cardiac arrest and bls

05/01/23

Dr M. Sikander Ghayas Khan , Riphah International University Lahore

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Dr M.Sikander KhanAssistant Professor

RCRS, Lahore.MBBS , MS-SLP,

PGD Ph.D.

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The heart is a muscular organ in humans and other animals, which pumps blood through the blood vessels of the circulatory system. The blood provides the body with oxygen and nutrients, as well as removing metabolic wastes. The heart is located in the middle compartment of the chest (mediastinum)

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Cardiovascular disease is the number one cause of death in the U.S., and many times the first indication of this disease is an acute coronary event

Cardiac arrest is the most severe manifestation of an acute coronary syndrome, and with rapid intervention EMS providers can make the difference between life and death

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Sudden Cardiac Arrest (SCA) occurs when the heart stops beating, abruptly and without warning. If this happens, blood stops flowing to the brain and other vital organs.

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SCA :accounts for more than 350,000 deaths in the U.S. each year and is one of the leading causes of death in the United States each year.

In fact, SCA claims one life every 90 seconds, taking more lives each year than breast cancer, lung cancer or AIDS.

Unfortunately, 95 percent of people who experience SCA die as a result, mainly because treatment within minutes is not accessible.

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Lack of circulation :absence of a palpable pulse

the patient will be unconscious and will have stopped breathing/abnormal breathing.

Diagnosis: cardiac arrest is usually diagnosed clinically by

the absence of a pulse. In many cases lack of carotid pulse is the gold standard .

The current recommendation of ILCOR is that cardiac arrest should be diagnosed in all casualties who are unconscious and not breathing normally.

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Who have had a heart attack (myocardial infarction) Who have experienced heart failure (poor pumping

heart) Who have survived a previous sudden cardiac arrest With a family history of sudden cardiac arrest With a low ejection fraction smoking, lack of physical exercise, obesity, diabetes

and family history.

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Cardiac Coronary artery disease. cardiomyopathy, cardiac rhythm

disturbances, hypertensive heart disease ,congestive heart failure.

Non-cardiac trauma, gastrointestinal bleeding, aortic rupture,

and intracranial hemorrhage , overdose, drowning and pulmonary embolism.

Environmental toxins from for jellyfish 05/01/23


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50-80%: VF and PULSLESS VT

20-30%: Asystole, severe bradycardia and pulseless electrical activity

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Uncoordinated electrical activity

Coarse/fine Exclude artefact

◦ Movement◦ Electrical interference

Bizarre irregular waveform

No recognisable QRS complexes

Random frequency and amplitude

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– Broad complex rythm– Rapid rate– Constant QRS morphology

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Absent ventricular (QRS) activity Atrial activity (P waves) may persist Rarely a straight line trace

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Clinical features of cardiac arrest ECG shows electrical activity

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Few cardiac arrest patients survive outside a hospital without a rapid sequence of events.◦ Chain of survival:

Early recognition and activation of EMS Immediate bystander CPR Early defibrillation Early advanced cardiac life support Integrated post-arrest care

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Why is CPR Important◦ Studies have shown that the general population

will start CPR only 1/3 of the time and only 15% of that total is done correctly

◦ Chest Compressions can be started within 18 seconds of arriving at the patient, whereas airway management first can delay compressions by 1-2 minutes or more

◦ CPR prolongs the period during which defibrillation can be effective

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Ventricular fibrillation is the most frequent rhythm found in cardiac arrest

Defibrillation is the most effective treatment for VF

Probability of successful defibrillation diminishes with time

VF will lead to asystole quickly without proper treatment

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2016AHA Guidelines2016AHA Guidelines05/01/23


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1. Make sure the scene is SAFE!2. Check responsiveness and breathing3. If alone call 9-1-1(1122) and get an AED4. Check for a pulse and if no pulse present

begin CPR Always start CPR with Compressions First!

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Always start CPR with Compressions First!

Push hard and fast Rate should be at least 100 per minute Provide 30 compressions then 2 breaths Make sure the chest is allowed to re-expand

completely at the end of each compression

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5. Open the airway with head tilt-chin lift6. Place the mask on the patient’s face7. Use the E-C clamp technique8. Deliver each breath over 1 second

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Head tilt and chin lift- lay rescuers

- non-healthcare rescuers

No need for finger sweep unless solid can be seen

in the airway

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• Some differences between pediatric BLS and adult BLS

• Chest compression depth –at least 1/3 of the anteriorposterior diameter of chest

–Infants: about 1½ inches –Children: about 2 inches • Lone rescuer provides 2 minutes of CPR

before activating emergency response

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• Two rescuers use 15:2 compression to ventilation ratio

• Traditional CPR (compressions and ventilations) by

Xiphoid process

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◦ Qualified help arrives and takes over

◦ The victim starts breathing normally

◦ Rescuer becomes exhausted

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cardiac arrest and bls

Healthcare