Your SlideShare is downloading. ×
0
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Sudden Cardiac Arrest
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Sudden Cardiac Arrest

5,478

Published on

Sudden cardiac arrest (SCA) is an event caused by a problem with the heart's "electrical" system. SCA occurs when the heart suddenly stops beating. The heart’s electrical system sends signals to the …

Sudden cardiac arrest (SCA) is an event caused by a problem with the heart's "electrical" system. SCA occurs when the heart suddenly stops beating. The heart’s electrical system sends signals to the heart to beat much too fast. The heart cannot beat that fast, so the heart muscle just quivers. Blood and oxygen do not reach vital organs like the brain. Then it stops altogether. The heart needs immediate treatment from an electrical shock (defibrillation) to restart the electrical system. If SCA is not treated within 7-10 minutes, it leads to sudden cardiac death.

Published in: Health & Medicine, Business
2 Comments
1 Like
Statistics
Notes
No Downloads
Views
Total Views
5,478
On Slideshare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
364
Comments
2
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. HANDLING SUDDEN CARDIAC ARREST DR. D. B. PAHLAJANI Consultant Cardiologist & Chief of Cardiac Catherization Laboratory, Breach Candy Hospital
  • 2. Sudden Cardiac Arrest (SCA) Statistics <ul><li>Every two minutes someone suffers a sudden cardiac </li></ul><ul><li>arrest (SCA). </li></ul>
  • 3. Major killer worldwide <ul><li>Over 250,000 deaths a year in the U.S. alone*. </li></ul><ul><li>Only 5 – 10 % of its victims survive. </li></ul>* American Heart Association 2002 Heart &amp; Stroke statistical Update, Dallas, Texas : AHA 2000. “ He died so suddenly and we didn’t even know he had heart disease” Sudden Cardiac Arrest (SCA)
  • 4. Source : American Heart Association 2002 Heart &amp; Stroke statistical Update , Dallas, Texas : AHA 2000. Sudden Cardiac Arrest (SCA) Incidence of SCA Vs Other Main causes of death
  • 5. <ul><li>Heart Attack (Myocardial infarction) occurs </li></ul><ul><li>when the coronary artery becomes blocked </li></ul><ul><li>and the blood supply to heart muscle is </li></ul><ul><li>interrupted. </li></ul><ul><li>If the blockage is not reversed in a matter </li></ul><ul><li>of hours, permanent damage occurs. </li></ul>Sudden Cardiac Arrest vs Heart Attack
  • 6. <ul><li>Sudden Cardiac Arrest occurs when the heart </li></ul><ul><li>starts beating chaotically and is unable to </li></ul><ul><li>pump blood to the body (no pulse or breathing). </li></ul><ul><li>It is the result of an electrical malfunction of </li></ul><ul><li>the heart. </li></ul>Sudden Cardiac Arrest vs Heart Attack
  • 7. <ul><li>The heart muscle contracts </li></ul><ul><li>in response to electrical </li></ul><ul><li>stimulus generated by the </li></ul><ul><li>heart’s pacemaker Cells </li></ul><ul><li>with the result of a pulse, </li></ul><ul><li>blood pressure, breathing </li></ul><ul><li>&amp; other signs of circulation. </li></ul>Cardiac Electrical Conduction
  • 8. Sinoatrial Node Normal Sinus Rhythm
  • 9. &nbsp;
  • 10. Ventricular Tachycardia Sudden Cardiac Arrest (SCA)
  • 11. Ventricular Fibrillation <ul><li>Causes : </li></ul><ul><li>Coronary artery disease </li></ul><ul><li>Acute coronary syndromes </li></ul><ul><li>Electrocution. </li></ul><ul><li>Drug toxicity and sensitivity </li></ul><ul><li>Asphyxia </li></ul><ul><li>Drowning </li></ul><ul><li>Blunt force trauma to the chest. </li></ul>Sudden Cardiac Arrest (SCA)
  • 12. <ul><li>150 Sudden Cardiac Deaths per 100,000 persons </li></ul><ul><li>annually in industrialised world. </li></ul><ul><li>40% of SCDs occur in people with no prior history of </li></ul><ul><li>heart disease. </li></ul><ul><li>SCD accounts for more than 50% of cardiac mortality. </li></ul><ul><li>Autospies revealed 90% victims have CAD. </li></ul><ul><li>Age above 40 yrs. </li></ul>Incidence of Sudden Cardiac Death (SCD)
  • 13. <ul><li>Prior Episode of V.TACH </li></ul><ul><li>Low LVEF. </li></ul><ul><li>Previous Myocardial Infarction. </li></ul><ul><li>Coronary Artery Disease </li></ul><ul><li>Family History of SCD. </li></ul><ul><li>Cardiomyopathy </li></ul><ul><li>Congestive Heart Failure </li></ul><ul><li>Long QT Syndrome. </li></ul><ul><li>Right Ventricular Dysplasia. </li></ul>Risk Factors of Sudden Cardiac Death (SCD)
  • 14. Treatment “ Chain of Survival” <ul><li>Early access. </li></ul><ul><li>Early CPR. </li></ul><ul><li>Early defibrillation. </li></ul><ul><li>Early advanced life support. </li></ul>Sudden Cardiac Arrest (SCA)
  • 15. “ Chain of Survival” First link – Early access <ul><li>Call for Help ! </li></ul><ul><li>Patient evaluation </li></ul><ul><li>Determine if conscious or not, by placing </li></ul><ul><li>one hand on patient’s forehead and </li></ul><ul><li>shaking shoulders gently with another </li></ul><ul><li>hand. </li></ul><ul><li>In case of SCA patient will not respond. </li></ul>Sudden Cardiac Arrest (SCA)
  • 16. “ Chain of Survival” Second link – Early CPR <ul><li>Steps preceding Cardiopulmonary Resuscitation (CPR) </li></ul><ul><li>Determine A,B,C of Basic Cardiac Life Support (BCLS). </li></ul><ul><li>* A for Airway. </li></ul><ul><li>* B for Breathing. </li></ul><ul><li>* C for Circulation. </li></ul>Sudden Cardiac Arrest (SCA)
  • 17. <ul><li>Airway </li></ul><ul><li>* Head tilt </li></ul><ul><li>* Finger sweep. </li></ul><ul><li>* Jaw Thrust. </li></ul>Sudden Cardiac Arrest (SCA) “ Chain of Survival” Second link – Early CPR
  • 18. <ul><li>Breathing </li></ul><ul><li>* Look – Down the line of chest to </li></ul><ul><li>to see it rise and fall. </li></ul><ul><li>* Listen – at mouth and nose for </li></ul><ul><li>breathing sounds. </li></ul><ul><li>* Feel – for expired air at patients </li></ul><ul><li>mouth and nose. </li></ul>“ Chain of Survival” Second link – Early CPR Sudden Cardiac Arrest (SCA)
  • 19. <ul><li>Circulation </li></ul><ul><li>* Feel - carotids </li></ul>“ Chain of Survival” Second link – Early CPR Sudden Cardiac Arrest (SCA)
  • 20. <ul><li>Once SCA is confirmed ………… </li></ul><ul><li>Patient should be placed on hard surface. </li></ul><ul><li>Start CPR. </li></ul><ul><li>Give 2 expired breaths, followed by 15 compressions. </li></ul><ul><li>Continue 2:15 cycles for CPR both for 1- &amp; 2 - rescuers </li></ul><ul><li>Compression rate -100 per minute </li></ul>“ Chain of Survival” Second link – Early CPR Sudden Cardiac Arrest (SCA)
  • 21. <ul><li>Mouth to mouth ventilation </li></ul><ul><li>Remove any obvious obstruction. </li></ul><ul><li>Open airway. </li></ul><ul><li>Pinch victims nose. </li></ul><ul><li>Give mouth to mouth ventilation. </li></ul><ul><li>Repeat breaths. </li></ul>“ Chain of Survival” Second link – Early CPR Sudden Cardiac Arrest (SCA)
  • 22. <ul><li>Cardiac compressions </li></ul><ul><li>Locate correct chest compression site, </li></ul><ul><li>2 - fingers above xiphoid. </li></ul><ul><li>Place heel of other hand on the lower end </li></ul><ul><li>of breast bone. </li></ul><ul><li>Fingers off the chest wall. </li></ul><ul><li>Continue till AED is available. </li></ul>“ Chain of Survival” Second link – Early CPR Sudden Cardiac Arrest (SCA)
  • 23. &nbsp;
  • 24. “ Chain of Survival” Second link – Early CPR Sudden Cardiac Arrest (SCA)
  • 25. “ Chain of Survival” Third link – Early Defibrillation <ul><li>CPR saves time </li></ul><ul><li>The most common cause of SCA is VF, a lethal rhythm </li></ul><ul><li>The only effective treatment is defibrillation </li></ul>Sudden Cardiac Arrest (SCA)
  • 26. “ Chain of Survival” Third link – Early Defibrillation <ul><li>Over 10 years ago, AHA expanded its early defibrillation standard of care to include </li></ul><ul><li>AEDs for in-hospital first responders (1990). </li></ul><ul><li>Resuscitation committees often “inappropriately” emphasize the arrival of core team </li></ul><ul><li>rather than the delivery of the first shock. </li></ul><ul><li>Treatment goal – defibrillation within 3 min. anywhere in the hospital. </li></ul>AHA/ERC Standards &amp; Guidelines VF Defibrillation NSR Defibrillation Electrical Current Stops VF Sudden Cardiac Arrest (SCA)
  • 27. “ Chain of Survival” Third link – Early Defibrillation Defibrillation Electrode Placement <ul><li>Anterior – lateral placement </li></ul>Sudden Cardiac Arrest (SCA)
  • 28. &nbsp;
  • 29. “ Chain of Survival” Third link – Early Defibrillation <ul><li>Guidelines 2000 </li></ul><ul><li>For communities : </li></ul><ul><li>3-5 minutes, preferably less than 3 minutes. </li></ul><ul><li>For hospitals : </li></ul><ul><li>less than 3 minutes. </li></ul>The Importance of TIME : Sudden Cardiac Arrest (SCA)
  • 30. Time is the enemy : % Success Time (minutes) Resuscitation Success vs. Time Success rates decrease 7-10% each minute Sudden Cardiac Arrest (SCA) “ Chain of Survival” Third link – Early Defibrillation <ul><li>Survival rates plunge 7 – 10 % </li></ul><ul><li>every minute defibrillation is </li></ul><ul><li>delayed. </li></ul><ul><li>Quick action by first responder on </li></ul><ul><li>scene can save a life. </li></ul><ul><li>Solution : Public Access Defibrillation </li></ul><ul><li>Recognize SCA (1 to 2 mins) </li></ul><ul><li>Locate AED &amp; deliver shock (2 mins). </li></ul>0 1 2 3 4 5 6 7 8 9
  • 31. <ul><li>% Witnessed VF Patients Surviving to Hospital Discharge </li></ul>Sudden Cardiac Arrest (SCA) “ Chain of Survival” Third link – Early Defibrillation
  • 32. <ul><li>Safety First </li></ul><ul><li>Attach AED only to someone not </li></ul><ul><li>breathing and without a pulse or signs </li></ul><ul><li>of circulation. </li></ul><ul><li>Make sure no one is touching the victim. </li></ul><ul><li>Be sure the electrodes are firmly </li></ul><ul><li>adhered to victims chest. </li></ul><ul><li>Move oxygen away from the rescue </li></ul><ul><li>effort before defibrillation. </li></ul>Sudden Cardiac Arrest (SCA) “ Chain of Survival” Third link – Early Defibrillation
  • 33. <ul><li>Today’s AEDs are more practical for use in the work place </li></ul><ul><li>and public places </li></ul><ul><li>* Voice prompts are more intuitive. </li></ul><ul><li>* AEDs do self tests and are virtually maintenance free. </li></ul>Sudden Cardiac Arrest (SCA) “ Chain of Survival” Third link – Early Defibrillation AEDs are WELL SUITED for USE by NON-TRADITIONAL RESPONDERS
  • 34. <ul><li>Who is Using AEDs Today ? </li></ul><ul><li>Flight Attendants </li></ul><ul><li>Firefighters. </li></ul><ul><li>Paramedics </li></ul><ul><li>Corporate Emergency Response Teams </li></ul><ul><li>Security Officers </li></ul><ul><li>Factories/ Industries </li></ul><ul><li>Shopping Malls </li></ul><ul><li>Corporate Offices </li></ul><ul><li>Police force </li></ul><ul><li>Golf Pros </li></ul><ul><li>Health club employees </li></ul>Automated external defibrillators (AEDs) are safe for trained lay rescuers to use, to treat sudden cardiac arrest. The devices analyze a victim’s heart rhythm and only allow an electric shock to be delivered when necessary . read more… DID YOU KNOW? Source : AHA website Sudden Cardiac Arrest (SCA) “ Chain of Survival” Third link – Early Defibrillation
  • 35. “ Chain of Survival” Third link – Early Defibrillation <ul><li>Semi Automatic : Analyses patient’s rhythm and advises if </li></ul><ul><li>rhythm needs a shock. Operator has to press “shock” button </li></ul><ul><li>to deliver the shock. </li></ul><ul><li>Fully Automatic : Analyses patient’s rhythm and delivers </li></ul><ul><li>shock if required all by itself. </li></ul>Types of AEDs Sudden Cardiac Arrest (SCA)
  • 36. <ul><li>Simple 2 Button Operation </li></ul><ul><li>ON/OFF </li></ul><ul><ul><li>(Auto Analyze) </li></ul></ul><ul><li>SHOCK </li></ul>“ Chain of Survival” Third link – Early Defibrillation <ul><li>Semi Automatic External Defibrillator : </li></ul>TYPES OF AEDs Sudden Cardiac Arrest (SCA)
  • 37. <ul><li>Simple 1 Button Operation </li></ul><ul><li>ON/OFF </li></ul><ul><li>(Auto Analyze &amp; Auto Shock if required) </li></ul>“ Chain of Survival” Third link – Early Defibrillation <ul><li>Fully Automatic External Defibrillator : </li></ul>TYPES OF AEDs Sudden Cardiac Arrest (SCA)
  • 38. “ Chain of Survival” Fourth link – Early ACLS <ul><li>For advanced Cardiac Life support (ACLS) shift the patient </li></ul><ul><li>to the nearest hospital. </li></ul><ul><li>Treat victim with medicine and advanced therapies. </li></ul>Sudden Cardiac Arrest (SCA)
  • 39. MESSAGE FOR ALL OF US Sudden Cardiac Arrest (SCA) The FUTURE will see severe competition due to which tensions are going to mount. We must care for HIGH PROFILE INDIVIDUALS. Must provide LIFE SAVING SUPPORT to handle such EVENTUALITIES.
  • 40. Thank you ! Handling Sudden Cardiac Arrest (SCA)

×