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Cardiopulmonary Resuscitation
Dr Hajijafari
anesthesiologist
KUMS
Introduction to CPR
BLS
ACLS
Time is Critical!
• > 300,000 people experience sudden
cardiac death in prehospital settings each
year.
• If resuscitation begins within a few
minutes, many of these individuals have a
chance for survival.
Time is Critical!
To begin resuscitation within a few minutes:
• Diagnosis
• EMS immediately activated
• CPR started immediately
• Defibrillation within minutes
What is the function of the
circulatory system?
The Circulatory System
• Delivers O2 and nutrients
• Removes CO2 and wastes
Time is Critical!
• Brain damage begins
in 4–6 min
• Brain damage
irreversible in 8–10
min
Circulation must be
restored within 4– 6
minutes.
CPR
• Combines external chest compressions
with artificial ventilation:
– Provides 30% (or less) of normal circulation
– Only effective for short period of time
Causes of Cardiac Arrest
Causes of Cardiac Arrest
•
•
•
•
•
•
Heart disease
Respiratory arrest
Medical emergencies
Drowning and suffocation
Congenital heart defects
Trauma
The cause of
cardiac arrest is
important
BUT
do not delay CPR to
obtain history
ABC
change to
CAB
CPR – 1 Rescuer
• Assess
responsiveness
• Summon EMS
• Position the
patient
CPR – 1 Rescuer
• Check for a pulse
(≤ 10 seconds)
CPR – 1 Rescuer
• If there is no
pulse, find your
landmarks, lower
half of the
sternum, between
the nipples
CPR – 1 Rescuer
• Begin chest
compressions
CPR – 1 Rescuer
• Perform 30 chest
compressions
• Push hard
• Push fast
• Allow the chest to
recoil after each
compression
CPR – 1 Rescuer
• Administer two
ventilations then
return to
compressions
CPR – 1 Rescuer
• Check for a pulse
(≤ 10 seconds)
• Normal pulse
• Open the airway
• If there is no
breathing, give
two breaths, each
lasting 1 second
CPR – 2 Rescuer
1
2
3
4
CPR - Children
• Use heel of one
hand
• Keep airway open
with other hand
• 30 compressions:2
ventilations if alone
(2 rescuers use
15:2)
CPR - Infant
• ABC
• 30 compressions:2
ventilations if alone
• 15 compressions: 2
ventilations with 2
rescuers
Sequence of Survival
Chain of Survival for Adult
Sequence of Survival
Also known as Chain of Survival
• Recognition and Early
Access
• Early CPR
• Defibrillation
• Early Advanced Care
Recognition and Early Access
• Depends on public
education
• EMS must be
immediately
notified
• 9-1-1 dispatchers
can provide CPR
instructions
Early CPR
• Must begin within
4-6 minutes of
collapse
• Public training is
necessary
• Rescuers have a
critical role
Defibrillation
•Ventricular fibrillation
a common cause of
arrest
•Can only correct with
defibrillation
Copyright © 2004 Elsevier (USA). All Rights Reserved
Ventricular Fibrillation
• The most common cause of sudden
cardiac death
– disorganized heart activity
– Heart muscle cannot pump blood
Ventricular Fibrillation
• Requires immediate defibrillation
• CPR lengthens window of survival
Early Advanced Care
• Medication
• Advanced airway
management
• Post-resuscitation
care
AED
AEDs
• Safe, accurate &
lightweight
• Easy to operate
AED
• AEDs in public
places
• Training the public
in CPR/AED
AED
Universal Steps
Power
↓
Patient
↓
Analyze
↓
Shock
Power
• Turn the power
on
Patient
• Apply pads to
patient
Analyze
• Stay clear while
patient’s heart
rhythm analyzed
Clear
Shock
• Defibrillate
Patient
• Standard is set of 1
shock
• Immediately restart
CPR for 2 minutes
then check pulse
Summary of BLS
• Continual beating, or contracting, of the
heart is necessary to keep blood
circulating throughout the body.
• Brain damage begins in 4 to 6 minutes of
cardiac arrest.
• There are many causes of sudden cardiac
death, but the most common is ventricular
fibrillation.
• ACLS
•
•
•
•
IV Access
Airway management
Medication and defibrilation
Post CPR
ADULT CARDIAC ARREST
ALGORITHM
MANAGEMENT OF SYMPTOMATIC
BRADYCARDIA & TACHYCARDIA
BRADYARRHYTHMIA
TACHYARRHYTHMIA
CARDIOVERSION
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