cardiopulmonary resuscitation dr.khanaliha 2015
TRANSCRIPT
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Cardiopulmonary resuscitation
Dr.Khanaliha 2015
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C.P.R
An effort to manually preserve intact brain function until restore blood
pressure & breathing
The objective is to delay tissue death & prevention of brain damage
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Indication
No breathing
Cardiac arrest
Agonal respiration
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Agonal breathing
Possible causes : cerebral ischemia –extreme hypoxia or
anoxia
Gasping &labor breathing with strong vocalization& myoclunus
Serious medical sign (general process to complete apnea or -
cardiogenic shock –cardiac arest- death)
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Guidelines (International liasion committee on
resuscitation )
Chest compression (5 cm depth- > 100 /min)
Breathing (mouth to mouth & nose _ artificial
breathing) Current recommenda
tion emphasis on high quality
chest compression
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During the first few minutes after the onset of cardiacarrest, chest compressions are the priority intervention,unless the cardiac arrest is due to asphyxiation, drowning,or suffocation, which are the only circumstancesthat ventilation must be provided before chest compressions.
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Methods & standards
Two hands for adult comp one hand for
children &two finger for infants
Pulse check hes been removed
Endotracheal tube &LMA 8-10/min
Children com/ven 15/2
Adult comp/ven is 30/2
New borne 3/1
ABC changed to
CAB
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Compression only CPR
Chest compression without artificial breathing
Rythmic compression staying alive
Method is the same
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Others techniques
Interposed abdominal compression
Internal cardiac massage in surgical patients
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Pregnancy
Uterous compress the IVC 30 degree left roll
Emergency C/S
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Advanced airway placement was pursued after theinitial 600 chest compressions in all patients.
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CPR prolongs the duration of VF but cannot convertthe arrhythmia to an organized rhythm in most circumstances.
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No device, other than a defibrillator, has been associatedwith consistently improved survival from cardiac arrest.
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Electric shock or defibrillation
Restore a viable or perfusing heart rythm
Uneffective for Asystole & pulseless electrical activity
Effective for VF & pulseless V tach
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Effectiveness
In hospital
Out of hospital
Withnessed 52%& 19%
Unwithnessed 33%&8%
Withnessed 41% & 15%
Unwithnessed 21% & 4%
Compression only 13%
Withnessed & shockable 53% &
37%
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Risk factors
TsHs
Hypovolemia
Hypoxia
Hydrogenion
Hyper &Hypo kalemia
Hypothermia
Hypoglycemia
Tablets or toxins
Tension pneumothorax
Tamponade
Thrombosis
Thromboembolism
Traumatic cardiac arrest
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Complications
Rib FX (Increase with age)
Fat emboli
Damage to abdominal viscus
Upper airway complication
Pulmonary complication
peneumotorax hemotorax lung contusion
Bleeding in ant . mediastinum
Sternal FX (higher in women)
Heart contusion
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Ending
C.P.R continue until
Return of spontaneous circulation
Dead
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Any Question???
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