Cardiac Arrest Cardiac Arrest IncidentsIncidents

Cardiac Arrest Cardiac Arrest IncidentsIncidents

February 2013 EMS Continuing EducationFebruary 2013 EMS Continuing EducationFebruary 2013 EMS Continuing EducationFebruary 2013 EMS Continuing Education11

When do we not start When do we not start CPR?CPR?

When do we not start When do we not start CPR?CPR?

•Patient with no pulse or respirations exhibiting Dependent Lividity and/or Rigor Mortis

•Obvious Mortal Injuries

•An approved "Do Not Resuscitate" order or signed "Living Will“

•ALS Units on the scene have assumed responsibility off patients care.

2

Patient with no pulse or Patient with no pulse or respirations exhibiting respirations exhibiting

Dependent Lividity and/or Dependent Lividity and/or Rigor MortisRigor Mortis

Patient with no pulse or Patient with no pulse or respirations exhibiting respirations exhibiting

Dependent Lividity and/or Dependent Lividity and/or Rigor MortisRigor Mortis

3

Obviously Mortal Obviously Mortal InjuriesInjuries

Obviously Mortal Obviously Mortal InjuriesInjuries

4

DNR or Living WillDNR or Living WillDNR or Living WillDNR or Living Will

5

Chain of survival consist Chain of survival consist of :of :

Chain of survival consist Chain of survival consist of :of :

1. Immediate recognition of cardiac arrest and activate of emergency response system.

2. Early CPR that emphasizes chest compressions

3. Rapid defibrillation if indicated.4. Effective advanced life support.5. Integrated post-cardiac arrest

care.

1. Don your PPE.

2. Determine responsiveness and breathing

3. Call for HELP

4. Check for a pulse, if none present

5. Start Chest Compressions

Sequence of events:Sequence of events:Sequence of events:Sequence of events:

Hand positioning for Hand positioning for Compressions and RatioCompressions and Ratio

Hand positioning for Hand positioning for Compressions and RatioCompressions and Ratio

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Rate: at least 100 per minute at least 100 per minute at least 100 per minute Depth: at least 2 inches at least 2 inches at least 1.5 inchesRatio: 30:2 with 1 or 2 rescuer 30:2 with 1 or 15:2 with 2 rescuer 30:2 with 1 or 15:2 with 2 rescuer

Ages : ? To Puberty Puberty to 1 year 1 year to Birth

Open the AirwayOpen the AirwayOpen the AirwayOpen the Airway

VentilationsVentilationsVentilationsVentilations

10

Pocket Mask

Bag-Valve -Mask

Each breath should be 1 second in duration

Cardiac Science G3 ProCardiac Science G3 ProCardiac Science G3 ProCardiac Science G3 Pro

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Cardiac Science G3 ProCardiac Science G3 ProCardiac Science G3 ProCardiac Science G3 Pro1. Use as Soon as Possible!!

2. Turn it on by opening the lid.

3. Apply the pads to chest.

4. Stand back and let it analyze.

5. “STAND CLEAR” If shock advised press the red button.

6. Start CPR immediately after the shock is delivered.

Trauma CodesTrauma CodesTrauma CodesTrauma CodesAre we as BLS responders going to treat the trauma arrest patient any differently?

NO!They Need CPR

The need no delay in getting to the Trauma center

After the Cardiac ArrestAfter the Cardiac ArrestAfter the Cardiac ArrestAfter the Cardiac Arrest1. Ensure the patient and their family are cared for.

2. Ensure all sharps and bio waste are properly disposed of.

3. IF a coroner is to be requested that must be done by Law Enforcement

4. Plug in a new set of pads in the AED and ensure it is “Rescue Ready”. Put it back in service, download will occur later.

5. Ensure EMS Bag is restocked and operationally ready.

6. Notify the Duty Chief that the AED has be deployed on a cardiac arrest patient. They will facilitate getting the data downloaded.

QUESTIONS??QUESTIONS??QUESTIONS??QUESTIONS??

Then Let’s Play!