The document discusses cardiopulmonary resuscitation (CPR) and management of cardiac arrest. It notes that over 300,000 people experience sudden cardiac death outside of hospitals each year, and that survival chances increase if resuscitation begins within minutes through early CPR and defibrillation. The key aspects of CPR discussed are chest compressions at a rate of 100 per minute with full chest recoil between compressions. Defibrillation is critical to revive those in ventricular fibrillation, and automated external defibrillators can be used by the public to increase survival rates from cardiac arrest.

1. CARDIOPULMONARY RESUSCITATION
& MANAGEMENT
Advisor: dr.Nicolaas P.S, Sp. An
1

2. Time is critical
• > 300,000 people experience sudden cardiac
death in prehospital settings each year.
• If resuscitation begins within a few
minutes, many of these individuals have a
chance for survival.
epidemiologi
2

3. Time is Critical!
• To begin resuscitation within a few minutes:
• Patient’s collapse witnessed
• EMS immediately activated
• CPR started immediately
• Defibrillation within minutes
3

4. Review of the Circulatory System
What is the function of the
circulatory system?
4

5. The Circulatory System
Delivers
O2 and
nutrients
Removes
CO2 and
wastes
5

6. Why is the function of the circulatory
system critical to our survival?
6

7. Lack of
O2
accumulatio
n of wastes
quickly lead
• to death 7

8. 8

9. Major
Arteries
9

10. Heart Physiology
• LV contracts – sends wave of blood
• Pressure wave felt as pulse
• No contraction = No blood flow = cardiac
arrest
10

11. Time is Critical!
• Brain damage begins
in 4–6 min
• Brain damage
irreversible in 8–10
min
Circulation must be
restored within 4–
6 minutes.
11

12. CPR
• Provides minimal amount of
circulation/oxygenation until cause of cardiac
arrest corrected
• External chest compressions circulate blood
• Artificial ventilations provide O2 to lungs
12

13. HISTORY
2010 : New Guidelines on CPR (AHA)
13

14. Causes of Cardiac Arrest
• Heart disease
• Respiratory arrest
• Medical emergencies
• Drowning and suffocation
• Congenital heart defects
• Trauma
14

15. AMERICAN HEART
ASSOCIATION
CHANGES IN THE 2010
GUIDELINES AFFECTING
ALL RESCUERS
AMERICAN HEART
ASSOCIATION
15

16. AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Health Care Provider*
 “PUSH HARD AND PUSH FAST”
 At least 100 COMPRESSIONS / MINUTE*
 Allow the chest to recoil -- equal compression and relaxation times
 <10 seconds for pulse checks or rescue breaths
 Compression Depth*
 Adults 2”
 Child/Infant 1/3 depth of chest 1.5" infant 2" child
 Avoid excessive ventilations
16

17.  A-B-C changed to C-A-B*
 Critical element is chest compressions
 Delay in A-B
 Avoidance of A & B
 Early defib
 If alone--call and retrieve AED
 Exception asphyxial arrest
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
17

18. New Sequence
18

19. • Cricoid pressure not recommended
• Advanced airway = 1 every 6-8 seconds
• Adult: 1 every 5-6 Peds: 1 every 3
• With advanced airway- no pause
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
19

20. AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
AHA ECC Adult Chain of Survival - New
20

21. Simplified Universal
BLS algorithm
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
21

22. Causes of Cardiac Arrest
• Heart disease
• Respiratory arrest
• Medical emergencies
• Drowning and suffocation
• Congenital heart defects
• Trauma
22

23. CPR
Compression : ventilation remains 30 : 2
Duration of 2 breaths = 5 seconds
23

24. CPR – 1 Rescuer
• If there is no
pulse, find your
landmarks, lower
half of the
sternum, between
the nipples

25. CPR – 1 Rescuer
• Begin chest
compressions

26. CPR – 1 Rescuer
• Perform 30 chest
compressions
• Push hard
• Push fast
• Allow the chest to
recoil after each
compression

27. CPR – 1 Rescuer
• Administer two
ventilations then
return to
compressions

28. CPR – 2 Rescuer
1 2
3 4

29. CPR - Children
• Use heel of one
hand
• Keep airway open
with other hand
• 30 compressions:2
ventilations if alone
(2 rescuers use 15:2)

30. CPR - Infant
• Give chest thrusts and
puffs of air
• 30 compressions:2
ventilations if alone
• 15 compressions: 2
ventilations with 2
rescuers

31. Copyright © 2004 Elsevier (USA). All Rights Reserved
Defibrillation
•Ventricular fibrillation
a common cause of
arrest
•Can only correct with
defibrillation

32. Copyright © 2004 Elsevier (USA). All Rights Reserved
• Chance of success
decreases with time
• AEDs save lives!
Defibrillation

33. AEDs
• Safe, accurate &
lightweight
• Easy to operate
33

34. PAD
• AEDs in public
places
• Training the public
in CPR/AED
34

35. AED

36. Assess • Check your
patient

37. Power
• Turn the power
on

38. Patient
• Apply pads to
patient

39. Analyze
• Stay clear while
patient’s heart
rhythm analyzed

40. Clear
• Head to toe and
toe to head:
everyone is clear!

41. Shock
• Defibrillate

42. Patient
• Standard is set of 1
shock
• Immediately restart
CPR for 2 minutes
then check pulse

43. ADULT CARDIAC ARREST ALGORITHM
43

44. 44

45. 45

46. 46

47. 47

48. 48

49. 49

50. 50

51. 51

52. Summary
• Continual beating, or contracting, of the heart
is necessary to keep blood circulating
throughout the body.
• Brain damage begins in 4 to 6 minutes of
cardiac arrest.
• There are many causes of sudden cardiac
death, but the most common is ventricular
fibrillation.
52

53. Summary
• Survival from cardiac arrest depends on the
sequence (chain) of survival.
• Rescuers are critically important in
maintaining the sequence (chain) of survival.
53

54. Thank you
54