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Introduction - CPR Perspective

The document provides an overview of cardiopulmonary resuscitation (CPR) including the objectives of CPR training, the differences between basic life support (BLS) and advanced cardiac life support (ACLS), key elements of the CPR process like the primary and secondary surveys, common cardiac rhythms seen in cardiac arrest, drugs used to treat cardiac arrest, and the importance of the "chain of survival" through early recognition, early CPR, rapid defibrillation, and effective advanced life support.

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Imtiaz Ahmad
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26 views

Introduction - CPR Perspective

The document provides an overview of cardiopulmonary resuscitation (CPR) including the objectives of CPR training, the differences between basic life support (BLS) and advanced cardiac life support (ACLS), key elements of the CPR process like the primary and secondary surveys, common cardiac rhythms seen in cardiac arrest, drugs used to treat cardiac arrest, and the importance of the "chain of survival" through early recognition, early CPR, rapid defibrillation, and effective advanced life support.

Uploaded by

Imtiaz Ahmad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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CPR perspective

Cardiac arrest
Sudden and complete
loss of cardiac output
 Due to
 VF/VT
 NON VF/VT asystole/PEA
 Return from the loss is possible.
1.Electrical activity
2. Mechanical activity
1. Electrical activity
Mechanical activity
Cardiac arrest

It is a clinical diagnosis
– Unconsciousness

– Pulselessness

– Breathing may take some


time to stop completely
• Agonal breathing
Oxygen content
 Hb. gm/dl x 1.34 ml/gm
 16x1.34 ml
 20 ml./dl x COP
 20x 5000/100
 20x50 ml
 1000 ml
 Metabolic need 250ml
 1000 ml/250 ml/min
 4 min
 Lung
 Expired air oxygen 16-17%
 Tv 500ml
heart
 Muscular bag
 Compressible
 In between two hard objects
 SV= 90 ml
 1/3 rd expressed with adequate compr.
 Brain and heart delays injury.
cpr
 AIM
 GOAL
 BLS buys time
 ALS achieves aim and goal
CPR: INTRODUCTION

1. Objectives:
 Idea of CPR is to familiarize with the modern
methods of life saving procedure in hospital.
 Course will help participant’s to achieve a better
understanding of person in cardiac arrest and to
learn the roles & intervention used by resuscitation
team.
 Resuscitation efforts can restore the stopping heart
to spontaneous activity before the brain has been
permanently injured.
CPR: INTRODUCTION

2. Objectives (cont.):
 On successful completion of CPR training
participants will be able to recognize
 Respiratory arrest or insufficiency
 Obstructed airway
 Cardiac arrest
 Able to perform CPR correctly to prevent needless
death results from
 Failure to recognize the symptoms
 Failure to accept the truth of the symptoms
 Frightening of the family & over crowding around the
patient.
 Incorrect way of resuscitation.
CPR

3. Content of the CPR Module:


A. Introduction - Life support in perspective
B. Video Presentation on BLS
C. Practical Demonstration on BLS
D. Demonstration on 6 Stations-
i. Defibrillation
ii. ECG
iii. Drugs
iv. Intubation
v. O2 Adjunct
vi. I.V Cannulation
E. Lecture on Trauma Resuscitation
F. ACLS Team: Case Scenario
G. Post Resuscitation Management
Lecture on
INTRODUCTION - LIFE SUPPORT IN PERSPECTIVE

4. Background:
 CPR: Broad range of maneuvers and techniques to
restore spontaneous circulation and respiration.
 CPR vs CPCR (Cardiopulmonary cerebral
resuscitation)
 Initially CPR started from OT to resuscitate cardiac
arrest during operation
 Then spread from OT to the rest of the hospital
 Then to the community at large.
5. Background (cont.)
 Over the post 30 years, CPR is widely practiced then

popularized by AHA and others organization


 AHA also develop courses at different levels to teach CPR

 FOR the Medical personal in 1966.


 For, the paramedical personal
 For, then lay people in 1973.
 AHA adapted ACLS course in 1975.
 This course will also be conducted in accordance with the
curriculum of AHA.
6. CPR
 Leading cause of death
Cardiovascular disease, Malignancy, Trauma,
Resp. Disease, Infection,Other systemic disease
 Cause of death from cardiovascular disease
1. Heart Attack
2. Stoke
3. Heart Disease
4. Hypotension
 Cardio Pulmonary arrest: - Sudden loss of Cardiac Function
 Terminal events signifying death.
 No respiration
 No Pulse

 Loss of consciousness
7. CPR include

 BLS or Basic life support


 ABC
 DIFFERENCES BETWEEN BLS/CPR

 ACLS or Advanced CPR


8. BLS- Attempt to restore spontaneous circulation and
respiration by using chest wall compression &
pulmonary ventilation without? addition of equipment.
 It covers recognition of early warming signs of
 Resp Arrest
 Obstructed airway
 Cardiac arrest
 EMS?.
 Tools of BLS
 Sincere desire to save life
 Hands & Mouth of resquer
 Pitfalls of BLS
 Expired air contain 16% O2.
 Adequate Chest compression gives 1/4 to 1/3rd of
normal carotid artery flow.
9. ACLS
 Attempt to restore spontaneous circulation
and respiration by using-
 Basic CPR
 Use of specialized equipment to monitor
 Advanced airway management -ET intubation
 Defibrillation
 I.V medication to stabilize the patient.
 ACLS also refers to the education programe
that provides guidelines for these
techniques.
ACLS

10. Primary Survey:


A. Airway - Open airway
B. Breathing - Provide the pressure
ventilation.
C. Circulation - Give chest compression
D. Defibrillation- Shock VF & pulse less VT.

Exception – DABC
CAB
ACLS
11. Secondary Survey:
A. - Airway - Established advanced airway
control. Perform ET intubation.
B. Breathing - Assess adequacy of ventilation via
ET tube - provide +ve pressure venti.
C. Circulation - Obtain IV access
- Continue CPR
- Provide rhythm appropriate drugs.
D. D/D - Identify possible reason of arrest
- Identify reversible cause that have
specific therapy.
12. Time is Critical

 There is enough O2 in the lungs and


blood stream to sustain life up to 6
minutes.
 The first 4 to 6 minutes hold the key to
another chance for life.
13. Time is Critical

Time to BLS Time to ACLS

CPR (min) <8 min 8-16 min >16 min

0-4 43% 19% 10%

4-8 26% 19% 5%

8-14 - 6% 0%
14. LIKELIHOOD OF RECOVERY WITHOUT
BRAIN DAMAGE
15. Cardiac rhythm in Cardiac Arrest : ECG

1. VF Need defibrillation
2. VT (Pulse less)

3. Asystole Treat the reversible causes

4. PEA
17. Drugs used in cardiac arrest
1. Epinephrine - Universally used
2. Lidocaine
3. Atropine
4. Sodium bicarbonate
5. Bretyllium : Not available in Bangladesh
6. O2
7. Steroid - still abused in Bangladesh
18. I/V bolus epinephrine

 In VF & Pulse less VT - When DC shock fails.


 In Asystole & PEA - Treat the reversible cause.
19. ET tube as a route of drug administration

 Epinephrine
 Atropin
 Lidocaine
 Naloxone
 Sodi-bi-carb
* Dose of drug through ET tube: 2 -3 times of I.V
dose
22. Chain of Survival : Successful

Survival depends on a series of critical


intervention:
 Early access - calling EMS support.
 Early basic CPR
 Early defibrillation
 Early ACLS
• Immediate recognition of cardiac arrest and activation of the emergency
response system

• Early compressions

• Rapid defibrillation

• Effective advanced life support

• Integrated post-cardiac arrest care


C ard iop u lm on ary A rrest

In C om m u n ity Typ e n am e h ere In H osp ital


Typ e title h ere

B ystan d er C P R / B asic
A m b u lan ce C P R

E m erg en cy D ep t In H osp ital


A d van ced C P R A d van ced C P R

S u rvival

IC U / C C U
24. CPR
25. Heart, Lung, Airway
26. Airway
27. Assessing unresponsiveness
28. Position the victim as a unit
29. Head tilt & chin lift
30. Assessment of breathing
31. Mouth to mouth breathing
32. Head tilt & carotid pulse
33. Correct location & cardiac compression
34. Mouth to Mouth & Chest Compression
35. Airway Obstruction
36. Airway obstruction
37. Suspected neck injury - jaw thrust
38. Infant - Head tilt & palpation of brachial A
39. Infant mouth to mouth & Chest compression
40. Back blows
Chest thrust
20. Na-bi-carbonate
 Usually used if other measures fail
 Preferably used in metabolic acidosis (not
due to lactic acidosis)
 Still an abused drugs in Bangladesh
 Paradoxical acidosis
16. Causes of Asystole & EMD
PEA
ASYSTOLE
1. Hypovalemia
1. Hypoxia 2. Hypoxia
2. Hyperkalemia 3. Pericardial Tempnode
4. Tension Pneumothorox
3. Hypokalaemia 5. Hypothermia
4. Pre-existing acidosis 6. Massive Pul embolism
5. Drug overdose 7. Drug overdose
8. Hypokealimia
6. Hypothermia 9. Adidosis
10. Massive AMI
 Muscular bag
 In between two hard objects
 Stroke vol
 1/3 SV

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