Just a review on cardiopulmonary resuscitation. I hope everyone finds it useful and resourceful. major reference is American Heart Association Guidelines if there is any mistake or somebody wants to make an edition please feel free to email me at sardar.saud@gmail.com By Dr Sardar Saud Abbas

1. Cardiopulmonary
Resuscitation
DR SARDAR SAUD ABBAS
PG 2 ANAESTHESIA, KTH

2.  C – Cardio (heart)
 P – Pulmonary (lung)
 R – Resuscitation (recovery)
 Definition:
Cardiopulmonary resuscitation is an emergency procedure consisting of
chest compressions often combined with artificial ventilation in an effort to
manually preserve intact brain function until further measures are taken to
restore spontaneous blood circulation and breathing in a person who is in
cardiac arrest.

3. Causes of Cardiac Arrest
6 H and 4 T
 Hypoxia
 Hypotension
 Hypothermia
 Hypoglycemia
 Hypokalemia
 Acidosis (H+)
 Cardiac Tamponade
 Tension Pneumothorax
 Thromboembolism
 Toxicity

4. Phases of Resuscitation
Phases Steps
Phase I Basic Life Support
C – Compression
A – Airway
B -- Breathing
Phase II Advance Cardiac Life
Support
D – Drugs
E – ECG
F -- Fibrillation
Phase III Prolong Life Support
Post Resuscitation Care

5.  BLS:
It is life support without the use of special equipment.
 ACLS:
It is life support with the use of special equipment (e.g airway, ETT,
defibrillator)
 Chain of survival :

6. Activation of Emergency response
Assessment:
 Check the victim for a response
 Shake shoulder gently
 Ask “are you all right”
 No breathing or no normal breathing
 Check for pulse (carotid) for at least 10 seconds

7. High quality CPR
C A B
 Compression
 Airway
 Breathing
Compression
Rate 100-120/min
Single rescuer = 30:2
In the presence of 2 rescuer chest compressions must not be interrupted for
ventilation

8. Technique for Chest Compression

9. Assessment of the adequacy of chest
compression
 Systolic BP: 60-80 mmHg
 Diastolic BP: > 40 mmHg
 Capnography at least 10 mmHg
Problems and complication of chest compressions
Rib fracture
Fracture sternum
Pnuemothorax
Hemothorax
Fat emboli

10. Airway
 Clear the airway
 Head tilt, Chin lift
 Jaw thrust
 Finger sweep: sweep out the foreign body in the mouth by index finger
(not adviced in awake or convulsing patient)

11. Breathing
 Rescue breathing can be mouth to mouth
 Or mouth to nose breathing

12. Assessment of restoration of breathing
and circulation
 Contraction of pupil
 Improved colour of the skin
 Free movement of the chest wall
 Swallowing attempts
 Struggling movement
 Return of a strong pulse
 Return of systemic blood pressure

13. Advanced Life Support
ACLS includes
 Compression
 Airway management equipment's
 Breathing by advanced technique
 Defibrillation by manual defibrillator
 Drugs

14. Compressions (already discussed)

15. Airway management equipment's
 Face mask
 Oropharyngeal airway
 Nasopharyngeal airway
 Laryngeal mask airway (LMA)
 Endotracheal tube
 Tracheostomy

16. Breathing
 Expired air contains 16% O2 so supplemental 100% O2 should be used as
soon as possible
 Successful breathing is achieved by delivery of a tidal volume 800-1200 ml
in adults at a rate of 10-12 breaths/min in adults
Advance technique include:
1) Self inflating resuscitation bag (ambu bag)
2) Mechanical ventilator in OR in ICU
Ambu bag 21% O2, Ambu Bag with O2 supplement 45%, Ambu bag with
O2 with reservoir bag 85% O2

19. Defibrillator
Position
 On paddle is placed in the right infraclavicular region
 The left 5-6 intercostal space anterior axillary line

20. Drugs

23. Thank You