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CARDIAC ARREST AND POST CARDIAC ARREST CARE.pptx
- 1. CARDIAC ARREST AND POST CARDIAC ARREST CARE DR MOHD YOUSUF PHYSICIAN SPECIALIST GOVT GOUSIA HOSPITAL KHANYAR
- 3. No, nonshockable Yes, shockable No normal breathing, pulse felt © 2020 American Heart Association AED arrives. Check rhythm. Shockable rhythm? • Give 1 shock. Resume CPR immediately for 2 minutes until prompted by AED to allow ( rhythm check). • C ontinue until ALS providers take over or victim starts to move. • Provide rescue breathing, 1 breath every 6 seconds or breaths/min. 10 • Check pulse every 2 minutes; if no pulse, start CPR. • I f possible opioid overdose, administer naloxone if available per protocol. • Resume CPR immediately for minutes (until prompted by AED 2 to allow rhythm check). • C ontinue until ALS providers take over or victim starts to move. Start CPR • Perform cycles of 30 compressions and 2 breaths. • Use AED as soon as it is available. Monitor until emergency responders arrive. Verify scene safety. • Check for responsiveness. • Shout for nearby help. • A ctivate emergency response system via mobile device if appropriate ( ). • Get AED and emergency equipment ( ). or send someone to do so Look for no breathing or only gasping and check pulse (simultaneously). Is pulse definitely felt within 10 seconds? Normal breathing, pulse felt No breathing or only gasping, pulse not felt By this time in all scenarios, emergency response system or backup is activated, and AED and emergency equipment are retrieved or someone is retrieving them.
- 10. Effective Team Dynamics 1) Roles during resuscitation attempts • Clear roles and responsibilities • Knowing your limitations • Constructive intervention 2) What to communicate • Knowledge sharing • Summarizing and re-evaluating 3) How to communicate • Closed loop communication • Clear messages • Mutual respect
- 11. IMMEDIATE POST-CARDIAC ARREST CARE
- 16. TOR RULE
- 18. Additional readings • Many alternatives and adjuncts to conventional CPR have been developed. These include mechanical CPR, impedance threshold devices (ITD), active compression-decompression (ACD) CPR, and interposed abdominal compression CPR. Many of these techniques and devices require specialized equipment and training. • Mechanical CPR devices deliver automated chest compressions, thereby eliminating the need for manual chest compressions. There are 2 different types of mechanical CPR devices: a load-distributing compression band that compresses the entire thorax circumferentially and a pneumatic piston device that compresses the chest in an anteroposterior direction. • ACD-CPR is performed by using a handheld device with a suction cup applied to the midsternum, actively lifting up the chest during decompressions, thereby enhancing the negative intrathoracic pressure generated by chest recoil and increasing venous return and cardiac output during the next chest compression. The ITD is a pressure-sensitive valve attached to an advanced airway or face mask that limits air entry into the lungs during the decompression phase of CPR, enhancing the negative intrathoracic pressure generated during chest wall recoil and improving venous return and cardiac output during CPR. • Interposed abdominal compression CPR is a 3-rescuer technique that includes conventional chest compressions combined with alternating abdominal compressions. The dedicated rescuer who provides manual abdominal compressions will compress the abdomen midway between the xiphoid and the umbilicus during the relaxation phase of chest compression. One RCT of adult OHCA15 did not show any survival advantage to interposed abdominal compression CPR.