cardiac arrest and bls
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05/01/23
Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 1
05/01/23
Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 2
Dr M.Sikander KhanAssistant Professor
RCRS, Lahore.MBBS , MS-SLP,
PGD Ph.D.
05/01/23
Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 3
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 4
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 5
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 6
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 7
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 8
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 9
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 10
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
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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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 12
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
Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 13
50-80%: VF and PULSLESS VT
20-30%: Asystole, severe bradycardia and pulseless electrical activity
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 14
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 15
– Broad complex rythm– Rapid rate– Constant QRS morphology
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 16
Absent ventricular (QRS) activity Atrial activity (P waves) may persist Rarely a straight line trace
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 17
Clinical features of cardiac arrest ECG shows electrical activity
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 18
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 19
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 20
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
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2016AHA Guidelines2016AHA Guidelines05/01/23
Dr M. Sikander Ghayas Khan , Riphah International University Lahore
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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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 24
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 25
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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
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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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 27
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 28
• 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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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
Pakistan 29
• Two rescuers use 15:2 compression to ventilation ratio
• Traditional CPR (compressions and ventilations) by
Xiphoid process
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Dr M. Sikander Ghayas Khan , Riphah International University Lahore
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◦ Qualified help arrives and takes over
◦ The victim starts breathing normally
◦ Rescuer becomes exhausted
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