CARDIAC 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.
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Gamal faheim, MD
Associate professor of cardiovascular medicine
- underpowered, small
- not randomized
- design limitations
Cardio-pulmonary resuscitation (CPR) is a means to provide temporary support to the coronary and cerebral circulation, till normal cardiac output is restored
Basic life support consists of the following sequence of actions:
If he responds:
If he does not respond:
START THE ABCD’s
(Look, Listen &Feel)
Monitor and check
An important advance in providing BLS is the availability of AED, which can be used to deliver defibrillation. improving survival outcomes in cardiac arrest cases.
Head tilt / chin lift
Check breathing and pulse for 10 sec
If no breathing & no pulse or unsure of pulse assume cardiac arrest
Caution of agonal 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.
Practice using these!
If he is breathing normally:
If he is not breathing normally:
• Ask someone to call for an ambulance or, if you are on your own, do this yourself; you may need to leave the victim.
not applied over the victim's ribs. Do not apply any pressure
over the upper abdomen or the bottom end of the bony
your arms straight, press down on the sternum 4 - 5 cm.
without losing contact between your hands and the sternum.
2 compressions a second).
Heel of hand in centre of chest
Keep arms straight
Compress 4-5 cm depth
Rate of 100 min-1
Allow chest to recoil
Combine chest compression with rescue breaths:
Continue resuscitation until:
Adult Basic Life Support
Restore Coronary & Cerebral Blood Flow
Spontaneous conversion to NSR (12-lead ECG)
ECG shows negative effect of delaying chest compressions after shock delivery. (From an AED record).
AED was turned on and attached. The rhythm is labeled “coarse VF.
Post-shock rhythm through the next 21 sec. Asystole is present, and the AED is analyzing the rhythm so no CPR is provided and there is no blood flow.