Cardiopulmonary resuscitation

Dr.Khanaliha 2015

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

Indication

No breathing

Cardiac arrest

Agonal respiration

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)

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

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.

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

Compression only CPR

Chest compression without artificial breathing

Rythmic compression staying alive

Method is the same

Others techniques

Interposed abdominal compression

Internal cardiac massage in surgical patients

Pregnancy

Uterous compress the IVC 30 degree left roll

Emergency C/S

Advanced airway placement was pursued after theinitial 600 chest compressions in all patients.

CPR prolongs the duration of VF but cannot convertthe arrhythmia to an organized rhythm in most circumstances.

No device, other than a defibrillator, has been associatedwith consistently improved survival from cardiac arrest.

Electric shock or defibrillation

Restore a viable or perfusing heart rythm

Uneffective for Asystole & pulseless electrical activity

Effective for VF & pulseless V tach

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%

Risk factors

TsHs

Hypovolemia

Hypoxia

Hydrogenion

Hyper &Hypo kalemia

Hypothermia

Hypoglycemia

Tablets or toxins

Tension pneumothorax

Tamponade

Thrombosis

Thromboembolism

Traumatic cardiac arrest

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

Ending

C.P.R continue until

Return of spontaneous circulation

Dead

Any Question???