Cpr drugs and monitoring of basic parameters

1. CPR drugs and monitoring of
basic parameters during CPR
DR. AHMED MAMUNUL HUQ
MD CARDIOLOGY
NATIONAL INSTITUTE OF CARDIOVASCULAR DISEASES
DHAKA, BANGLADESH

2. What is cardiac arrest?
• cardiac arrest is the sudden cessation of cardiac activity so that the
victim becomes
• unresponsive,
• with no normal breathing and
• no signs of circulation (no pulse and BP)
Source: American Heart Association and the American College of Cardiology

3. Source: 2018 American Heart Association Focused Update on Advanced
Cardiovascular Life Support
Cardiac arrest algorithm

4. Basic rhythms of cardiac arrest
• Shockable – pulseless VT and VF
• Non shockable – PEA and asystole

5. asystole
Venrticular fibfillation (VF)
Pulseless electrical activity (PEA)

6. Important CPR drugs
• Epinephrine
• Amiodarone OR
• Lidocaine
• NO ATROPINE DURING CPR

7. epinephrine
• Administration
• 1 mg IV every 3 to 5 mins
• First dose after 2nd shock then onwards
• Used in both shockable and non shockable rhythm

8. amiodarone
• Administration
• First dose : 300 mg IV bolus
• Second dose : 150 mg IV bolus
• Preparation
• Take required dose in 10 ml DS and dilute it with
5% DA to make it 10 ml, then push IV slowly.
• First dose after 3rd shock
• Used in shockable rhythm only

9. lidocaine
• Administration
• First dose : 1 mg/kg IV
• Second dose 0.5 mg/kg IV

10. Monitoring basic parameters during CPR

11. Parameters to check
• Check rhythm every 2 minutes of CPR – shockable or
non shockable
• Pulse – check carotid pulse every 2 mins CPR
• BP
• Sudden increase in PETCO2 > 40 mmHg
• Spontaneous arterial pressure wave with intra-arterial monitoring

12. Treat reversible cause
• 5 H
• Hypoxia
• Hypothermia
• Hypo/ hyper kalaemia
• Hydrogen ion (acidosis)
• Hypovolemia
• 5 T
• Tamponade
• Tension pneumothorax
• Toxin
• Thrombosis – pulmonary
• Thrombosis – coronary

13. THANKS