Cardiac Arrest
Cardiac Arrest
Cardiac Arrest
CARDIAC ARREST
DR. ABU TAREK IQBAL
MBBS, D-CARD, MD (MEDICINE), MD (CARDIOLOGY)
ASSISTANT PROFESSOR & CONSULTANT CARDIOLOGIST
NATIONAL HEART FOUNDATION HOSPITAL & RESEARCH
INSTITUTE
Cardiac arrest is characterized by abrupt Loss of consciousness caused by lack of adequate
cerebral blood flow as a result of failure of cardiac pump function.
A victim of cardiac arrest is unresponsive, pulse less & apneic
Cardiac arrest is a medical emergency, if not treated immediately, it causes sudden cardiac death.
Mechanism
Ventricular fibrillation
Pulseless ventricular Tachyc ardia
Cardiac Asystole
Pulse less Electrical activity (PEA)
Causes of Cardiac Arrest:
Acute Ml
Anesthesia
Electrocution
Drowning
Drugs:-
Digitalis, Adrenalin, lsoprenaline, Quinidine
Electrolyte lmbalance-Hypokalemia, Hypomagnesemia
Hypothermia
R/ F of Cardiac arrest:
Age - Cardiac Arrest increases age.
Male - men are two to three times more
H/O of CAD
Smoking
High BP
Obesity
DM
Dyslipidemia
Alcohol
Sedentary Life Style
Drug -Cocaine or Amphetamine
Electrolyte Imbalance - K or Mg level
H/O Previous episode of cardiac arrest
Heart Conditions that can lead to cardiac arrest:
CAD
Cardiomyopathy
Valvular heart disease
Congenital heart disease
Electrical problems in the heart
Heart rhythm abnormalities include conditions such as Brugada syndrome & Long Q T-
syndrome.
C/F:
Sudden Collapse
No Pulse
No Breathing
Loss of consciousness
Pupil dilated.
Technique:
CPR technique typically includes external delivery of chest compressions and
ventilations/breaths.
Basic Life Support (BLS):
BLS is the level of medical care which is used for victims until they can be given
full medical care at a hospital.
It can be provided by trained medical personnel & by laypersons who have
received BLS training. BLS is generally used in the pre hospital setting, and can
be provided without medical equipment.
CPR comprises 3-steps, performed in order:
A. Airway
B. Breathing
C. compressions
Positioning for CPR:
Patient supine on a relativity hard surface, which allows effective compression of
the sternum.
The person giving compression should be positioned high enough above the
patient, so that he or she can use bodyweight to adequately compressed the chest.
Chest compression:
Pericardial thump-sharp blow with a closed fist on the patients sternum
Give 30 chest compressions
Air Way:
Perform the head tilt chin Lift maneuver to open the airway
Ventilation:
If the patient is not breathing, 2 ventilations are given via the providers mouth
After 30 chest compression, give 2 breaths (30:2 cycle of CPR)
Give each breath for approximate I second with enough force to make the patient's chest rise
After giving the 2 breaths, resume the CPR cycle
Indication
• Ventricular fibrillation.
• Pulseless ventricular tachycardia.
Cardioversion
Delivery of energy synchronized to the large R wave or QRS Complex.
It uses energy less than that used for defibrillation.
Avoids delivering shock during repolarization period (T wave on ECG)
Indication
Atrial fibrillation
Reentry SVT
Atrial flutter
Monomorphic VT
Polymorphic VT
Wide complex tachycardia of uncertain type.
Difference between cardioversion & Defibrillation
Cardioversion Defibrillation