Cardiac emergencies and cpr

HISTORICAL REVIEW

5000 - 3000 BC - first artificial mouth to

Introduction

Basic Life Support needed for patient whose breathing or heart has

Review of Circulatory System

Circulatory system consists of heart, blood, and blood

Cardiovascular System: Primary Functions

Transports blood to lungs
Delivers carbon dioxide and picks

Anatomy and Physiology of the Heart

Ventricles pump blood through two

Heart is composed of a unique type of muscle (myocardium) that

Contractions are controlled by electrical signals under nervous system control

Heart Muscle

Arteries

Arterial blood is oxygenated, bright red, and under pressure
Carotid arteries —

Pulse

When left ventricle contracts, wave of blood is sent through arteries

Pulse continued

Palpate femoral pulse in crease between abdomen and thigh
Palpate radial

Capillaries

Arteries progressively branch into smaller vessels that eventually reach capillaries
Capillaries are

Veins

From capillaries, blood drains back to heart through extensive system of

Heart Rate

Heart rate, measured as pulse, is affected by many factors
With

Circulatory System: Emergencies

Any condition that affects respiration
Reduces ability to deliver oxygen
Severe

Circulatory System: Emergencies continued

Heart attack
Can lead to cardiac arrest
Ventricular fibrillation
Heart muscle

Cardiac Arrest

Heart may stop (cardiac arrest) as a result of heart

Causes of cardiac arrest

cardiac

extracardiac

Primary lesion of cardiac muscle leading to the

Causes of Cardiac Arrest

Heart attack
Drowning
Suffocation
Stroke
Allergic reaction

Diabetic emergency
Prolonged seizures
Drug overdose
Electric shock
Certain injuries

Causes of circulatory arrest

Cardiac
Ischemic heart disease (myocardial infarction, stenocardia)
Arrhythmias of different

Cardiac Chain of Survival

Diagnosis of cardiac arrest

Symptoms of cardiac arrest

absence of pulse on

Sequence of operations

Check responsiveness
Call for help
Correctly place the

In case of unconsciousness it is necessary to estimate quickly

the

Main stages of resuscitation

C (Circulation) – restore the circulation by external

A (Airway)
 ensure open airway

Open the airway using a head tilt lifting of chin. Do

B (Breathing)
Tilt the head back and listen for. If not breathing

mouth to mouth or mouth to nose respiration

ventilation by a face

C. Circulation
Restore the circulation, that is start external cardiac massage

2 mechanisms explaining the restoration of circulation by external cardiac massage

Cardiac

Cardiac pump during the cardiac massage

Blood pumping is assured by the

Thoracic pump at the cardiac massage

Blood circulation is restored due to

ALGORITHM of Cardiopulmonary resuscitation

4 cycles: 15 compression and 2 breaths

10 cycles:

VENTRICULAR FIBRILLATION OR PULSELESS TACHYCARDIA

Witnessed

Unwitnessed

Precordial thump

Check pulse, if none:

Begin CPR
Defibrillate with

Possible arrhythmias after cardiac defibrillation

ventricular tachycardia
bradyarrythmia including electromechanical dissociation and asystole
supraventricular

Operations in case of asystole

Asystole

Start CPR
IV line
Adrenaline:IV 1

Call First vs. Call Fast

Call First
If alone with adult victim
Any victim

Cardiopulmonary Resuscitation (CPR)

CPR helps keep patient alive by circulating some oxygenated

CPR continued

Blood circulation resulting from chest compressions not as strong as

CPR continued

Often electric shock from AED is needed to restore a

CPR Saves Lives

CPR and defibrillation within 3-5 minutes can save over

General Technique of CPR

If unresponsive, not breathing, and no pulse,

General Technique of CPR continued

Compress chest hard and fast at a

General Technique of CPR continued

If alone, alternate 30 chest compressions and

Single-Rescuer CPR

Check patient’s responsiveness,
open airway,
and determine that patient is

Single-Rescuer CPR

2. Give 2 ventilations, each lasting 1 second
3. Determine victim

Put hand(s) in correct position for chest compressions

Give 30 chest compressions at rate of 100 per minute

Continue CPR until:
Patient begins to move
AED brought to scene and ready

If patient starts moving, check for adequate breathing
If patient is breathing

Chest Compressions Alert

Be careful with your hand position
For adults/children, keep your

Chest Compressions Alert

When compressing, keep elbows straight and hands in contact

Chest Compressions Alert

Compress chest hard and fast, but let chest recoil

Problems with CPR Technique

CPR often ineffective because of poor technique
Compressions not

Chest Compressions: Bradycardia in Child

Infant or child being given rescue breaths

Skill:

CPR For Adult or Child
(Two Rescuers)

Two-Rescuer CPR for Adults and Children

Minimizes time between rescue breaths and

Two-Rescuer CPR

Performed in cycles of 30:2 for adult (15:2 for infant

Two-Rescuer CPR continued

If AED present, one rescuer gives CPR while the

Two-Rescuer CPR continued

If you are assisting another trained rescuer who places

Transitioning from One-Rescuer CPR to Two-Rescuer CPR

Second rescuer moves into position

Transitioning from One-Rescuer CPR to Two-Rescuer CPR

When first rescuer says, “No

Differences in Two-Rescuer Training

If First Responder started CPR, arriving second rescuer

Rescuer 1 checks ABCs. Rescuer 2 locates site for chest

If no pulse, rescuer 2 gives 30 compressions for adult

Rescuer 1 gives 2 breaths.

Continue cycles of 30:2 for adults (15:2 for child). After

Adult or Child Two-Rescuer CPR Continued

Continue CPR until:
Patient moves
AED brought to

Uses different hand position
Place thumbs of both hands on sternum while

Skill:

CPR: Infants
Two Rescuers

Rescuer 1 checks ABCs. Rescuer 2 locates site for chest

If no pulse, rescuer 2 gives 15 chest compressions.

Rescuer 1 gives 2 breaths.

Infant Two-Rescuer CPR Continued

Continue cycles of 15:2 for ~ 2

When Not to Perform CPR

Presence of a Do-Not-Resuscitate (DNR) order
Patient