Cardio-pulmonary arrest.
Cardio-Pulmonary Resuscitation
in the world of modern protocols of the
European resuscitation association
Speaker: Head of the department of emergency medicine,
TSMU І.Horbachevsky Ljakhovych R.М.
Provide patency of airways support, find out if
there are signs of life
• Patient’s response
• Provide patency of
airways support
• Check respiration and
pulse (not more than 10
sec)
…to confirm or oppose
the circulatory arrest.
Patency of airways support
Suction units (aspirators)
Resuscitation should be
viewed as a protest against
ungrounded death. A belief
in true sense of human
longevity and the
importance to maintain
human life.
Scientist V.А. Nehovsky
One of the most important tasks of
becoming a physician is to acquire the skill
of cardio-pulmonary-cerebral resuscitation,
which allows to renew vital functions of
life.
Patency of airways support
Respiratory mask
Patency of airways support
Laryngeal mask
Laryngeal tube
Intensive therapy– a complex of temporary methods of
artificial maintenance of vital life functions in
decompensated stages, which is directed to provision of
life support.
Resuscitology – study about revival of the organism;
prophylaxis and treatment of terminal stages.
( according to V.А. Nehovsky).
Patency of airways support
laryngeal tubes
laryngeal tubes
Patency of airways support
Combitube
Terminal state is divided into several
stages:
1. Preagony
2. Terminal pause
3. Agony
4. Clinical death
Patency of airways support
Respiratory mask and Ambu bag
Patency of airways support
A set for conicopuncture
Main signs of clinical death:
Absence of pulsation on magistral arteries
(carotid and femoral),
Pupils are fixed and dilated, non-reactive to light,
Absence of independent breathing.
Additional signs :
Change in skin colour (grey or cyanotic),
Absence of consciousness,
Absence of reflexes and loss of muscle tone
Portable set of respiratory equipment
Support of artificial
ventilation of lungs
Oxygen therapy
Training equipment for developing
skills of patency of airways support
First stage of resuscitation - provision of
first aid ( basic life support).
First step – maintenance of airway
patency.
Provide airway patency
Check for sign of life
• Patient’s reaction
• Provide airway patency
• Evaluate respirations
and pulse (not more
then 10 seconds)
… to confirm
stopping of
circulation
кровообігу
Maintain airway patency
Evaluate sings of circulation
Confirmed ceasing of blood
circulation
Call
resuscitation
team
CPR 30:2
Up to the point of
hooking up a
defibrillator/monitor
Precardiac stroke
• Immediate treatment
of observed and
monitored circulatory
arrest in VF/VT
• Perform, if defibrillator
is unavailable
Chest compressions
• 30:2
• depth 4-5 сm
• 100 min-1
• “center of chest”
• Avoid
• Exhaustion
• Breaks
“Quick Evaluation”
Conduct ECG , classic electrodes, self adhesive electrodes.
Provision of airway patency
Determination of signs of life
Call resuscitation team
CPR 30:2
Until defibrillator/monitor is hooked up
Evaluation
of rhythm
To defibrillation
(VF/VT without pulse)
No defibrillation
(PEA/ asystole)
During CPR:
1 Defibrillation
150-360 J Biphasic
or 360 J Monophasic
Immediately start
CPR 30:2
2 min.
•Rule out problems that can be corrected
•Check placement and function of electrodes
•Check:
IV availability
airway patency and oxygen
•After airway support conduct chest
compressions continuously
•Inject adrenalin every 3-5 mins.
•Choose: amiodarone, atropine, magnesium
Immediately start
CPR 30:2
2 min.
Rhythms prior to
defibrillation
(VF/VT)
Evaluate
rhythm
Prior to defibrillation
(VF/VT without
pulse)
1 Defibrillation
150 J biphasic
First defibrillation
• 150 - 200 J biphasic
•
Immediate
CPR 30:2
2 min
After performing defibrillation
•Continue CPR for the next 2 min
•Stop CPR only when patient has signs of
circulation
•Defibrillation – priority
•Adrenalin 1 mg
•Аmiodarone 300 mg (post 3)
Rhythm not before defibrillation
Asystole/PEA
Asystole/РЕА
During CPR:
• Check for electrode connection
• Adrenalin 1 mg i. v. every 3-5 min.
• Rule out/ treatable condition
Potentially treatable conditions:
•Hypoxia
•Hypovolemia
•Hypo/hyperkalemia and metabolic
disruptions
•Hypothermia
•Tension pneumothorax
•Тamponade (Pericardial)
•Тoxins
•Тhromboembolism (coronary or
pulmonary)
During CPR:
• Rule out potentially treatable conditions
• Check placement of electrodes
• Check:
IV availability
Airway patency and oxygen
• After maintenance of airway patency
conduct continuous chest compressions
• Inject adrenalin every 3-5 mins.
• Choose : Amiodarone, atropine,
magnesium
Algorithm action during
performance of CPR
Summary
• Algorithm ALS standardizes a way of
treatment of circulatory arrest in adults
• Allows to increase effectiveness of
treatment.
Thank
you for
attention!