Cardiopulmonary arrest

1. By- Michael Makasare
2nd Year (3rd Sem)
Bsc Nursing
St. Andrew's College
of Nursing, Pune

2. CARDIAC ARREST
Sudden stop in effective
blood circulation due to the
failure of the heart to
contract effectively.
 Medical personnel may
refer to an unexpected
cardiac arrest as a sudden
cardiac arrest (SCA).

3. PATHOPHYSIOLOGY
RISK FACTORS, ETIOLOGY
CONDUCTION ABNORMALITY IN HEART
INABILITY OF HEART TO CONTRACT
PROPERLY
DECREASED CARDIAC OUTPUT
DECREASED TISSUE PERFUSION COMPROMISED FUNCTION OF HEART
SIGN AND SYMPTOMS

4. SIGN AND SYMPTOMS
 loss of pulse
Absence of BP
Unconscious
Seizures
Chocking
Dilatation of pupil

6. DIAGNOSIS
1. Assessment of signs and symptoms
2. E.C.G
3. Serum Electrolytes
4. Cardiac Biomarkers
5. ABG Analysis
6. Chest X-Ray

7. 1. VENTRICULAR FIBRILLATION
BASIC ECG PATTERNS WITH CARDIAC
ARREST

8. 2. VENTRICULAR ASYSTOLE

9. MANAGEMENT
Early assessment
CPR
Defibrillation
Medications
Post cardiac care

10. TREATMENT
“Chain of Survival”
 Early access.
 Early CPR.
 Early defibrillation.
 Early advanced life support.

11. “Chain of Survival” First link – Early
access
Call for Help !
Patient evaluation
 Determine if conscious or not, by
placing one hand on patient’s forehead
and shaking shoulders gently with
another hand.
 In case of SCA patient will not
respond.

12. “Chain of Survival” Second link –
Early CPR
Steps preceding Cardiopulmonary
Resuscitation (CPR)
 Determine A,B,C of Basic Cardiac Life Support
(BCLS).
* A for Airway.
* B for Breathing.
* C for Circulation.

13.  Airway
* Head tilt
* Finger sweep.
* Jaw Thrust.
“Chain of Survival” Second link –
Early CPR

14.  Breathing
* Look – Down the line of chest to
to see it rise and fall.
* Listen – at mouth and nose for
breathing sounds.
* Feel – for expired air at patients
mouth and nose.
“Chain of Survival” Second link –
Early CPR

15.  Circulation
* Feel - carotids
“Chain of Survival” Second link –
Early CPR

16. Cardiac compressions
 Locate correct chest compression
site, 2 - fingers above xiphoid.
 Place heel of other hand on the
lower end of breast bone.
 Fingers off the chest wall.
“Chain of Survival” Second link –
Early CPR

17. Once SCA is confirmed …………
 Patient should be placed on hard surface.
 Start CPR.
 Give 2 expired breaths, followed by 30 compressions.
 Continue 30:2 cycles for CPR both for 1- & 2 -rescuers
 Compression rate – atleast 100 per minute
“Chain of Survival” Second link – Early
CPR

18. Mouth to mouth ventilation
 Remove any obvious obstruction.
 Open airway.
 Pinch victims nose.
 Give mouth to mouth ventilation.
 Repeat breaths.
“Chain of Survival” Second link –
Early CPR

19. “Chain of Survival” Second link –
Early CPR

20. “Chain of Survival” Third link – Early
Defibrillation
 CPR saves time
 The most common cause of SCA is VF, a lethal rhythm
 The only effective treatment is defibrillation

22. PADDLE PLACEMENT

27. NURSING MANAGEMENT

28. NURSING MANAGEMENT
1) ASSESSMENT :
- Observe sign and symptoms
- Observe pulse
- Assess A, B, C
- Call for help
START CPR

29. Immediate care after CPR
Level of consciousness
Vital signs
ECG
 CVP
 Urine output
 ABG value

30. NURSING DIAGNOSIS
Administer drugs, antidysrhythmic medication as ordered.
Administer fluid therapy as ordered.
Decreased cardiac output cardiac arrest, dysrhythmia.
Assess vital signs, CVP, urinary output and peripheral pulses.
Assess heart rate and rhythm (ECG).
Oxygen administration as hypoxia can lead to further dysrhytmias.

31. NURSING DIAGNOSIS
Note the color and temperature of the skin.
Monitor peripheral pulses
Monitor urine out put
Provide warm environment.
Impaired tissue perfusion to decreased cardiac output.

32. NURSING DIAGNOSIS
MANAGEMENT
condition.
 Assess respiratory rate.
 Auscultate breath sounds.
 Fowler’s position if difficulty.
 Monitor pulse oximetry and ABG analysis. Report any
abnormality.
 Continuous monitoring for the first half hour of
defibrillation.
Risk for ineffective respiratory pattern disease

33. NURSING DIAGNOSIS
Monitor intake and output.
Administer fluid and diuretics.
Monitor electrolytes daily and replace as ordered.
Monitor BUN, creatinine and urine electrolytes daily.
Risk for fluid electrolyte imbalance physiological changes.

34. NURSING DIAGNOSIS
and defibrillation.
 Assess level of consciousness. Reorient the time, place and person.
 Assess vital signs and ECG continuously.
 Initiate IV antidysrhythmics therapy as prescribed
 Administer IV fluid to correct fluid electrolyte imbalances
Risk for complications disease process, procedure performed

35. NURSING DIAGNOSIS
 Prepare patient and family and explain what is expected.
 Clarify any misconceptions.
 Provide adequate rest to the patient.
 Encourage to ask questions related to equipments, monitoring,
treatment.
Anxiety fear about unknown outcome.

36. SUMMARY
Definition of cardiac arrest
Difference b/w heart attack and cardiac arrest
Etiology of cardiac arrest
Risk factors of cardiac arrest
Sign and symptoms of patient with cardiac arrest
Diagnosis of patient with cardiac arrest
Management of patient with cardiac arrest

37. REFERENCES
Textbook of Adult Health Nursing -( I Clement)
Textbook of Adult Health Nursing -(Usha Ukande)
Brunner&Suddharth's Textbook of Medical Surgical
Nursing -(Adrianne Dill Linton and Mary Anna Matteson)