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Medical Emergency- Cardiac Arrest and Basic Life Support (BLS)!

 MEDICAL EMERGENCY- CARDIAC ARREST AND BASIC LIFE SUPPORT

Definition:

"Cardiac Arrest is a medical emergency requiring a systematic approach".

  • Early recognition must be followed by prompt, effective application of Basic Life Support (BLS) techniques to sustain the patient until Advanced Life Support (ALS) capabilities are available.

Management:

The management of Cardiac Arrest is a 4-step approach:

  1. Recognition and Assessment
  2. BLS
  3. Advanced Cardiovascular Life Support (ACLS)
  4. Post-resuscitation Care


1. RECOGNITION AND ASSESMENT

Verify that the respiration and circulation have ceased:

  1. Loss of consciousness
  2. Loss of functional ventilation (respiratory arrest or inadequate respiratory effort)
  3. Loss of functional perfusion (No pulse).



2. BASIC LIFE SUUPORT (BLS)

  • The goal in cardiac arrest is the restoration of spontaneous circulation (ROSC).
  • The first step towards achieving this ROSC goal is prompt initiation of BLS, where the goal is to rapidly and effectively perfuse the tissues with oxygenated blood. A delay in initiating BLS or providing ineffective BLS can result in Irreversible hypoxic (not enough oxygen to the tissues) brain injury.

  1. Summon help and resuscitation equipment.
  2. Establish adequate airway.
  3.  Provide rescue breathing by delivering two slow, deep breaths. Ventilate by mouth-to mouth, mouth-to mask, or bag-valve-mask techniques.
  4. Check for pulse and other signs of circulation. When available, assess heart rhythm with an automated external defibrillator or Monophasic/Biphasic defibrillator.

  • If ventricular tachycardia or ventricular fibrillation are documented, defibrillate with 200 joules of direct current shock.
  • If the first shock fails to terminate the dysrhythmia, a second shock with 200-300 joules should be attempted. if the first two shocks fail, shock again with 360 Joules.

      5. Reassess cardiac rhythm and check for a pulse. If no pulse or other signs of circulation are                      present, initiate rescue breathing and Chest compressions.

  • For Rescue breathing:
        Give each breathing slowly over 2 seconds.

        Deliver 1-12 breaths per minute or 1 breath every 4-5 seconds.

  • For External Chest compression:

        Position patient supine on a firm surface.

        Ensure proper placement of your hands on sternum.

        Depress sternum at a rate of 80-100 cycles per minute (50% of cycle should be compression).

        For every 15 chest compressions, give 2 breaths.

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