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Tongwen Sun Emergency Department, The First Teaching Hospitalof Zhengzhou University

Cardiopulmonary resuscitation (CPR) involves three phases: basic life support, advanced life support, and prolonged life support. Basic life support establishes an open airway, rescue breathing if not breathing, and chest compressions if no pulse. Advanced life support includes defibrillation, drug administration like epinephrine, and ventilation. Prolonged life support focuses on cerebral and renal protection and ICU care. Successful CPR relies on identifying cardiac arrest victims quickly and starting basic life support, then administering advanced cardiac life support.

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55 views

Tongwen Sun Emergency Department, The First Teaching Hospitalof Zhengzhou University

Cardiopulmonary resuscitation (CPR) involves three phases: basic life support, advanced life support, and prolonged life support. Basic life support establishes an open airway, rescue breathing if not breathing, and chest compressions if no pulse. Advanced life support includes defibrillation, drug administration like epinephrine, and ventilation. Prolonged life support focuses on cerebral and renal protection and ICU care. Successful CPR relies on identifying cardiac arrest victims quickly and starting basic life support, then administering advanced cardiac life support.

Uploaded by

api-19916399
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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CARDIOPULM

ONARY
CEREBRAL
RESUSCITATI
ON Tongwen Sun
Emergency Department,
The First Teaching Hospitalof Zhengzhou

University
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Heart － Engine of Life

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[Definition]
• cardiac arrest is unexpected
cessation of cardiac mechanical
activity, confirmed by the absence
of a detectable pulse, and apnea
or gasping respiration.

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[Cause]
• Cardiac Causes

• Coronary Artery Disease


• Arrhythmias
• Acute heart failure

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• cardiac arrest include VT
and VF , bradycardia or
ventricular standstill,
pulseless electrical
activity(PEA)

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• Noncardiac Causes

• Pulmonary Disease
• Acute poisoning
• Stroke

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[Recognition of
cardiac arrest]
• Loss of consciousness;
• Cessation of breathing;
• Death-like appearance, pallor, cyanosis;
• Pulselessness of large arteries;
• Absent heart sounds.
• Dilated pupils.

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[treatment]
• Chain of survival
The chain of survival is a
series of actions that, when
performed in sequence, will
give a person having a heart
attack the greatest chance of
survival.
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Chain of survival
 Early Access
 Early CPR
 Early defibrillation
 Early advanced life support

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Early Access
• When an emergency situation
is recognized, the first link in
the chain of survival is early
access.
• This means activating the
emergency medical services
system (EMSS) by calling 120.

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Early CPR

• The earlier you give CPR to a person in


cardiopulmonary arrest, the greater
the chance of a successful
resuscitation.

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Early defibrillation
• Early defibrillation is the most
important factor influencing survival.
• In some areas of the country, simple,
computerized defibrillators, known as
automated external defibrillators
• (AED), may be available for use by
the lay public or first person on the
scene.
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AED

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Early advanced life
support
• This involves administering
medications, using special
breathing devices, and
providing additional
defibrillation shocks if needed.

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CPCR consists of
three phases:
• Basic life support(BLS)
• Advanced life support(ALS)
• Prolonged life support(PLS)

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BLS
• 1.A irway

a. Open the airway.


b. Establish breathlessness
(look, listen and feel).

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Check to see if the person is breathing normally by opening the
airway. Tilt the victim’s head back by lifting the chin gently with
one hand, while pushing down on the forehead with the other
hand.

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Look, listen, and feel for rising of the
chest, sounds of normal breathing, or
air movement on your cheek..
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BLS
2.Breathing
a. Start mouth-to
mouth rescue
breathing
(chin lift, head tilt,
nasal occlusion).

b. Remove any
foreign body
airway obstruction.

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If the victim is not breathing, place your mouth
around the victim’s mouth, pinch the victim’s nose
shut, and give 2 slow breaths. Make sure that the
chest rises with each breath. 26
BLS

• 3.C irculation

a.Establish presence or absence of

pulse.

b.Begin chest compression ( if pulse


absent).

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chest compression 28
 Place the heel of one
hand on the center of the
chest

 Place the heel of your


other hand on top of the
first hand.

 Press down on the chest


with enough force to move
the breastbone down about
2 inches.

 Compress the chest at a


rate of about 100 times per
minute. 29
ALS
• Early defibrillation
• Administration of drugs
• Ventilation (oxygenation)
• Circulator support

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Defibrillation
• One paddle should
be placed to the
right of the upper
half of the sternum,
below the clavicle;
the other is placed
to the left of the
cardiac apex, below
the left nipple.

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Defibrillation
• Defibrillation attempts should
begin with 200 J and a quick look
at the ECG. If VT or VF continues,
300 J is applied immediately. If
these attempts are unsuccessful,
360 J is applied.
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Ventilation
(oxygenation)
• Endotracheal intubation remains
the definitive means of airway
control during resuscitation and
should be performed as soon as
possible in all patients for whom
CPR is indicated.
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Administration of
drugs

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Drugs--Epinephrine
• (1) peripheral α -receptor stimulation,
resulting in greater perfusion pressure
through heart and brain.
• (2) β-receptor effect on the coronary
arteries and brain vessels, resulting in
increased blood flow to both of these
organs.
• (3) help convert fine VT into coarse VF,
which is more susceptible to termination
by electrical countershock.
47
Drugs--Epinephrine
• Dose: l mg/70 kg body weight as
an IV bolus and repeated every 3
to 5 minutes.
• lf administered intratracheally,
the dose of epinephrine should be
at least doubled and diluted in
l0mL of normaal sodium.
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Drugs--Lidocaine
• In persistent or refractory VF,
lidocaine is the first choice.

• The recommended dose of lidocaine


is l .0 to l .5 mg/kg by IV push, which
could be repeated once in 3 to 5
minutes to a total of 3 mg/kg.

• An additional countershock should


be administered between these
doses.
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Drugs--Atropine
• Atropine is a parasympatholytic drug
that accelerates atrioventricular
conduction and the atrial pacemakes.

• It is indicated for symptomatic


bradycardia with evidence of poor
perfusion or hypotension.
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Drugs--Atropine

• Dose: 1 mg IV push if absolute


(<60 beats/min) or relative
bradycardia. Repeat every 3-5
min up to a total of 0.04 mg/kg.

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PLS
• Cerebral resuscitation
• Treatment of shock or
hypotension
• Prevention of renal failure
• Prevention of infection

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Cerebral resuscitation
• Maintenance of an adequate systemic
blood pressure and oxygenation.

• The effective physical treatment is


mild cerebral hypothermia(34℃)

• Drugs: calcium channel blocker,


corticosteroids , etc. 53
Summary
• Cardiopulmonary resuscitation is
the true life or death emergency.
• Successful resuscitation depends
on rapidly identifying the cardiac
arrest victim and promptly
instituting basic life support .
• Once basic life support has been
established, advanced cardiac life
support is begun.
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• CPCR consists of 3 phases
and 9 steps:

• 1. Basic Life Support, BLS


A—Airway
B—Breathing
C—Circulation

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• 2. Advanced Life Support,
ALS
D—Drugs
E—ECG
F—Fibrillation Treatment

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• 3. Prolonged Life Support,
PLS
• C:Cerebral resuscitation
• R:Prevention of renal failure
• I: ICU

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