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ARREST
By
Gamal faheim, MD
Associate professor of cardiovascular
medicine
DEFINITIONS
CARDIAC ARREST: Abrupt
cessation of cardiac pump function
which may be reversible by a rapid
intervention but will lead to death
in its absence.
DEATH: Irreversible cessation of all
biologic functions
MECHANISMS OF CARDIAC
ARREST
50-80%:
20-30%:
VF and PULSLESS VT
Asystole, severe
bradycardia and pulseless
electrical activity
Background
Cardio-pulmonary resuscitation
(CPR) is a means to provide
temporary support to the
coronary and cerebral
circulation, till normal cardiac
output is restored
PERSON
COLLAPSES
Check if he is
unresponsive.
Call Emergency
number.
Get AED (automatic
Electric Defibrillator)
Begin the ABCDs
Make sure the victim, any bystanders, and you are safe.
Check the victim for a response.
Gently shake his shoulders and ask loudly, Are you all right?
If he responds:
Leave him in the position in which you find him provided there is
no further danger.
Try to find out what is wrong with him and get help if needed.
CONFIRM LOSS OF
CONSCIOUSNESS
Shout
Loudly!
Shake Gently!!
Check Breathing
Breathing
Non Breathing
Check Circulation
Circulation:.
Monitor and check
Circulation
the pulse.
Arrest
Breathing:
Keeping the airway open, look, listen, and feel for normal breathing.
Look for chest movement.
Listen at the victim's mouth for breath sounds.
Feel for air on your cheek.
In the first few minutes after cardiac arrest, a victim may be barely
breathing, taking infrequent, noisy, gasps. Do not confuse this with
normal breathing.
Look, listen, and feel for no more than 10 sec to determine if the victim
is breathing normally. If you have any doubt whether breathing is
normal, act as if it is not normal.
Signs of life...
Normal breathing
Coughing
Movement
Palpable pulse
Assess ABCDE
Call expert help
immediately
Place the heel of your other hand on top of the first hand.
Interlock the fingers of your hands and ensure that pressure is
not applied over the victim's ribs. Do not apply any pressure
over the upper abdomen or the bottom end of the bony
sternum (breastbone).
2 compressions a second).
Chest compressions
30 chest compressions
Heel of hand in
centre of chest
Interlock fingers
Keep arms straight
Compress 4-5 cm
depth
Rate of 100 min-1
Allow chest to recoil
After 30 compressions open the airway again using head tilt and chin
lift.
Pinch the soft part of the victims nose closed, using the index finger
and thumb of your hand on his forehead.
Allow his mouth to open, but maintain chin lift.
Take a normal breath and place your lips around his mouth, making
sure that you have a good seal.
Blow steadily into his mouth whilst watching for his chest to rise; take
about one second to make his chest rise as in normal breathing; this is
an effective rescue breath.
Maintaining head tilt and chin lift, take your mouth away from the victim
and watch for his chest to fall as air comes out.
RECOVERY POSITION
MINIMISE INTERRUPTIONS
CHANGE REGULARLY
Restore Coronary & Cerebral Blood Flow
Technique of CPR
Change Regularly
Ventricular Flutter
Spontaneous conversion to NSR (12-lead ECG)
Torsades de Pointes
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