2. PRESENTED BY,
Dr. S. SATHYA MPT ( Cardio
thoracic)
Assistant professor
Faculty of Physiotherapy,
Dr. MGR Educational And
Research Institute
3. 1. DEFINITION
2. CLASSIFICATION
3. RISK FACTORS
4. SIGNS AND SYMPTOMS
5. CLINICAL FEATURES
6. DIAGNOSIS
7. MEDICAL MANAGEMENT
8. CARDIOPULMONARY
RESUSCUTATION
9. INDICATIONS
10. PATHOPHYSIOLOGY
11. STEPS IN RESUSCITATION (
DRSCABD )
12. STEPS IN CPR
13. RECOGNITION OF ARREST
14. DIAGNOSIS OF CARDIAC
ARREST
15. COMPRESSIONS
16. HOW CPR WORKS
17. INFANT CPR
4. Cardiac arrest is the cessation of normal circulation of the
blood due to failure of the heart to contract effectively.
Medical personnel can refer to an unexpected cardiac
arrest as a sudden cardiac arrest or SCA
5. Cardiac arrest is classified based upon the
ECG rhythm into:
1. Shockable (ventricular fibrillation and pulseless
ventricular tachycardia)
2. Non Shockable (Asystole and pulseless electrical
activity)
6.
7. Sex: The lifetime risk is three times greater in men
(12.3%) than women (4.2)%
Smoking
Lack of physical exercise
Obesity
Diabetes
Family history
8. The most reliable sign in absence of pulse
Unconsciousness
No breathing
No blood pressure
Pupils begin dialating within 45 seconds
Seizures may or may not occur
Death – like appearance
Lips and nails buds turn blue
9. Cardiac arrest is synonymous with clinical death
Lack of carotid pulse is the gold standard for
diagnosing cardiac arrest
Cardiac arrest is usually diagnosed clinically by the
absence of a pulse, but lack of a pulse ( particularly
in the peripheral pulse) may be a result of other
conditions.. Eg shock, or simply an error on the part
of the resuer
10.
11. ADRENALINE:
This is the first drug given in all causes of cardiac arrest and should be readily
aavailablein all clinical areas
AMIODARONE:
This drug is given during cardiac arrest to treat specific cardiac arrthymias
mainly fibrillation and ventricular tachycardia.
ATROPINE:
The action of this drug to block the effect of the bags nerve on the heart. This
nerve normally slows heart rate and during cardiac arrest is common cause of
asytole. Atropine also acts on the conduction system of the heart and
accelerates the transmission of electrical impulses through cardiac tissue
MAGNESIUM SULPHATE:
Is an important electrolyte involved in the contraction of muscular tissue
including cardiac muscle. A reduction in blood levels of this element can
frequently cause cardiac arrthymias often leading to cardiac arrest.
MISCELLANEOUS DRUGS:
12. Sudden cardiac arrest may be treated via
attempts at resuscitation.
This is usually carried out based upon.
Basic life support (BLS)
Advanced cardiac life support ( ACLS)
Pediatric advanced life support ( PALS)
Neonatal resuscitation program ( NRP)
15. Cardio pulmonary resuscitation,
Immediate medical attention,
No trendelenburg position,
Segemental breathing,
Bed at or deep breathing in cardiac position 45 to 60
degrees head elevated.
16.
17.
18. Cardiopulmonary resuscitation (CPR) is an
emergency procedure which is performed in an effort
to manually preserve intact brain function until further
measures are taken to restore spontaneous blood
circulation and breathing In a person in cardiac arrest
19. To restore partial flow of oxygenated blood to the
brain and heart who are not breathing and do not
have a pulse
HANDS-ONLY CPR
22. 1. Check for danger
2. Check for response
3. Send for help
4. Chest compression
5. Open the airway
6. Check breathing
7. D stands for AED
23. Recognition of the arrest
Compressions
Managing the airway
Rescue breaths
24. Check for response
Tap the victim on the soulder and shout,
“Are you all right ”
No more than 10 seconds to check for a
pulse
ADULTS – carotid artery
INDANTS- brachial artery
25.
26. Check the pulse on carotid
artery using fingers of the
other hand
In infants brachial pulse is
more easily located and
palpated Tham Tham carotid
pulse
27. Push hard and fast ( 100/min)
Compressions to relaxation ratio 50:50 . To ensure full chest recoil
Minimal interruption
TETECHNQUE
1. Position yourself of victim’s side.
2. Make sure the victim is lying on his back.
3. Remove all clothings covering the victims chest.
4. Put the heel of one hand on the center of the
victim’s bare chest between the nipple.
5. Put the heel of your other hand on the top of the
first hand.
6. Straighten your arms And position your
shoulders directly over your hands.
7. Push hard and fast.
8. At the end of each compression make sure that
you allow the chest to recoil completely .
35. Mouth to mouth rescue breathing
Mouth to barrier device breathing
Mouth to nose and mouth to stoma ventilatikn
Ventilation with bag and mask
Ventilation with an advanced airway
36.
37. Can’t open mouth
Can’t make a good
seal
Severely injured
mouth
Stomach distension
Mouth to stoma (
tracheotomy)
42. 1. Position yourself directly above the victims head
2. Place the mask on the victims face.
3. Use the E C clamp technique to hold the mask on place.
Perform head tilt, use thumb and index finger of one hand to make a
c pressing the edges of the mask to the face,
Use the remaining fingers to lift the angles of the jaw .
4. Squeeze the bag to give breaths while watching for chest rise.
43. Shout and gently tap the child on the
shoulder. If there is no response,
position the infant on his back.
Begin chest compression
If not breathing give 2 small gentle
breaths
Cover the baby’s mouth and nose with
your mouth
Each breath should be 1 second long.
You should see the baby’s chest rise
with each breath.
44. The person revives and starts breathing again on
their own.
Medical help, such as amubulance, paramedics,
arrive to take over.
The person performing the CPR is forced to stop
from physical exhaustion.
Death of the victim.
CPR continued for 30 minutes I’d the time to onset of
CPR in < 6 min.
45. 1. Lung expansion.
2. Pupil will react to light / will appear normal
3. Normal heart beat will return
4. A spontaneous gasp/ breathing will occur.
5. May move legs / arms and colour may improve.
46. Rib fracture.
Aspiration
Vomiting
Laceration related to the tip of the sternum.
Local blunt trauma.
Gastric inflation.
Compression at the xiphoid process causes
laceration of liver.
47. DelaY in starting.
No ACLS follow upAnd delay in defribillation.
……only 15 % who receive CPR live to go home .
....improper techniques
Terminal disease or unmanageable disease (
massive heart attack).
48.
49. Cash’s textbook of chest, vascular disorders for
physiotherpists.
- Patricia A. Downie
Textbook of physiotherapy for cardio respiratory
,cardiac surgery and thoracic surgery condition.
- G B Madhuri.
CARDIO PULMONARY RESUSCITIATION
- https://g.co/kgs/ptmZq9
CARDIAC ARREST
https://g.co/kgs/YHw4ad
