Cardiac arrest occurs when the heart suddenly stops beating effectively due to problems with its electrical system. Basic cardiopulmonary resuscitation (CPR) involves chest compressions and rescue breathing to provide oxygen to the brain and vital organs until definitive medical treatment can restore normal heart function. High quality CPR includes compressing the chest at a rate of 120 times per minute to a depth of 2-2.4 inches, minimizing interruptions, and providing rescue breaths every 5 seconds. Defibrillation, applying an electrical shock, may help restore an effective heart rhythm for shockable rhythms like ventricular fibrillation.

1. BASIC CARDIO-PULMONARY
RESUSCITATION
Sadhana
Chattopadhyay

2. Abrupt cessation of spontaneous
and effective ventilation and
systemic perfusion
What Is Cardiac Arrest ?

3. How Do you Recognize a Cardiac Arrest?
EARLY
Unresponsiveness
In case of adults absence of carotid pulse
and in case of infants Brachial pulse
Absence of normal respiration( the victim
is not breathing or only gasping)

4. LATE SIGN
 Cyanosis
 Cold clammy skin
 Dilated pupils
 ECG –Asystole / PEA/ pulse less VT/ VF

5. REVERSABLE CAUSES
‘HIT THE TARGET’
H – Hypoxia
I – Increased H Ions [Acidosis],
T – Tension Pneumothorax,
T – Toxins/Poisons,
H – Hypovolaemia,
E – Electrolyte Imbalance [Hypo-/Hyperkalaemia],
T – TamponadeCardiac,
A – Acute Coronary Syndrome,
R – Raised Intracranial Pressure [SubarachnoidHaemorrhage]
G – Glucose [Hypo-/hyperglycaemia],
E – Embolism (Pulmonary Thrombosis),
T – Temperature [Hypothermia]).

6. CARDIO-PULMONARY RESUSCITATION
A basic life support for the purpose of
oxygenating the brain, heart and other
vital organs until the appropriate
definite medical treatment can restore
the normal heart and lung function.

8. Core Links In BCLS

9. Compression rate is 120/min
Compression depth is now 2-2.4 inches in adults
Allow complete chest recoil after each compression
Minimize interruption during chest compression(<
10secs)
Avoid hyperventilation.
Rotate compressor every 2 mins
High quality CPR criteria

10. 1. Assessment and Activate ERS & get an AED
Make sure that scene is safe
Check for response --Tap & shout "Are you all right?"
Check pulse & breathing for absent or abnormal breathing
simultaneously
Activate code blue (7201) & get an AED/Defibrilator
STEPS OF BASIC LIFE SUPPORT

11. 2. Chest compression
Check for pulse for 10 sec.
If no pulse within 10 sec. start CPR with chest
compressions first followed by 2 breaths at 5
sec interval over 1 sec
STEPS OF BASIC LIFE SUPPORT

12. Two-finger chest compression technique in infant (1 rescuer).

13. Two thumb-encircling hands chest compression in infant
(2 rescuers)‫‏‬

14. STEPS OF BASIC LIFE SUPPORT
>Position self correctly (i.e. close to and adequately above
patient, kneel on the bed close to patient),
>Locate correct hand position. (2 finger above the xyphoid
sternum)
>Push hard at 2-2.4 inches & Push fast at the rate of
120/minute

15. STEPS OF BASIC LIFE SUPPORT
3. Opening Airway
 Clean the airway by finger sweep in case of visible
foreign body, or oral suction
 Tilt the head back and lift the chin((using head –
tilt/chin – lift), Double maneuver – SNIFFING
POSITION

16. STEPS OF BASIC LIFE SUPPORT
4. Giving mouth- to-mouth breaths
 The nostrils of the victim are pinched closed to assist with an airtight
seal
 The provider puts his mouth completely over the patient’s mouth
 If victim is not breathing or only gasping, GIVE 2 RESCUE BREATHS &
Observe for visible chest rise
 If victim is not breathing or only gasping, GIVE 2 RESCUE BREATHS &
Observe for visible chest rise

17. STEPS OF BASIC LIFE SUPPORT
4. Using bag –mask device
 The provider ensures a tight seal between the mask and the
patient’s face.
 The bag is squeezed with one hand for 1 second, forcing at least
500 mL of air into the patient’s lungs.

18. DEFIBRILLATION
Defibrillation is the
application of
electrical shock to
help restore the
heart’s regular
rhythm

19. Shockable (VT)
 Monomorphic VT
– Broad complex rythm
– Rapif rate
– Constant QRS morphology
 Polymorphic VT
– Torsade de pointes

20. VENTRICULAR TACHYCARDIA
Fast heart rhythm which does not allow the
heart to fill properly and cardiac output is
compromised and reduced

21. Shockable (VF)
 Uncoordinated electrical
activity
 Coarse/fine
 Exclude artefact
– Movement
– Electrical interference
 Bizarre irregular
waveform
 No recognisable QRS
complexes
 Random frequency and
amplitude

22. Non-shockable (Asystole)
 Absent ventricular (QRS) activity
 Atrial activity (P waves) may persist
 Rarely a straight line trace
 Adrenaline 1 mg IV then every 3-5 min

23. Non-shockable (Pulseless Electrical Activity)
 Clinical features of cardiac arrest
 ECG normally associated with an output
 Adrenaline 1 mg IV then every 3-5 min

24. Non-shockable (Pulseless Electrical Activity)
 Clinical features of cardiac arrest
 ECG normally associated with an output
 Adrenaline 1 mg IV then every 3-5 min

27. Placement of Defibrillator's Paddles
There are two accepted positions to optimize current
delivery to the heart:
(1) Anteroapical – Sternal paddle is placed to the right of
the sternum just below the clavicle on mid-clavicular line,
and the Apex paddle is centred lateral to the normal cardiac
apex in the mid-axillary line on 4th to 5th intercostal space
(2)Anteroposterior – the anterior pad/paddle is placed over
the praecordium or apex, and the posterior pad/paddle is
placed on the back in the left or right infrascapular region.

28. Mid

29. Amount of Jule
 Adult – 120-J , 120J ,120J ,200J,200J
 Paediatric- 2-4J /kg of BW

30. Be ready with a defibrillator
Assess shock-able rhythm
Remove metallic items from patient's body
Maintain PAAS(P-power cord, A-attach
defibrillator lead, A-analyze shock, S-shock)
Apply jelly properly
Apply 25lb pressure on paddle for fixation
Be clear before shock(I clear, you clear , all
clear)
DO’S & DON’TS
DO'S

31. DON'T s
 Do not -
Defibrillate on ECG lead
Defibrillate on hairy or wet chest
Defibrillate over a pacemaker generator
box(permanent pace maker)
Defibrillate until temporary pacemaker is turned off
Have any direct or indirect contact with the patient
Have the patient in contact with the metal fixtures
Use loose or extension cord
Charge or discharge paddles in the air
Pass charged paddles to another members of the
staff
Discharge over medication patch
Touch beds

34. Drug interventions

37. Common complications due to CPR
Complications are
rib fracture,
sternal fractures,
bleeding in the anterior mediastinum,
heart contusion,
hemopericardium
upper airway Complications,
damage to the abdominal viscera - lacerations of the liver and spleen,
fat emboli,
pulmonary complications - pneumothorax, hemothorax, lung contusions.

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Thank You