CPR

What signs entail cardiac arrest?

unresponsive, no normal breathing, and no pulse

Cardiac catheterization suite or lab

Where post cardiac arrest care occurs (and/or ICU). A group of procedure rooms in a hospital or clinic where heart and the blood vessels around the heart and in the lungs. Procedure involves insertion of a catheter through an artery or vein into the heart to study the heart and its surrounding structures and function.

Links in the Chain of Survival for an adult that had a cardiac arrest out of the hospital

1. Immediate recognition of cardiac arrest and activation of the emergency response system 2. Early CPR with an emphasis on chest compressions 3. Rapid defibrillation with an AED 4. Effective advanced life support (including rapid stabilization and transport to post-cardiac arrest care) 5. Multidisciplinary post-cardiac arrest care

Pediatric Chain of Survival

1. Prevention of arrest 2. Early high quality bystander CPR 3. Rapid activation of the emergency response system 4. Effective advanced life support (including rapid stabilization and transport to post cardiac arrest care) 5. Integrated post cardiac arrest care.

% of out of hospital cardiac arrests?

70%

Links in the Chain of Survival for an adult that had a cardiac arrest in the hospital

1. Surveillance, prevention and treatment of prearrest conditions 2. Immediate recognition of cardiac arrest and activation of the emergency response system 3. Early CPR with an emphasis on chest compressions. 4. Rapid defibrillation 5. Multidisciplinary post-cardiac arrest care

% of surviving pts with nontraumatic cardiac arrest who are treated by emergency medical services

10%

30:2 CPR

A lifeguard who rescues a drowning young child or an adult in cardiac arrest will provide both chest compressions and breaths, using a ratio of 30 compressions to 2 breaths.

Hands-only CPR

A single rescuer with little training and limited equipment who witnesses a cardiac arrest in a middle aged man might provide only chest compressions until help arrives.

Age definitions

Adult: adolescents (after the onset of puberty) and older Child: 1 year to puberty Infant: Less than 1 year old (excluding newly born infants in the delivery room)

Advanced life support (the 4th link in OHCA)

Bridges the transition from BLS to more advanced care. Can occur in any setting (both out of hospital and in hospital). Effective ALS teams may provide the pt with additional care if needed, such as... -12 lead electrocardiogram or advanced cardiac monitoring -Electrical therapy interventions (eg cardioversion) -Obtaining vascular access -Giving appropriate drugs -Placing an advanced airway

CPR consists of 3 main components:

CAB chest compressions, airway, breathing

Signs of puberty

Chest or underarm hair in males Breast development in females

Chest compression depth precautions

Compression depth greater than 2.4 in (6 cm) in adults may cause injuries. Optimum to target compression depth from 2 to 2.4 in (5 to 6 cm).

OHCA

Out-of-hospital cardiac arrest. Most happen unexpectedly and result from underlying cardiac problems. Successful outcome depends on early bystander CPR and rapid defibrillation in the first few minutes after the arrest. Lay rescuers are expected to recognize the victim's distress, call for help, start CPR, and initiate public-access defibrillation until EMS arrives. EMS then take over resuscitation efforts.

ECC

Emergency cardiovascular care

Teamwork

Emergency responders who are called to a scene to care for a cardiac arrest victim will perform multirescuer coordinated CPR: one rescuer performs chest compressions, a second rescuer gives breaths with a bag mask device, and a third rescuer uses the defibrillator. With a team approach, several lifesaving actions are performed at the same time.

IHCA

In-hospital cardiac arrest Usually happens as a result of serious respiratory or circulatory conditions that get worse.

Heart attack definition

Occurs when blood flow to part of the heart muscle is blocked. Occurs when a clot forms in a blood vessel carrying oxygenated blood to the heart muscle. If the blocked vessel is not reopened quickly, the muscle normally nourished by that vessel begins to die. Often a "clot" problem. Signs of a heart attack may appear immediately or last weeks or longer, and may include: severe discomfort in the chest or other areas of the upper body, shortness of breath, cold sweats, nausea/vomiting. Typically, during a heart attack, the heart continues to pump blood. The longer the person with a heart attack goes without tx, the greater the possible damage to the heart muscle. Occasionally, the damaged heart muscle triggers an abnormal rhythm that can lead to sudden cardiac arrest. Women heart attack symptoms include: pain in the jaw, arms, back or neck, light-headedness, nausea/vomiting.

Sudden cardiac arrest definition

Occurs when the heart develops an abnormal rhythm and can't pump blood. Often a "rhythm" problem Within seconds, the person becomes unresponsive and is not breathing or is only gasping. Death occurs within minutes if the victim does not receive immediate lifesaving treatment.

What is PPE?

Personal protective equipment. Equipment worn to help protect the rescuer from health or safety risks. Vary based on situations and protocols. Can include a combo: Medical gloves Eye protection Full body coverage High visibility clothing Safety footwear Safety helmets

Key differences between IHCA and OHCA Chains of Survival

Pg 6-7 Elements: -Initial support -Resuscitation teams -Available resources -Resuscitation constraints (Both settings may be affected by factors such as crowd control, family presence, space constraints, resources, training, transportation, and device failures.) -Level of complexity (both are complex)

High quality CPR

Start chest compressions within 10 seconds of recognition of cardiac arrest. Push hard, push fast. Compress at a rate of 100 to 120/min with a depth of At least 2 in (5 cm) in adults At least 1/3 the depth of chest, about 2 in for children At least 1/3 the depth of chest, about 1 1/2 in for infants Allow complete chest recoil after each compression. Minimize interruptions in compressions (less than 10 sec). Give effective breaths that make chest rise. Avoid excessive ventilation.

Where do most of out of hospital cardiac arrests occur?

at home

AED

automated external defibrillator It is a lightweight, portable device that can identify lethal heart rhythms and deliver a shock to terminate the abnormal rhythm and allow the heart's normal rhythm to resume.

BLS

basic life support

CPR

cardiopulmonary resuscitation

Components of CPR include....

chest compressions and breaths

What is the most common cause of cardiac arrest in children?

often secondary to respiratory failure and shock

What is the leading cause of death in the US?

sudden cardiac arrest