1. CARDIAC ARREST AND POST
CARDIAC ARREST CARE
DR MOHD YOUSUF
PHYSICIAN SPECIALIST
GOVT GOUSIA HOSPITAL KHANYAR

3. No,
nonshockable
Yes,
shockable
No normal
breathing,
pulse felt
© 2020 American Heart Association
AED arrives.
Check rhythm.
Shockable rhythm?
• Give 1 shock. Resume CPR
immediately for 2 minutes
until prompted by AED to allow
(
rhythm check).
• C ontinue until ALS providers take
over or victim starts to move.
• Provide rescue breathing,
1 breath every 6 seconds or
breaths/min.
10
• Check pulse every 2 minutes;
if no pulse, start CPR.
• I f possible opioid overdose,
administer naloxone if
available per protocol.
• Resume CPR immediately for
minutes (until prompted by AED
2
to allow rhythm check).
• C ontinue until ALS providers take
over or victim starts to move.
Start CPR
• Perform cycles of 30 compressions
and 2 breaths.
• Use AED as soon as it is available.
Monitor until
emergency
responders arrive.
Verify scene safety.
• Check for responsiveness.
• Shout for nearby help.
• A ctivate emergency response
system via mobile device
if appropriate
( ).
• Get AED and emergency equipment
( ).
or send someone to do so
Look for no breathing
or only gasping and check
pulse (simultaneously).
Is pulse definitely felt
within 10 seconds?
Normal
breathing,
pulse felt
No breathing
or only gasping,
pulse not felt
By this time in all scenarios, emergency
response system or backup is activated,
and AED and emergency equipment are
retrieved or someone is retrieving them.

8. Effective Team Dynamics

10. Effective Team Dynamics
1) Roles during resuscitation attempts
• Clear roles and responsibilities
• Knowing your limitations
• Constructive intervention
2) What to communicate
• Knowledge sharing
• Summarizing and re-evaluating
3) How to communicate
• Closed loop communication
• Clear messages
• Mutual respect

11. IMMEDIATE POST-CARDIAC ARREST CARE

16. TOR RULE

18. Additional readings
• Many alternatives and adjuncts to conventional CPR have been developed. These include mechanical CPR,
impedance threshold devices (ITD), active compression-decompression (ACD) CPR, and interposed abdominal
compression CPR. Many of these techniques and devices require specialized equipment and training.
• Mechanical CPR devices deliver automated chest compressions, thereby eliminating the need for manual chest
compressions. There are 2 different types of mechanical CPR devices: a load-distributing compression band that
compresses the entire thorax circumferentially and a pneumatic piston device that compresses the chest in an
anteroposterior direction.
• ACD-CPR is performed by using a handheld device with a suction cup applied to the midsternum, actively lifting up
the chest during decompressions, thereby enhancing the negative intrathoracic pressure generated by chest recoil
and increasing venous return and cardiac output during the next chest compression. The ITD is a pressure-sensitive
valve attached to an advanced airway or face mask that limits air entry into the lungs during the decompression
phase of CPR, enhancing the negative intrathoracic pressure generated during chest wall recoil and improving
venous return and cardiac output during CPR.
• Interposed abdominal compression CPR is a 3-rescuer technique that includes conventional chest compressions
combined with alternating abdominal compressions. The dedicated rescuer who provides manual abdominal
compressions will compress the abdomen midway between the xiphoid and the umbilicus during the relaxation
phase of chest compression. One RCT of adult OHCA15 did not show any survival advantage to interposed
abdominal compression CPR.