2. WHAT IS CARDIAC
ARREST
Cessation of normal circulation of blood due to
failure of heart to contract effectively.
Sudden cessation of mechanical activity of
heart with some or no electricalactivity.
May be reversible by a rapid intervention
but will lead to death in its absence.
5. BLS
Its Cardiopulmonary Resuscitation (CPR).
It Combines rescue breathing and chest
compressions
It requires knowledge and skill to perform CPR
and how to operate AED / defibrillartor.
These are Sequences of procedures performed to
restore the circulation of oxygenated blood
after a sudden pulmonary and/or cardiac arrest
8. STEPS of BLS
Assessment and scene safety
1. Scene is safe??
2. Asses the patient
3. Check breathing
9. Assesse the patient
Shake shoulders gently
Ask “Are you all right?”
If he responds
Find out what is wrong.
Reassess regularly.
10. Check for pulse: no more than 10
sec
Feel the pulse
Feel the pulse at least for 5 seconds
Slide the finger laterally
Into the groove between trachea and muscle
Locate the trachea
Using 2 or3 fingures
12. Start CPR
Ratio: 30:2
High quality CPR
Chest compression
is foundation of CPR
Push hard and push
fast
100-120/min
2.5-2-1.5 inch depth
Allow complete chest
recoil
Avoid excessive
ventilation
Minimize interruption
<10 seconds
Effective rescue
breaths.
13.
14. Chest Compressions
Position yourself at patient’sside
Victim should be laid on firm, flat surface
Remove the clothings of the patient.
Put the heel of one hand on the centre of chest
(sternum) at the level of nipples and put your other
hand on the top of the former hand.
15. Strengthen arms and shoulders ditrectly over
hands
Lockall joints ; movement is allowed only at hip
joint
Pushhard and fast (100 - 120 times/ min)
At the end of each compression, chest is allowed
torecoil completely
Avoid excessiveventilation
Then give next compression immediately
17. Mechanisms
• CardiacPump–
1. Blood pumping is assured by compression of
heartbetween sternum andspine
2. Between compressions, thoracic cageexpands and
heart gets filled with blood.
31. Bagand Mask ventilation
Position yourself directly above patient’shead
o Perform headtilt
o Make “C”with thumb and index finger to seal the mask
o And other 3 fingers,forms“E” jawthurst
o Chestrise is checked while squeezing the bagto give
breaths to thepatient.
33. Defibrillation is used for the treatment of
tachydysrhythmias.
Defibrillation depolarises the critical mass of
myocardial cell at once. It recaptures the SA
node as its role as the pacemaker .
Is treatment of choice for pulseless VT/VF.
Prof. Dr. RS Mehta, BPKIHS
Defibrillation
37. Defibrillators can be classified as :
Monophasic(delivers current of
one polarity only)
Biphasic (deliver current of 2
polarity)
Defibrillator
37 Prof. Dr. RS Mehta, BPKIHS
38. Position of defibrillator paddle:
1st paddle - on the right
side of the chest just
below the clavicle
2nd at precordial,
region.
Paddle should be applied
with pressure equivalent
to 10 kg.
38 Prof. Dr. RS Mehta, BPKIHS
39. Adult: 13cm
Children:8cm
Infants:4.5cm
Latest Recommendation for shock protocol ;
Previous recommendation of 3 successive shock
(200,300,360J)
Now a days only single shock is recommended .i.e.
360J by monophasic
150-200J by biphasic
Paddle
size
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40. Apply conducting jelly between the
paddle and the skin.
Place the paddle so that they don't
touch patient’s clothing and bed
linen and aren't near medication and
direct oxygen flow.
Ensure that defibrillator is not in
synchronized mode.
Don't charge the device until ready to
shock
keep the thumbs and fingers off
discharge button until paddle are on
Nurses role while performing
defibrillation
41. Before pressing the discharge button call “ all
clear” 3 times
1st clear: Ensures" YOU” aren’t touching
patient,bed, equipment
2nd clear: Ensures “no one" is touching patient, bed ,
equipment
3rd clear: Ensures “you and everyone" else are clear off
the patient and anything touching the patient.
Nurses role in
defibrillation
42. Nurses role in
defibrillation
Record the delivered energy and the results (cardiac
rhythm and pulse).
After the event is complete inspect the skin under
the pads and paddles for burns , and if any
detected consult about the treatment.
42 Prof. Dr. RS Mehta, BPKIHS
43. First turn it on.
Then simply follow
instructions.
Using an AED
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