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Cardiopulmonary Resuscitation

Cardiopulmonary resuscitation (CPR) involves chest compressions and ventilation to maintain some circulatory flow and oxygenation during cardiac arrest. It is indicated for sudden unconsciousness with no pulse due to arrhythmias like ventricular fibrillation, ventricular tachycardia, asystole, or pulseless electrical activity. Early initiation of CPR within 4-6 minutes is vital to prevent irreversible brain damage. The order of resuscitation is now chest compressions, airway, breathing. Chest compressions should be at least 5cm deep at a rate of 100/min, with a 30:2 compression to ventilation ratio without advanced airways or continuous compressions with ventil

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131 views14 pages

Cardiopulmonary Resuscitation

Cardiopulmonary resuscitation (CPR) involves chest compressions and ventilation to maintain some circulatory flow and oxygenation during cardiac arrest. It is indicated for sudden unconsciousness with no pulse due to arrhythmias like ventricular fibrillation, ventricular tachycardia, asystole, or pulseless electrical activity. Early initiation of CPR within 4-6 minutes is vital to prevent irreversible brain damage. The order of resuscitation is now chest compressions, airway, breathing. Chest compressions should be at least 5cm deep at a rate of 100/min, with a 30:2 compression to ventilation ratio without advanced airways or continuous compressions with ventil

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cainzkeinz
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Cardiopulmonary

Resuscitation
Introduction
• Emergency procedure performed in the event of cardiac arrest.
• CPR involves providing chest compressions and ventilation to ensure
some circulatory flow and oxygenation is maintained.
• Another important aspect of resuscitation is cardiac defibrillation
where indicated.
• The rhythms that are associated with cardiac arrest are VF, VT,
asystole and PEA.
• Early initiation of CPR is vital as even a delay of 4-6 min leads to
irreversible brain damage and death.
Chain of Survival
Indications for CPR

Sudden Absence of
unconscious and spontaneous Ventricular
has no palpable circulation due to Fibrilation
pulse. arrhythmias.

Pulseless
Ventricular Pulseless Electrical
Asystole
Tachycardia Activity (PEA)
(Pulseless VT)
Contraindications for CPR

Futile or not
DNAR the best of the
patient.
CPR

Chest Airway Breathing


compressions management support

*The order of resuscitation has been change from A-B-C to C-A-B for adults, children and infants (excluding the newly born)
Chest Compression

• Place one hand on the middle of the patient’s


sternum
• Compress chest to a depth of at least 5cm
• In patients without and advanced airway,
ensure a compression-to-ventilation ratio of
30:2.
• In patients with an advanced airway, chest
compressions can be continuous at a rate of
100/min. Ventilation can then be provided at
one breath every 6-8s/min.
Airway

• Clear airway of any secretions or


foreign bodies under direct vision.
• Use ‘head tilt-chin lift’ manoeuvre to
open airway if no trauma is
suspected. Where trauma is
suspected, use ‘jaw thrust’.
• Use oropharyngeal airway to ensure
airway patency
Ventilation

• Two ventilations by mouth to mouth.


One can also use a pocket mask if
available.
• Ventilations can also be achieved with
a bag-valve mask (BVM), ideally by
two people.
• Avoid exesscive ventilation
Defribilator/Monitor

Do not interrupt chest compression while self-


applying the defribilation pads

Position of the pad is anterotypical, usually one


pad below the right clavicle and the other one
over cardiac apex
International
Advanced Life
Support
Algorithm
Shockable Rythm (VF/Pulseless VT)

After attaching the pads analyse rythm If the rythm VT/VF restart chest
compression while charging defribilator

Once the defribilator is charged clear everyone  pause chest compression


deliver shock (200 J for first shock & 150-360 J for subsequent shock

Recommence chest compression after delivering the shock for 2 minutes

After 2 min check the rythm again if VT/VF repeat the step with adrenaline 1 mg
after the second shock and 300mg amniodarone after the third shock

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