Chapter 3- cardiac emergencies (Part 2 -

CPR

CPR, or cardiopulmonary resuscitation, is a skill that is used when a person is in cardiac arrest to keep oxygenated blood moving to the brain and other vital organs until advanced medical help arrives (Figure 3-5). CPR involves giving sets of 30 chest compressions followed by sets of 2 rescue breaths.

cardiac arrest

Cardiac arrest is not the same as a heart attack. Cardiac arrest, on the other hand, occurs when the heart stops beating or beats too ineffectively to circulate blood to the brain and other vital organs. A network of special cells in the heart muscle conducts electrical impulses that coordinate contraction, causing the heart to beat rhythmically. In cardiac arrest, the electrical impulses become abnormal and chaotic. This causes the heart to lose the ability to beat rhythmically, or to stop beating altogether

Comparison of CPR Technique in Adults, Children and Comparison of CPR Technique in Adults, Children and Infants Infants

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Giving CPR to a Child

Giving CPR to a child is very similar to giving CPR to an adult. However, in a child, you open the airway by tilting the head to a slightly past-neutral position, rather than to a pastneutral position (see Table 3-1). Rather than compressing the chest to a depth of at least 2 inches as you would for an adult, you compress the chest to a depth of about 2 inches for a child. Also, for a small child, you may only need to give compressions with one hand, instead of two.

Two abnormal heart rhythms in particular, ventricular fibrillation (V-fib) and ventricular tachycardia (V-tach), can lead to sudden cardiac arrest.

In V-fib, the heart muscle simply quivers (fibrillates) weakly instead of contracting strongly. In V-tach, the heart muscle contracts too fast (tachy- means "fast"). Both abnormal rhythms impair the heart's ability to pump and circulate blood throughout the body and are life threatening. . However, in many cases, V-fib and V-tach can be corrected by an electrical shock delivered by an AED. This shock disrupts the heart's electrical activity long enough to allow the heart to spontaneously develop an effective rhythm on its own. Starting CPR immediately and using an AED as soon as possible gives the person the best chance for surviving cardiac arrest

AED

While CPR can help to prevent brain damage and death by keeping oxygenated blood moving throughout the body, an AED can correct the underlying problem for some people who go into sudden cardiac arrest.

agonal breathing

(In an unresponsive person, isolated or infrequent gasping in the absence of normal breathing may be agonal breaths, which can occur even after the heart has stopped beating. Agonal breaths are not breathing and are a sign of cardiac arrest.) The person has no heartbeat.

Giving CPR to an Infant

The general principles of giving CPR to an infant are the same as they are for children and adults. However, because the infant's body is smaller, you will position your hands differently to deliver compressions. Place the pads of two fingers on the center of the infant's chest, just below the nipple line. If you feel the notch at the end of the infant's breastbone, move your fingers slightly toward the infant's head. Place your other hand on the infant's forehead. Give compressions by using the pads of your fingers to compress the chest about 1½ inches.

Adult Cardiac Chain of Survival

■ Recognition of cardiac arrest and activation of the emergency medical services (EMS) system. ■ Early CPR. CPR circulates oxygen-containing blood to the brain and other vital organs, helping to prevent brain damage and death. ■ Early defibrillation. Defibrillation (delivery of an electrical shock using an AED) may restore an effective heart rhythm, significantly increasing the person's chances for survival. ■ Early advanced life support. Provided by EMS personnel at the scene and en route to the hospital, early advanced life support gives the person access to emergency medical care delivered by trained professionals. ■ Integrated post-cardiac arrest care. After the person is resuscitated, an interdisciplinary team of medical professionals works to stabilize the person's medical condition, minimize complications, and diagnose and treat the underlying cause of the cardiac arrest to improve survival outcomes.