Health Care Providers

  CARDIAC ARREST MANAGEMENT AT A GLANCE.

 Basic Life Support
Safety Assesses Danger

Make sure you, the victim and  bystanders are safe

·         Check that the patient’s surroundings are safe.

·         Wear Personal Protective Equipment (PPE )-Gloves, apron, Mask

Confirm cardiac arrest Establishes unResponsiveness ·         Tap shoulders and say ‘Hello”/ Call by name!
Open the Airway ·      Head tilt-chin lift  or  if trauma is suspected,

·      jaw thrust without head extension

Check  for Breathing ·      Look for the rise and fall of the patient’s chest.
Check for pulse  (During the breathing assessment ( < 10 sec )

Only by Health care providers

·      carotid pulse > 1year

·      Brachial Pulse in Infants

 

      Shout for Help /send for help ·         Call resuscitation team. Ask for  defibrillator
             Support the circulation Start 30 Chest compressions almost immediately after confirming cardiac arrest

( in Non-asphyxiated cardiac arrest)

(If Asphyxiated arrest – Strat with 5 rescue breaths)

·         Centre of the chest ( Lower half of the                          sternum)

·         Push fast – Rate – 100-120 /min

(30 compressions in 15-18 sec)

·         Push hard – at least 2 inches (5 cm)

·         Allow chest to fully recoil.

·         Minimal Interuptions

Followed by 2 rescue breaths

 

 AMBU ventilate  or Use Pocket Mask

  – 2 breaths < 5 sec – Inspiratory time 1 sec

 Add Oxygen

Allow visible chest rise

 If LMA in place or Intubated – give 10 breaths /minute

 

       Continue Basic life support until defibrillator / Automated External Defibrillator (AED) is                      available. – Follow the prompts

 

 Advanced Life Support
Make sure Quality CPR in progress Capnography  trace > 14 mmHg
Prepare for rhythm Check Attach ECG leads while CPR in progress

Select Lead II, and correct gain

What is the arrest type? Quickly stop of compressions to recognize ECG the rhythm 
Treatment of shockable rhythms (VF/ pulse less VT) with manual hand held paddles
Get ready for the First shock, while chest compressions   in progress Charge on the defibrillator

Select Energy  150 J, apply gel / Gel pads

Safety check  while charging Shout “Stand clear” “Oxygen away” compressions continue.
Safe & effective delivery of 1st Shock once fully charged

Aim- Pre-shock pause < 5 sec

 

Shout “Hands off/ stand clear”; when clear

Bring one paddle first , then the next paddle

Correct paddle position & 8-10 kg weight on to the paddles, good contact…

Quick glance –No one is in contact with the victim 

Final look at the ECG monitor.(make sure rhythm is still ,shockable)

Immediately resumes CPR after the shock  – Continue CPR  30:2  for 2 minutes
During 2 minute intervals – Consider LMA/ETT  Insertion,

                                                          Look for reversible/Treatable  causes ( 4Hs- 4Ts)

After the 2 minutes – Pause briefly to check the ECG rhythm on the monitor.
If VF/Pulseless VT – Deliver 2nd Shock Safely – Highest Energy on the Defibrillator- (270 J )
Look for reversible causes ( 4Hs- 4Ts)
After 2 minute CPR – Pause briefly to check the ECG rhythm on the monitor.

Deliver 3rd  Shock safely – Highest Energy on the Defibrillator- (270 J)

Resume chest compressions immediately and then give

adrenaline 1 mg ( 1:10000) IV and amiodarone 300 mg IV bolus ( after 3 consecutive shocks)

Give adrenaline 1 mg IV after alternate shocks (Repeat in every 3-5 min).
Consider Amiodarone 150 mg IV after the 5th Shock