3. CONDITIONS MAY LEAD TO A CARDIOPULMONARY ARREST
DEMAMDING IMMEDIATE INITIATION OF CPR
Approximately 700,000 cardiac arrest /year…
Early resuscitation can lead to >60% survival
4. The AHA developed the concept to highlight the importance of timely,
coordinated care for people experiencing sudden cardiac arrest. The chain
of survival consists of four key steps: early recognition and activation of the
emergency response system, early CPR, rapid defibrillation, and advanced
life support.
10. AUTOMATED EXTERNAL DEFIBRILATOR (AED)
Automated external
defibrillator or
automatic electronic
defibrillator (AED) is
a portable electronic
device that
automatically
diagnoses the life-
threatening cardiac
arrhythmias (VF ,
Pulse less VT) and is
able to treat them
through defibrillation
i.e. the application of
11.
12. Advanced cardiac life support, advanced cardiovascular life support (ACLS) refers to a set of
clinical guidelines for the urgent and emergent treatment of life-threatening cardiovascular
conditions that will cause or have caused cardiac arrest, using advanced medical procedures,
medications, and techniques. ACLS expands on Basic Life Support (BLS) by adding
recommendations on additional medication and advanced procedure use to the CPR guidelines
that are fundamental and efficacious in BLS. ACLS is practiced by advanced medical providers
including physicians, some nurses and paramedics
COMPONENTS:
•RHYTHM DIAGNOSIS
•CPR
•ELECTROTHERAPY
•AIRWAY MANAGEMENT
•VENTILATION
•MEDICATION
•SPECIALISED RESUSITATION TECHNIQUES
13. ECG, clinical exam Diagnosis of arrythmias
Chest compressions, mechanical CPR Perfusion of blood before ROSC is
achieved
•Biphasic defibrillation,
• Double sequential
defibrillation,
• Transvenous/ transcutaneous pacing
Termination of shockable rhythms
use of advance airway devices (ET
tube,LMA, Airway devices,
capnography,etc)
Clear and protect the airway to allow
for adequate ventilation.
Oxygen therapy, bag valve mask,
ventilator management
Ventilate the lungs to allow for
subsequent oxygenation of the blood
Drugs such as
EPINEPHINE, LIDOCAINE,
AMIDARONE,MgSO4, ATROPINE,IV
CRYSTALLOIDS, BLOOD AND PRODUCTS
etc
Stabilizes arrhythmia, promote ROSC
and increase perfusion.
ECG, TEE, ECMO, PCI, TTM,
CENTRAL VENOUSACCESS
Identification of underlying cause of
cardiac arrest, augmentation of perfusion
and/or treatment of PCAS.
19. DEFIBRILLATIO
N
CARDIOVERSIO
N
NOT
Synchronized
Synchronized on
R wave
For Cardiac
Arrest
For periarrest
tachyarrhythmia
's
Higher energy
joules
Lower energy
joules
No escalating
energy for next
shock
Escalate for
next shock
100- 200- 300-
360
FREQUENTLY PONDERED UPON CONCEPTS…
MONOPHASIC BIPHASIC
Delivers current in
one direction
Delivers current
in two directions
Requires more
energy (upto
360J)
Requires less
energy (upto
200J)
More Trauma Less Damage
More Myocardial
damage
Less Myocardial
damage
First Shock
survival rate
around 60%
First Shock
survival rate
around 90%
Outcome is Good Better compared
20. 1.Turn the equipment On/Off
2. Luminous Alarm Indicator
3. Luminous Battery Indicator
4. Luminous Battery Charging
Indicator
5. NIBP
6. Printer
7. Sync.
8. Disables alarm for 2 minutes
9. Defibrillator charge command
10. Enables / Disables AED Mode
11. Shock trigger command
Cancel Charge
12. External Paddle for Shock
Triggering
13. Display
14. Transport handle
15. External Paddle for Shock
Triggering
DEFIBRILLATOR
A defibrillator is a device that
provides an electric stimulus to
your heart to allow it to get out of
a potentially fatal abnormal heart
rhythm, or arrhythmia, —
ventricular tachycardia (with no
pulse) or ventricular fibrillation
— and back to a normal
rhythm.
21. Post cardiac arrest care
Treatment for a victim of cardiac arrest must continue post
resuscitation in order to optimize the outcomes. The post
cardiac arrest care algorithm includes the following steps:
•Verify ROSC.
•Manage the airway including ETT placement and provide 10
breaths per minute.
•Using quantitative waveform capnography, titrate the oxygen
to maintain a PETCO2 of 35-40 mm Hg. If you do not have
access to a waveform capnography machine, titrate oxygen to
keep the oxygen saturation 92% to 98%.
•Insert and maintain an IV for medication administration.
•Maintain systolic blood pressure above 90 mm Hg and/or
mean arterial pressure above 65 mm Hg. For a low blood
pressure, consider one or more of these treatments:
•Give 1 to 2 liters of saline or Ringer’s lactate IV fluid.
•Start an epinephrine IV or a dopamine IV infusion
•Consider norepinephrine for extremely low systolic
blood pressure.
•Obtain a 12-lead ECG and rule out myocardial infarction. If
myocardial infarction is suspected, consider percutaneous
coronary intervention (PCI) to open the coronary arteries.
Determine if the patient is comatose.
• If comatose:
• Targeted temperature management ASAP
•keeping body temp 32-36°C for 24 hours
initially.
•Monitor EEG and assess for nonconvulsive
seizures (treat if present)
•Obtain head CT
•Maintain oxygen, glucose, carbon dioxide, etc.
•Avoid barotrauma
• If NOT comatose (awake):
•Maintain oxygen, glucose, carbon dioxide, etc.
•Avoid barotrauma
