CARDIAC ARREST & CARDIOPULMONARY RESUSCITATION (CPR)

OBJECTIVES

* Describe Cardiac Arrest

* Enumerate the criteria  for not starting CPR and when to STOP CPR.

PSYCHOMOTOR

* Demonstrate  how to provide  Cardiopulmonary Resuscitation to an adult, child and infant who have cardiac arrest .

CARDIAC ARREST

   > Is the condition in which circulation ceases and vital organs are deprived of oxygen.

*** Approximately  50% of deaths from cardiovascular  disease occur as SUDDEN CARDIAC ARREST.

*** Sudden Cardiac Arrest is the most common mode of death in patients with coronary artery disease.

*** Almost 80% of out-of-hospital  cardiac arrests occur at home and are witnessed by a family member..

*** Only 4-6% of sudden cardiac arrest victims survive because majority of those witnessing the arrest do not know how to perform CPR.

CARDIOPULMONARY RESUSCITATION (CPR)

   > This is  a combination of chest compression and rescue breathing. 

      This must be combined  for effective resuscitation  of the victim of cardiac arrest.

CRITERIA FOR NOT STARTING CPR

** All patients in cardiac arrest  receive resuscitation unless:

         -- the patient has a valid Do Not Attempt Resuscitation

         -- the patient has a sign of irreversible death: 

             *** Rigor Mortis, Decapitation or Dependent Lividity

WHEN TO S.T.O.P. CPR?

1. SPONTANEOUS signs of circulation are restored.

2. TURNED over to medical  services or properly  trained and authorized personnel.

3. OPERATOR is already exhausted and cannot continue CPR.

4. PHYSICIAN assumes responsibility (declares death, take over, etc.).

TABLE OF COMPARISON ON CPR FOR ADULT , CHILD & INFANT

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CPR SEQUENCE

STEP 1:

  Survey the scene.

  "The scene is safe!"

  "I found one victim lying on the ground."

    presumed unconscious

  "Give way! 2x

  "I am ___________, a trained first aider. Can I help?"

           --(Granted)--     

STEP 2:

  Check the consciousness.

  "Hey, Hey, Are you ok? 2x"

          --(Unresponsive)--

STEP 3:

  Activate Medical Assistance or Transfer Facility.

  (Get AED if available)

  "Call for medical assistance or transfer facilities  and Report back to me

    while I'm helping  the patient."

STEP 4:

  Check the signs of life by palpating the carotid pulse and the rise and fall of the    patient's chest not more than ten seconds.

  Counting: "1, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010"

          --(NO PULSE, NO BREATHING)--

  Note:

    ** For Adult: initial 2 ventilation (Rescue Breaths) eliminated except in cases of drowning or other Respiratory Emergencies.    

    ** For Child and Infant: Retain 2 initial rescue breaths with the exception of a witnessed            sudden collapse in which case you would skip the 2 initial rescue breaths.

STEP 5:

  Start CPR - if patient has No Pulse and Not Breathing

  "Give 5 cycles of 30 compression and 2 ventilation for 2 minutes."

  Counting: 1*2*3*4*5*6*7*8*9*10*11*12*13*14*15*16*17*18*19*20

      1*2*3*4*5*6*7*8*9 and 1 ... Breath... Breath (1 Cycle)

STEP 6: 

  RE-CHECK FOR CIRCULATION after 2 minutes of RB/CPR

  Counting: "1, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010"

          --(HAS PULSE, HAS BREATHING)--

STEP 7:

  If patient has REVIVED, PLACE IN RECOVERY POSITION and give needed care.

  Note: 

    ** If at any time an obvious sign of life is found, stop RB/CPR place in recovery position            and monitor breathing.

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HANDS ONLY CPR

(COMPRESSION ONLY CPR)

*** If a person is unwilling or unable to perform mouth-to-mouth ventilation for an adult  victim, chest compression only CPR should be provided rather than no attempt at CPR being made. 

*** If a bystander is not trained in CPR, the bystander should provide Hands-only (Compression-only) CPR for the adult victim who suddenly collapses, with an emphasis to "push hard and fast" on the center of the chest, or follow the directions of the EMS dispatcher. The rescuers should continue  Hands-Only CPR until an AED is available and ready for use or an EMS provider or other responder takes over care of the victim.

*** For witness sudden collapse of any person , steps of opening the airway is eliminated.

STEPS: 

1. Check for consciousness

2. Call local emergency number and get AED

3. Quickly look normal breathing

4. If no breathing give continuous chest compression

5. Push hard and fast

AED

A-AUTOMATED

E-EXTERNAL

D-DEFIBRILLATORS

SOURCE: PHILIPPINE RED CROSS Davao del Norte Chapter