advanced airway inplace during CP, continuous chest

compressions are perormed at a rate o atleast /44 per minute without pausesorventilation, and ventilations are delivered atthe rate o /breath about every @ to seconds#which will deliver appro"imately to/4 breaths per minute&0


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Automated -"ternal

Defbrillator #A-D&Cardiopulmonary resuscitationand the use o

A-Ds by public saety frst responders

arerecommended to increase survival rates orout6o6hospitalsudden cardiac arrest0 (he 14/4A+A !uidelines or CP and-CC again recommendthe establishment o A-D programsin publiclocations where there is a relatively highlikelihood owitnessed cardiac arrest #eg, airports,casinos, sports acilities&0


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)*% orhealth

careprovider


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Advanced lie support/0 +igh68uality chest compressions with

minimal interruptions

10 Airway management and ventilation

20 Intravenous access and drugs

;0 (he identifcation and correction o

reversible actors

Boundation o successul AC*% is good )*%0


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Air*a+ ,a!a-e,e!t a!de!ti.atio!

/0 -ndo (racheal (ube

10 *aringeal :ask Airway


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ey changes rom AC*% 14/5 '

/0 Continuous 8uantitative waveorm capnography isrecommendedor confrmation and monitoring oendotracheal tube placement0

10 Cardiac arrest algorithms are simplifed and redesignedtoemphasi>e the importance o high68uality CP

20 Atropine is no longer recommended or routine use inthemanagement o pulseless electrical activity

#P-A&.asystole0

;0 Chronotropic drug inusions are recommended as analternative to pacing in symptomatic and unstablebradycardia0


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No!"s/oc0a1.e r/+t/,s (PEA a!d as+sto.e)

/0 %tart cpr 24'1 and give adrenaline / mg i0v

10 !ive adrenaline / mg i0v every 265 min

20 I there is doubt about whether the rhythm isasystole or fne B, do not attempt defbrilationEinstead, continue chest compressions andventilation0

;0Considered advanced airway and capnography


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Post6cardiac arrest

care (o emphasi>e importance o comprehensive multidisciplinary

care through hospital discharge and beyond

Includes'$ptimi>ing vital organ perusion

(itration o Bi$1 to maintain $1 sat F G;H and /44H

(ransport to comprehensive post6arrest system o care

-mergent coronary reperusion or %(-:I or high suspicion

o A:I

(emperature control

Anticipation, treatment, J prevents multiple organdysunction0


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#I$#LI$#

T C#AN$E%OR PACBASED ONA#A &'


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?hen do we stop

resuscitation/0 eturn o %pontaneous Circulation

10 escuer too tired20 (here is someone who can replace us

;0 Ater 24 min K / hour without

improvement

50 Patient already death defnitely


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Complications

/0 ib racturesE the most common

10 %ternal ractures

20 Anterior mediastinum bleeding

;0 +eart contusion

50 +emopericardium

@0 Pulmonary complications ' pnemothora",hemothora", lung contusion

L0 Abdominal organ inMury ' lacerations o the liver

and spleen, damage abdominal viscus


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Cardiopulmonary-Resuscitation-2015.pptx

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