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SAUDI PHARMACISTS ELECTRONIC UNION @SAUDIPEU PH.Muna Alsohemy PH.Muna Alamri Cardiopulmonary arrest: Defenition: is the abrupt cessation of spontaneous and effective ventilation and circulation after a cardiac or respiratory event. Pathophysiology: Cardiopulmonary arrest in adults usually results from arrhythmias. The most common arrhythmias are ventricular fibrillation (VF) and pulseless ventricular tachycardia (PVT), often in patients after myocardial infarction (MI) or pulmonary embolism (PE). In children, cardiopulmonary arrest is often the terminal event of progressive shock or respiratory failure. CLINICAL PRESENTATION: • The onset of cardiopulmonary arrest may be characterized by symptoms: anxiety, mental status changes, or unconsciousness; cold, clammy extremities; dyspnea, shortness of breath, or no respiration; chest pain; diaphoresis, and nausea or vomiting. • Physical signs: Hypotension; tachycardia, bradycardia, irregular or no pulse; cyanosis; hypothermia; and distant or absent heart and lung sounds. DESIRED OUTCOME: • The goal of CPR : - is the return of spontaneous circulation (ROSC) with effective ventilation and perfusion as quickly as possible to minimize hypoxic damage to vital organs. • After successful resuscitation, the primary goals include : 1-optimizing tissue oxygenation, 2-identifying precipitating cause(s) of arrest, 3- preventing subsequent episodes. • The successful resuscitation outcome is enhanced if each of four critical elements in the “chain of survival” is implemented promptly: (1) early recognition of the emergency and activation of emergency medical services; (2) early bystander basic life support and CPR; (3) early delivery of a shock with a defibrillator; (4) early ACLS followed by resuscitation care delivered by healthcare professionals. Cardiopulmonary resuscitation (CPR) : - provides artificial ventilation and circulation until it is possible to provide advanced cardiac life support (ACLS) and reestablish spontaneous circulation. When do I Perform CPR? CPR stands for Cardiopulmonary Resuscitation, which means Heart and Lung Resuscitation. When an individual’s heart beat and breathing have stopped, it becomes your job to breathe for them and to beat their heart in order to keep them alive. These are the two functions that aren’t working, and these are the two functions you’re going to attempt to replace. Activate 997 first, but if you want to keep this person alive long enough for the fire department and paramedics to arrive, CPR may be the key to their survival. Performing CPR : -The first step in determining if there is a true emergency is to find out if the person really requires help. Approach the victim cautiously and tap them as you ask, “Are you O.K.?”. If the person does not respond, Activate 997 immediately. Call 911 or have a bystander call for you. Make eye contact and shout’ “Call 911 and come back”. It may take several minutes for help to arrive, syou should begin the ABC’s of CPR. Before we go into details with numbers, the ABC’s apply to everyone, whether they’re an adult, child oran infant. Lets’ go over them first. *Airway: Open the airway. Place on hand over the victim’s forehead, and two fingers under the bony part othe chin. Gently tilt the head backward. This will open the airway and lift the tongue off the back of the throat. *Breathing: Lean over the victim’s face and look, listen and feel. Look for the chest to rise. Listen for air movement and feel for air movement. If the victim is not breathing, continue tilting the head back, pinch the nostrils and administer 2 effective rescue breaths. You should blow until the victims chest slowly stops rising. *Circulation: Look, listen and feel for signs of circulation. While attempting to find the victims pulse, look to see if there’s movement, listen for sounds of movements or moaning, and feel for movement and pulse. If the victim has a pulse but is not breathing begin Rescue Breathing for the victim by giving them one breath every 5 seconds. If there’s no pulse present begin CPR. You should wait no more than 10 seconds to find a pulse. If you don’t know or are just unsure begin CPR. *now look at the details of administering CPR. Remember, the initial ABC’s check will be the same for all victims regardless of age. ADULT CPR VEDIO LINK: https://www.youtube.com/watch?v=hdIK-qCKuJ8 IN THE UPOVE LINK , ITS IMPORTANT TO LISTEN AND APPLY WHAT THE AED DEVICE TELLS YOU TO DO. https://www.youtube.com/watch?v=iAVAGIoHT7g CHILD CPR VEDIO LINK: https://www.youtube.com/watch?v=_Qo_Pnr-L-g WHATS DIFFERENT HERE IS USING ONE HAND FOR COMPRESSION. https://www.youtube.com/watch?v=No6RuO3kvjg INFANT CPR VEDIO LINK: https://www.youtube.com/watch?v=ZjnkJf07vCw Reference: - Pharmacotherapy Handbook Seventh Edition - http://www.dshs.wa.gov/pdf/ca/CPR.pdf