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    CPR Updated 2022

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    Tathagata Bakuli
    Cardiopulmonary resuscitation (CPR) aims to maintain oxygen supply to vital organs during cardiac arrest, restore spontaneous circulation, minimize post-resuscitation injury, and improve survival and neurological outcomes. The chain of survival identifies six critical actions for out-of-hospital cardiac arrest: early recognition, early CPR, early defibrillation, early advanced life support, integrated post-resuscitation care, and early rehabilitation. CPR techniques differ between adults and children, with variations in compression depth, hand placement, compression-to-ventilation ratios, and pulse check sites. Advanced life support may involve defibrillation, intravenous drug therapy including epinephrine and amiodarone, and securing an air

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    CPR Updated 2022

    Uploaded by

    Tathagata Bakuli
    527 views32 pages
    Cardiopulmonary resuscitation (CPR) aims to maintain oxygen supply to vital organs during cardiac arrest, restore spontaneous circulation, minimize post-resuscitation injury, and improve survival and neurological outcomes. The chain of survival identifies six critical actions for out-of-hospital cardiac arrest: early recognition, early CPR, early defibrillation, early advanced life support, integrated post-resuscitation care, and early rehabilitation. CPR techniques differ between adults and children, with variations in compression depth, hand placement, compression-to-ventilation ratios, and pulse check sites. Advanced life support may involve defibrillation, intravenous drug therapy including epinephrine and amiodarone, and securing an air

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    Latest on CPR guidelines Anaesthesia as of 2022.

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    CPR UPDATED 2022

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    Cardiopulmonary resuscitation (CPR) aims to maintain oxygen supply to vital organs during cardiac arrest, restore spontaneous circulation, minimize post-resuscitation injury, and improve survival and neurological outcomes. The chain of survival identifies six critical actions for out-of-hospital cardiac arrest: early recognition, early CPR, early defibrillation, early advanced life support, integrated post-resuscitation care, and early rehabilitation. CPR techniques differ between adults and children, with variations in compression depth, hand placement, compression-to-ventilation ratios, and pulse check sites. Advanced life support may involve defibrillation, intravenous drug therapy including epinephrine and amiodarone, and securing an air

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    © All Rights Reserved
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    Download as pdf or txt
    527 views32 pages

    CPR Updated 2022

    Uploaded by

    Tathagata Bakuli
    Cardiopulmonary resuscitation (CPR) aims to maintain oxygen supply to vital organs during cardiac arrest, restore spontaneous circulation, minimize post-resuscitation injury, and improve survival and neurological outcomes. The chain of survival identifies six critical actions for out-of-hospital cardiac arrest: early recognition, early CPR, early defibrillation, early advanced life support, integrated post-resuscitation care, and early rehabilitation. CPR techniques differ between adults and children, with variations in compression depth, hand placement, compression-to-ventilation ratios, and pulse check sites. Advanced life support may involve defibrillation, intravenous drug therapy including epinephrine and amiodarone, and securing an air

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    © All Rights Reserved
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    of 32

    CARDIO PULMONARY

    RESUSICATION
    GOALS

    1. Maintain oxygen and blood supply to vital organs during cardiac arrest

    2. Restore spontaneous circulation (Cardiac output during CPR with


    effective, uninterrupted chest compression is at best 25% to 30% of the
    normal spontaneous circulation.

    3. Minimize post resuscitation organ injury

    4. Improve the patient’s survival and neurologic outcome.


    CHAIN OF SURVIVAL
    • Identifies a sequence of SIX critical actions that increase survival
    rates from sudden cardiac arrest (SCA)
    O U T S I D E H O S P I TA L C A R D I A C A R R E S T
    I N S I D E H O S P I TA L C A R D I A C A R R E S T

    Recovery (including additional treatment, observation, rehabilitation,


    and psychological support)
    CPR IS AS EASY AS CAB
    Age & site of pulse check in cpr
    CATEGORY AGE SITE FOR PULSE CHECK
    NEONATE 1ST 30 DAYS AFTER BIRTH PRECORDIAL
    AUSCULTATION\ 3 LEAD
    ECG
    INFANT 30 DAYS TO 1 YEAR BRACHIAL ARTERY
    AFTER BIRTH
    CHILD 1YEAR TO PUBERTY FEMORAL\ CAROTID
    ARTERY
    ADULT \ ADOLOCENT AFTER PUBERTY CAROTID ARTERY

    • PUBERTY: FEMALE: BREAST DEVELOPMENT +


    MALE: AXILLARY HAIR +
    CHEST COMPRESSIONS
    DIFFERENCE IN ADULT AND PEDIATRIC CPR
    POINT OF DIFFERENCE ADULTS CHILDREN\ INFANT
    1: Activation of emergency 1st: Activate ERS & get AED Witnessed collapse: same as adult
    response system 2nd: Start CPR
    Unwitnessed collapse:
    1st : 2 mins of CPR
    2nd: leave the victim to active ERS
    2: Compression to ventilation Always 30:2 1 rescuer: 30:2
    ratio without advanced airway 2 rescuer: 15:2

    3: Compression to ventilation ratio 1 breath every 6 secs (10 1 breath every 2-3 secs (20-30 breaths
    with advanced airway breaths\min) \mins)
    4: Depth of compression 2 to 2.4 inches Children: about 2 inches
    Infants: about 1.5 inches

    5: Hand placement Lower half of sternum Infants: 1 rescuer: 1 finger technique


    2 rescuer: thumb encircling technique
    airway
    • Bag-mask ventilation with a
    head tilt–chin lift or head
    tilt–jaw thrust manoeuvre is
    recommended for initial airway
    control in most circumstances.

    • Triple manoeuvre: head tilt-


    chin lift , mouth open, jaw
    thrust
    ADVANCED AIRWAY
    • DEPENDING ON THE LEVEL OF
    EXPERTISE OF THE CPR PROVIDER
    • ENDOTRACHEAL TUBE
    • LARYNGEAL MASK AIRWAY
    • COMBITUBE

    • “ UNDER NO CIRCUMSTANCES
    SHOULD THE INSERTION OF
    ADVANCED AIRWAY COMPROMISE THE
    CHEST COMPRESSIONS”
    breathing

    WITH PULSE WITHOUT PULSE

    10 BREATHS PER MIN UNSECURED AIRWAY SECURED AIRWAY


    (RESCUE BREATHS)

    30: 2 COMPRESSION
    TO VENTILATION 10 BREATHS PER MIN
    DEFIBRILLATION
    • Delivery of an electrical current through the
    myocardium to interrupt disorganized cardiac activity
    and restore an organized cardiac rhythm
    • Monophasic defibrillator :a single 360 joule (J) shock is
    delivered. ( old – not used anymore)
    • Biphasic defibrillator :(120-200 J) is usually sufficient to
    terminate the arrhythmia ( new & better)
    • If the rescuer is unfamiliar : maximal available energy
    should be used as the default energy
    • Pediatric patients: 1st shock : 2-4 J\kg---subsequent
    shocks 4 J\kg ( MAX 10J\kg)
    DEFIBRILLATOR

    MANUAL
    DEFIBRILLATOR

    ( ADVANCED
    CARDIAC LIFE
    SUPPORT)

    AUTOMATED
    EXTERNAL
    DEFIBRILLATOR

    ( BASIC LIFE SUPPORT)


    PLACEMENT OF ELECTRODES:
    ADULT:
    • Upper right sternal border, just below
    the clavicle
    • Lateral to the left nipple.

    CHILD OR INFANT :
    • Anterior and Posterior.
    BLS & ACLS
    BASIC LIFE SUPPORT ADVANCED CARDIAC LIFE SUPPORT

    CAN BE PERFORMED BY ANYONE TRAINED MEDICAL \ PARAMEDICAL STAFF

    RHYTHM IDENTIFICATION BY AED RHYTHM IDENTIFICATION BY


    RESUSICATOR
    AED FOR DEFIBRILLATION MANUAL DEFIBRILLATOR

    NO IV LINE \ DRUG USE IV LINE AND DRUG MANAGEMENT

    NO ADVANCED AIRWAY ADVANCED AIRWAY USE

    NO OXYGEN SUPPORT OXYGEN SUPPORT


    ADVANCED CARDIAC LIFE SUPPORT
    • TEAM OF TRAINED PROFESSIONALS
    • COMPRISES OF DOCTORS, TRAINED PARAMEDICAL STAFF,
    NURSES
    • MEMBERS: MINIMUM 6 AND MAXIMUM 10
    ✓1 TEAM LEADER
    ✓1 COMPRESSOR & 1 VENTILATOR ( CHANGE ROLES EVERY 2
    MINS)
    ✓1 DEFIBRILLATOR
    ✓1 INTRAVENOUS DRUG DELIVERY
    ✓1 TIME KEEPER
    ROUTES OF ACCESS
    INTRAVENOUS ROUTE INTRAOSSEOUS ROUTE ENDOTRACHEAL ROUTE

    Intravenously push bolus Most common: lower end least preferred


    injection of femur or upper end of
    tibia
    Flush with 20 mL of fluid or Dose is 2-2.5 times the iv dose
    saline

    Raise extremity for 10 to 20 5 drugs:( NAVAL)


    seconds to enhance delivery of Naloxone
    drug to circulation Adrenaline
    Vasopressin
    Atropine
    Lignocaine
    DRUG THERAPY IN CPR
    DRUG EPINEPHRINE
    ADULT AMIODARONE
    PEDIATRIC
    ADRENALINE\ 1mg (1:10000) bolus every 3-5 mins 0.01Mg\kg (0.1ml\kg of 1:10000
    EPINEPHRINE
    ADULT: Endotracheal:
    1.0 mg (1:10000) 2-2.5
    IV or 2 to 2.5 dose concentration)
    mgtimes VF/pulseless VT / VT with pulse /Tachy rate
    (1:1000) ETT every 3 to(1:1000)
    5 min diluted in 10 ml normal
    control Max dose:1 mg
    saline Repeat every 3-5mins.
    Pediatric: 0.01-0.03 mg\kg VF/VT: 300 Endotracheal:
    mg dilute in 200.1
    tomg\kg
    30 mL,(0.1
    mayml\kg
    repeat 150 mg
    of in 3 to 5concentration)
    1:1000 min
    Do not administer via the ET tube route
    AMIODARONE 1st dose: 300mg 5 mg\kg bolus during cardiac
    2nd dose: 150 mg arrest.
    May repeat 3 doses for refractory
    VF\pulseless VT
    LIGNOCAINE 1st dose: 1-1.5mg\kg 1mg\kg bolus dose
    2nd dose: 0.5-0.75 mg\kg
    POST CARDIAC ARREST CARE
    FOREIGN BODY OBSTRUCTION\CHOKING

    HEIMLICH
    MANEUVER

    Only in
    complete
    airway
    obstruction
    THANK YOU & ALL THE BEST
    • HOW TO CONTACT ME????

    • FACEBOOK MESSENGER

    • TAG ME ON THE DAMS EXCLUSIVE CLUB 2021 USING


    @ANSHULDIWAKAR

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